Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

Nicholas' progress thread
#11
(05-30-2017, 07:58 AM)Sleeprider Wrote: ... the line I would want to see is flow limitation, not mask pressure...
Click on the Imgur link above, and you should be able to see flow limitation in the 3rd image, towards the top.

Will try a range of 10 - 16 tonight.
Post Reply Post Reply
#12
@TASmart Thanks
Post Reply Post Reply
#13
(05-30-2017, 04:09 PM)Nicholas Wrote:
(05-30-2017, 07:58 AM)Sleeprider Wrote: ... the line I would want to see is flow limitation, not mask pressure...
Click on the Imgur link above, and you should be able to see flow limitation in the 3rd image, towards the top.

Will try a range of 10 - 16 tonight.

I guess I missed this.  As you can see, nothing warned the CPAP of the upcoming OA events at 23:00, so the machine got caught flat at near minimum pressure.  I probably didn't need to see it, but it helps.  I'll still say, we can get by with just the one chart.

[Image: siOADA6.jpg]
Post Reply Post Reply


#14
I've been reading a good deal on RobySue's Beginner's Guide to SleepyHead, and from what I'm gather so far, increases in pressure are usually triggered by either an event, a flow limitation, or snoring, or some combo of those. Events typically occur when the pressure decreases back down towards the minimum. Am I right to recognize the *general* patterns?
Post Reply Post Reply
#15
Another update. Here's my data for Tuesday night 5-30-17. The previous night, my range was 9-20. Last night I had it at 10-16 per several suggestions. The change to my AHI was minimal.
Post Reply Post Reply
#16
Pressure is more stable, and in spite of the numbers not changing much, you need to give this setting some time to settle in. It's possible your occasional OA is a function of positional apnea, where you may be tucking your chin, or assuming another position that cuts off your airway. The AHI is not bad at all, and will go down in time. I noticed that your best result so far is at fixed CPAP of 9.0 with EPR off. This actually results in an EPAP of 9.0 vs the EPAP of 8.0 that you have with the current settings with minimum pressure of 10 and EPR at 2. This continues to suggest a higher EPAP achieved through either increased minimum pressure or decreased EPR may be your solution.

Your conclusions from robysue's beginners guide are correct. you have relatively little FL or VS to cause pressure increases, and this is why using CPAP or a high minimum pressure is the approach we have adopted.
Post Reply Post Reply


#17
(05-31-2017, 08:25 AM)Sleeprider Wrote: Pressure is more stable, and in spite of the numbers not changing much, you need to give this setting some time to settle in.  It's possible your occasional OA is a function of positional apnea, where you may be tucking your chin, or assuming another position that cuts off your airway.   The AHI is not bad at all, and will go down in time.  I noticed that your best result so far is at fixed CPAP of 9.0 with EPR off.  This actually results in an EPAP of 9.0 vs the EPAP of 8.0 that you have with the current settings with minimum pressure of 10 and EPR at 2.  This continues to suggest a higher EPAP achieved through either increased minimum pressure or decreased EPR may be your solution.

Your conclusions from robysue's beginners guide are correct. you have relatively little FL or VS to cause pressure increases, and this is why using CPAP or a high minimum pressure is the approach we have adopted.

Will give it time. However, it's very tempting to turn it back to a fixed 9 and turn off the EPR and just see what happens. It's also tempting to just turn the EPR off with the current range of 10-16 like you suggest.

I hear you about the position changes. My default, preferred position is on my back, but I will usually turn onto my left and also my right sides at least once a night. What is VS again?

It's interesting looking back at my lowest AHI of 0.08 back on 5/25. Another interesting thing about that night is that 4h 9m is the single longest session I've ever had on the machine in the roughly 6 weeks I've had a machine. Lower AHI = longer time asleep.

More data in the morn.
Post Reply Post Reply
#18
I really don't have any problem with reverting to fixed 9, especially since you are seeing the rationale behind maintaining EPAP pressure, and more steady pressure. It actually seems like a good idea. If you decide to go that way, give it time to establish a baseline. I think we can agree that in your case, APAP does not anticipate events sufficiently to prevent them, and CPAP may actually be as good or better.
Post Reply Post Reply
#19
Last night was somewhat of a breakthrough. EPR off and range of 10-16 led to my lowest AHI since going on APAP. And yet this still doesn't match my best AHI of 0.08 while on a fixed pressure of 9. In the graphics post, I included my lowest AHI night for direct comparison (bummer we don't have the graphs because I didn't have an SD card yet by that point). Yes, it seems getting the EPAP right is the bigger determinant of a favorable AHI for me.

An interesting observation: last night saw my *highest* pressure spike since going APAP of 15.02 (just shy of my current max setting of 16). Curiously, this large pressure spike corresponded not with an OA but with an H(10) event (my second of the night) accompanied by a *major* snoring spike and a relatively *modest* flow limitation spike.

This is an apparent contrast with my first H(10) of the night, which was accompanied by neither snoring nor flow limitation and did *not* trigger a pressure increase. This suggests that snoring and/or flow limitation are *more* likely to trigger a pressure spike than either an OA or H event, which I wouldn't have guessed.

BTW, it's also curious that the few OAs I *did* have triggered only *minor* pressure increases and did *not* coincide with snoring or flow limitation.

Overall, even with the substantial improvement in AHI, it was not a particularly "good" night for me in terms of how I slept. The numbers don't reflect how I feel this morn - tired. I am definitely conscious of my diaphragm working harder with the EPR off (although, I don't believe that by itself is responsible for last night's restlessness). At around 4:20, I felt awake and couldn't go back to sleep, so I ended up getting out of bed, going out to the couch for a bit, and then returned to bed to sleep untreated until my wake time at 6:30 - not ideal.

Tonight, I'll keep the EPR off again. But, do you think it worth going back to a fixed pressure to see what happens, or should I stick at 10-16 for another night? Any feedback is welcome.
Post Reply Post Reply


#20
EPR is fine, and does not harm your therapy as long as EPAP minimum remains 9.0.
Post Reply Post Reply


Possibly Related Threads...
Thread Author Replies Views Last Post
  [How to] Better Thread Titles PaulaO2 3 304 10-04-2017, 10:45 PM
Last Post: PaulaO2
Information [Admin Note] THREAD SUBSCRIPTIONS - need to re-set notification settings SuperSleeper 16 751 09-30-2017, 10:57 AM
Last Post: Sheepish
  [How to] Start a New Thread with the Right Subject Line! PaulaO2 41 3,412 09-19-2017, 01:03 PM
Last Post: SarcasticDave94
  [CPAP] Guidance required, 10+ months and no progress! antstephenson 12 393 08-21-2017, 09:03 AM
Last Post: Sleeprider
  Progress report David44142 11 739 07-29-2017, 06:46 PM
Last Post: David44142
Exclaimation My sleep thread "Jstuts5797" Jstuts5797 10 418 06-15-2017, 04:56 AM
Last Post: Jstuts5797
  another progress report David44142 4 353 04-30-2017, 04:34 AM
Last Post: lmost

Forum Jump:

New Posts   Today's Posts




About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.

For any more information, please use our contact form.