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Newbie with question about pressure
#1
Newbie with question about pressure
Hi, I've been struggling to sleep with CPAP for about 5 weeks. I still wake multiple times each night (same as pre-CPAP), and fiddle with mask (seal), and back strap (slips up on my hair), and trouble getting back to sleep. But I HAVE seen progress. No more headaches in the morning (yay!) and although I have multiple wakings, I do not get out of bed to go to the bathroom half a dozen times per night anymore. Most nights just once. 

I started out with my pressures set at 6-20. Received recommendations to tighten up to 8-16, 10-16, and most recently 11-16. Last night, for the first time ever, I actually hit 16! That worries me a little. Do I need to adjust the pressure higher? I only settled on a mask less than a week ago, and my AHI varies, but is mostly under 5. I am attaching several charts, last night's first. Thanks!

[attachment=4629]

[attachment=4630]
Flow rate was strange below, ~3:45-4:20
[attachment=4633]

I appreciate any help/advice you can give.

I did read PaulaO2's Better Thread Titles post and tried to follow her tips, hope I did OK.  Thanks Paula!
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#2
RE: Newbie with question about pressure
Looks not bad to me, I wouldn't bother upping the pressure unless it keeps hitting 16, if you have more data later post it on this thread so we can see any changes.  I would leave it for now, see what happens in another week, unless someone else has other advice.   Thinking-about
I am NOT a doctor.  I try to help, but do not take what I say as medical advice.


Every journey, however large or small starts with the first step.

Sleep-well
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#3
RE: Newbie with question about pressure
I agree I wouldn't move the maximum pressure. I noticed you seen to have a couple of clusters of events on two charts. That could be caused by your sleeping position. Overall your numbers are OK.
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#4
RE: Newbie with question about pressure
Your numbers are good, so in general make only small changes (.4/.6 cmw) and give it time.  Focus on your comfort, not the numbers now.

You high number can be set to 20 if you wish, you do not tent to run away with high pressure which is one of the reasons for lowering it, 16 is definitely ok)

Can you provide a 2 minute zoom of your daily targeting the unusual flow, and one of your normal flow for comparison.

I would like to try something a little different, I would like you to raise your minimum pressure to 12.  The reason is I just found a reference to continued sleepiness with a solution of raising pressure, This is a comfort change.  Hopefully it helps with your sleepiness.  No issues with leaving your minimum at 11, that is a good place for you. 


Fred
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#5
RE: Newbie with question about pressure
I am not an expert on pressure but here is something that has worked for me. I am right at 2 years and my sleep has gradually improved over the last 2 years. It takes time to adjust completely. Like you, my worst symptoms disappeared immediately, however, good sleep came slowly. It has only been in the last 3 months my AHI has averaged <1 and not a single day over 1 in the last 30 days. Only 1 OA event I the last 30 days. 

I believe my success is partially based on raising my min pressure to lowest the machine would drop to on any given night and lowering my max pressure to .2 below my 95% pressure. Yes, I knock up against it during the night but I sleep good. 

The other thing that helped was my EPR. I reduced it to 1 and that further reduced my RERA which now I am sure was waking me up. 

My next adjustment might be to turn off EPR entirely since my pressure requirements have also been reduced. 

My best advice is to have patience. It takes some people longer to adjust.
CPAP is a journey like “The Wizard of Oz”. It’s a long slow journey. You will face many problems and pick up many friends along the way. Just because you reach the poppies, it doesn’t mean you are in Kansas. 
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#6
RE: Newbie with question about pressure
I am not an expert on pressure but here is something that has worked for me. I am right at 2 years and my sleep has gradually improved over the last 2 years. It takes time to adjust completely. Like you, my worst symptoms disappeared immediately, however, good sleep came slowly. It has only been in the last 3 months my AHI has averaged <1 and not a single day over 1 in the last 30 days. Only 1 OA event I the last 30 days. 

I believe my success is partially based on raising my min pressure to lowest the machine would drop to on any given night and lowering my max pressure to .2 below my 95% pressure. Yes, I knock up against it during the night but I sleep good. 

The other thing that helped was my EPR. I reduced it to 1 and that further reduced my RERA which now I am sure was waking me up. 

My next adjustment might be to turn off EPR entirely since my pressure requirements have also been reduced. 

My best advice is to have patience. It takes some people longer to adjust.
CPAP is a journey like “The Wizard of Oz”. It’s a long slow journey. You will face many problems and pick up many friends along the way. Just because you reach the poppies, it doesn’t mean you are in Kansas. 
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#7
RE: Newbie with question about pressure
Well, I had an awful time falling asleep last night. Although I was sleepy, I tossed and turned, adjusted the pillows and straps, for about an hour! I am a restless sleeper and woke each time I changed position but dropped off again. When I woke around 3:30 (and took a bathroom break), I was thrilled to see my AHI at 0.6! I had trouble going back to sleep for the rest of the night, I feel like I just dozed rather than really slept. But my overall AHI of 1.6 was good.

Also, my max pressure last night was much lower, just over 14.

What do y'all think?

[attachment=4644]
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#8
RE: Newbie with question about pressure
It's not your pressures that matter, it's the events that occur, are the pressures preventing the events from occurring?   If so your settings, your pressures are fine and yours are great!!!.  it's how you feel.  

Fred
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#9
RE: Newbie with question about pressure
(02-28-2018, 09:21 AM)bonjour Wrote: Your numbers are good, so in general make only small changes (.4/.6 cmw) and give it time.  Focus on your comfort, not the numbers now.

You high number can be set to 20 if you wish, you do not tent to run away with high pressure which is one of the reasons for lowering it, 16 is definitely ok)

Can you provide a 2 minute zoom of your daily targeting the unusual flow, and one of your normal flow for comparison.

I would like to try something a little different, I would like you to raise your minimum pressure to 12.  The reason is I just found a reference to continued sleepiness with a solution of raising pressure, This is a comfort change.  Hopefully it helps with your sleepiness.  No issues with leaving your minimum at 11, that is a good place for you. 


Fred

Hi, Fred,

Here is a zoom of the unusual flow:

   

and of normal flow, with no events:

   

I'm creeping up on raising my minimum pressure to 12. I go up to 11.4 tonight. Baby steps. When I tried a bigger increase, I had chipmunk cheeks and air puffing out my mouth!

Thank you for your help and advice!
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#10
RE: Newbie with question about pressure
(02-28-2018, 12:20 PM)booksfan Wrote:
(02-28-2018, 09:21 AM)bonjour Wrote: Your numbers are good, so in general make only small changes (.4/.6 cmw) and give it time.  Focus on your comfort, not the numbers now.

You high number can be set to 20 if you wish, you do not tent to run away with high pressure which is one of the reasons for lowering it, 16 is definitely ok)

Can you provide a 2 minute zoom of your daily targeting the unusual flow, and one of your normal flow for comparison.

I would like to try something a little different, I would like you to raise your minimum pressure to 12.  The reason is I just found a reference to continued sleepiness with a solution of raising pressure, This is a comfort change.  Hopefully it helps with your sleepiness.  No issues with leaving your minimum at 11, that is a good place for you. 


Fred

Hi, Fred,

Here is a zoom of the unusual flow:



and of normal flow, with no events:



I'm creeping up on raising my minimum pressure to 12. I go up to 11.4 tonight. Baby steps. When I tried a bigger increase, I had chipmunk cheeks and air puffing out my mouth!

Thank you for your help and advice!

This is your normal.   the movements on this may just be normal heart rate showing up. There is however a prodigeous snore at 03:29:30 and flow limits throughout.

[Image: attachment.php?aid=4650]


On  this, your unusual flow.  It's classic expiratory mouth breathing. See second to last wave form in Flow Limitation in Beginner's guide 
[Image: attachment.php?aid=4649]
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