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Newbie - need advice on settings and machine
#11
[Image: S6AQmXNl.png]
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The first night (Nov 30) was horrible. The time from about 1:20 to 2:20, I was definitely not asleep, and I started to panic a little as the pressure increased. I was also having trouble getting my mask to sit comfortably on my face. I gave up, got up and read for a while, and then successfully fell asleep again.

The second night (Dec 2) was pretty great. I didn't wake up feeling awesome (because I probably have a sleep deficit of about a year at this point), but I felt really good compared to my usual state.

BTW, I have my machine set to auto-ramp, which has been very helpful in helping me fall asleep comfortably when I turn off the light. It is not so successful if I wake up in the middle of the night and have to try to get back to sleep.
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#12
I'm glad you were able to post some data. This is a bit different than I was originally led to believe. The majority of events both nights are primarily obstructive Your pressure is not only low, but with the EPR set at 3, your EPAP rarely rises above the minimum of 4.0 cm. I'm going to stick with my last suggestion that you taper off the EPR to a lower setting, and I might also suggest a minimum pressure of 6.0. I think you will find this greatly stabilizes the pressure you feel and prevents some of these events. It should avoid getting into CA events as well. We may also want to limit maximum pressure lower. What is your average and 95% or 90% maximum pressure for the last 7 days and 30 days. This will show up in the Statistics.

Nothing in these charts points to a need for bilevel ST or ASV. By the way, great job on the charts. Your leaks are excellent, and no apparent flow limits with these low pressures, so we are going to just try to limit movement of the pressure to keep you more comfortable.
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#13
(12-04-2016, 08:05 PM)tmc712 Wrote: BTW, I have my machine set to auto-ramp, which has been very helpful in helping me fall asleep comfortably when I turn off the light. It is not so successful if I wake up in the middle of the night and have to try to get back to sleep.
When you wake in the middle of the night, just turn the machine off and back on. That will restart the auto-ramp feature that helps you get back to sleep.

Questions about SleepyHead?
See my Guide to SleepyHead
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#14
(12-04-2016, 09:54 PM)Sleeprider Wrote: I'm glad you were able to post some data. This is a bit different than I was originally led to believe. The majority of events both nights are primarily obstructive Your pressure is not only low, but with the EPR set at 3, your EPAP rarely rises above the minimum of 4.0 cm. I'm going to stick with my last suggestion that you taper off the EPR to a lower setting, and I might also suggest a minimum pressure of 6.0. I think you will find this greatly stabilizes the pressure you feel and prevents some of these events. It should avoid getting into CA events as well. We may also want to limit maximum pressure lower. What is your average and 95% or 90% maximum pressure for the last 7 days and 30 days. This will show up in the Statistics.

Nothing in these charts points to a need for bilevel ST or ASV. By the way, great job on the charts. Your leaks are excellent, and no apparent flow limits with these low pressures, so we are going to just try to limit movement of the pressure to keep you more comfortable.

Thank you SO MUCH for your input. This is very helpful and I will gradually work on increasing the minimum pressure and decreasing the EPR. Just FYI, I was having about half-and-half obstructive and central events maybe a month ago. It seems to have gotten a lot better lately, as you observed from my charts. I feel justified in not changing to a new machine at this time.

Anyway, last night I set the EPR to 2 (down from 3), and I had only one central event all night. AHI was 2.38. I still woke up in the middle of the night, but that's nothing new.

SleepyHead seems to have a bug re: 90%/95% statistics. I tried rebuilding CPAP data, and I got a value for 7 days, but 30 and beyond are still all 0s. Anyway, the 7 day value is 8.66. The screen says 90%, but my preferences are set to 95%. So I have no idea which % it really is. Smile


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#15
(12-05-2016, 09:52 AM)robysue Wrote:
(12-04-2016, 08:05 PM)tmc712 Wrote: BTW, I have my machine set to auto-ramp, which has been very helpful in helping me fall asleep comfortably when I turn off the light. It is not so successful if I wake up in the middle of the night and have to try to get back to sleep.
When you wake in the middle of the night, just turn the machine off and back on. That will restart the auto-ramp feature that helps you get back to sleep.

Thanks for the reminder - I have been doing this by default because I usually end up taking my mask off for a few minutes, but I guess I need to be more willing to restart it if the pressure starts ramping up when I'm still awake. I am (stupidly) not wanting the myAir app to subtract a point for mask on/off. Why I care, I do not know. Smile
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#16
(12-05-2016, 05:50 PM)tmc712 Wrote:
(12-04-2016, 09:54 PM)Sleeprider Wrote: I'm glad you were able to post some data. This is a bit different than I was originally led to believe. The majority of events both nights are primarily obstructive Your pressure is not only low, but with the EPR set at 3, your EPAP rarely rises above the minimum of 4.0 cm. I'm going to stick with my last suggestion that you taper off the EPR to a lower setting, and I might also suggest a minimum pressure of 6.0. I think you will find this greatly stabilizes the pressure you feel and prevents some of these events. It should avoid getting into CA events as well. We may also want to limit maximum pressure lower. What is your average and 95% or 90% maximum pressure for the last 7 days and 30 days. This will show up in the Statistics.

Nothing in these charts points to a need for bilevel ST or ASV. By the way, great job on the charts. Your leaks are excellent, and no apparent flow limits with these low pressures, so we are going to just try to limit movement of the pressure to keep you more comfortable.

Thank you SO MUCH for your input. This is very helpful and I will gradually work on increasing the minimum pressure and decreasing the EPR. Just FYI, I was having about half-and-half obstructive and central events maybe a month ago. It seems to have gotten a lot better lately, as you observed from my charts. I feel justified in not changing to a new machine at this time.

Anyway, last night I set the EPR to 2 (down from 3), and I had only one central event all night. AHI was 2.38. I still woke up in the middle of the night, but that's nothing new.

SleepyHead seems to have a bug re: 90%/95% statistics. I tried rebuilding CPAP data, and I got a value for 7 days, but 30 and beyond are still all 0s. Anyway, the 7 day value is 8.66. The screen says 90%, but my preferences are set to 95%. So I have no idea which % it really is. Smile

That is great information. I think you are telling me your 7-day 95% pressure is 8.66. This means if the higher pressures remain a problem and are disruptive to your sleep, a maximum pressure setting of 10 or less is going to be just fine. Basically we are talking about the rare runaway pressure increase can be limited well below your current maximum pressure of 16.
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#17
Hi tmc712,
WELCOME! to the forum.!
Good luck to you with your CPAP therapy and getting it fine-tuned to meet your needs.

trish6hundred
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#18
(12-05-2016, 06:06 PM)tmc712 Wrote:
(12-05-2016, 09:52 AM)robysue Wrote:
(12-04-2016, 08:05 PM)tmc712 Wrote: BTW, I have my machine set to auto-ramp, which has been very helpful in helping me fall asleep comfortably when I turn off the light. It is not so successful if I wake up in the middle of the night and have to try to get back to sleep.
When you wake in the middle of the night, just turn the machine off and back on. That will restart the auto-ramp feature that helps you get back to sleep.

Thanks for the reminder - I have been doing this by default because I usually end up taking my mask off for a few minutes, but I guess I need to be more willing to restart it if the pressure starts ramping up when I'm still awake. I am (stupidly) not wanting the myAir app to subtract a point for mask on/off. Why I care, I do not know. Smile
Yes, remember the real name of the game is to get a decent night's sleep, not to have good numbers.

Here's the thing: If you are waking up a lot with the feeling that the air pressure is just too high to comfortably get back to sleep, you're much better off turning the machine off and back on so that you get to sleep rather than lying in bed becoming more miserable because you can't get back to sleep.

Eventually as your brain figures stuff out you should start waking up less in the middle of the night.
Questions about SleepyHead?
See my Guide to SleepyHead
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#19
Thanks all for the encouragement and advice. I'm going to take some time to gradually adjust my settings to a pressure range of about 6-10 and EPR off. I'll report back in a few weeks to let you know how it's going. It's exciting to feel like I have some control over my treatment - finally!
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#20
It's been about 4 months, and I've made a lot of improvement, but I could use some fine-tuning advice. I hope it's ok to add to this older thread instead of starting a new one.


Quick update:
I've settled on a pressure range of 6-11, with EPR 1. I tried EPR off a couple times, but my pressure just seemed to shoot up and I had a hard time exhaling. It wasn't comfortable, so I set it back to 1.

I also tried decreasing my max pressure to 10, but that seemed to increase my AHI somewhat, so I put it back to 11. No idea why. It could have been a coincidence.

I do feel like I've been sleeping better than when I first posted. The few times I've fallen asleep without my mask (usually after waking up in the middle of the night), I've felt more tired than usual the next day. So I'm convinced CPAP is helping me. Smile


Questions:
(1) I'm still not feeling like my sleep is as restful as it could be. I'm wondering if I can get my average AHI any lower. It's nearly always under 3.0, and under 2.0 maybe 50% of the time. Is it realistic to try to get it any lower?

(2) I'm wondering if I should try raising my minimum pressure to 7 or even 8, since nearly all of my obstructive events seem to happen when the pressure is under 8, and many of them happen when it's under 7. Does that sound reasonable?

(3) I tend to wake up in the middle of the night or wake up earlier than I'd like (e.g., 4:30 AM). If anyone can see anything in my screen shots that would explain this, I'd love to hear it. (It could very well be unrelated to sleep apnea or CPAP; I'm still working on my chronic anxiety.)


FYI, the first night below I woke up too early. The second night I woke up sometime around 3:00-3:30 (not sure exactly when), but fell back asleep almost right away.

I'd appreciate any suggestions or advice. Thank you!

[/url][url=http://imgur.com/hNFnLQl.png][Image: hNFnLQll.png]

[Image: l1Mw0Yll.png]



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