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[Pressure] Pressure tics and awakenings, plus the 90% question
#11
Well ended up setting the machine in APAP at a very minimal range of 9.0 - 9.5cm. And looking at Sleepyhead this morning, I've had one of my best nights, with an AHI of .94.

Well you'd never know it. Woke up with a headache and my eyeballs ache. Bug-eyed But one good thing, I did not wake up with that panicky feeling I was getting with the wider pressure range.

So based on this, and Teddy's input, I am going to lower it one step, to 8.0 - 9.0cm and give it another try.

Now where's my coffee? lots-o-coffee
-Ailu
Reformed CPAP Outlaw
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#12
I think that you're focusing on AHI numbers a bit too much.

Focus on how you feel upon awakening, how you feel during the day, how many hours rest the night before on CPAP.

I thought you were going straight CPAP. Apparently not. My recommendation was to start at 7cm and try that for a few nights.

Since I am not an 'Advisory Member', and you are, don't know what to say except that this is my last post here.
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#13
(07-15-2015, 08:15 AM)Ailu Wrote: Well ended up setting the machine in APAP at a very minimal range of 9.0 - 9.5cm. And looking at Sleepyhead this morning, I've had one of my best nights, with an AHI of .94.

Well you'd never know it. Woke up with a headache and my eyeballs ache. Bug-eyed But one good thing, I did not wake up with that panicky feeling I was getting with the wider pressure range.

So based on this, and Teddy's input, I am going to lower it one step, to 8.0 - 9.0cm and give it another try.

Now where's my coffee? lots-o-coffee


Hi Ailu,
The only advice I can give you, is don't make too many changes without giving your first change a chance. Yes, .94 is good, but tomorrow could be 1.4 with the same pressure range. Every day is different and a lot of different factors play out in how we sleep and what our AHI will be. Give it a week to 10 days on one setting.

Other than that, you seem to be doing well, except for the headache????

I see I'm not the o my one who loves coffee.
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#14
Do NOT make changes based on a single night. Never ever.
PaulaO2
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#15
Not familiar with the Respironics machines, but still curious.

Is there a way to turn off the "hunt and peck" and still maintain an APAP range?

Without a solid answer, were it me, I would try just tighten the range a bit.
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#16
Thanks so much for your replies guys, really appreciate all the advice. I guess I just need to be a bit patient...

Teddy, I don't know what to say. As I really appreciated and took your post to heart. I am deeply sorry if somehow I have offended you, but please know I would never intend to do so, as I felt your advice was very valuable. I really wanted to go to straight cpap, but got worried that I might not chose a high enough pressure and have a really bad nights sleep. Because I had a very important day today and had to be at my best. My intention was to narrow it down and then eventually going with a fixed pressure. Anyhow, I hope you will forgive me. Shy
-Ailu
Reformed CPAP Outlaw
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#17
(07-15-2015, 02:19 PM)TyroneShoes Wrote: Not familiar with the Respironics machines, but still curious.

Is there a way to turn off the "hunt and peck" and still maintain an APAP range?

Without a solid answer, were it me, I would try just tighten the range a bit.


TyroneShoes,
I don't think you can turn off the "hunt and peck". When I first started therapy,
I thought that's what was disturbing my sleep, but that wasn't it. The APAP will only go up 1.5cm, but is done slowly. OP should 't notice this.

What is disturbing to sleep for some is that it responds to Flow Limiations, and snores by raising the pressure quickly to ward off any possible apnea. I've seen on my graphs that the pressure would go from a setting of 9 to 16 very fast. Then if no apnea, it would drop back down just as fast. This is what disturbs sleep, and that is why I have a narrow range of 9-12. My pressure needs do require at least 11 max, so I can't narrow it by too much. In time, I may change to 10-12.
I call this "taming the beast". Rolleyes




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#18
Here is what I would do:

take it out of APAP mode,
set CPAP for 9 and an EPR of 1or 2.
try for 7 days.

Dave
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#19
Ailu: I have a respironics 560. I went thru similar hoops. Here are a few things to note:
1) you were titrated via a sleep study for a straight pressure of 7. This means your prescribed 'cpap' pressure is 7cm h2o.
2) Respironics machines provide an exhale relief aflex which reduces your EPAP by exactly 2cm h2o by end of exhalation (for all settings of x1,x2 and x3). it is different from EPR on resmed machines in this regard.
3) if you want to try straight pressure which is in agreement with your titrated pressure, you should set the machine to 9cm H2o. This will put your EPAP to 7 and IPAP to 9.

You can do this for a week, see the result and then you may want to bump pressure up or down by 0.5cm at a time. Also, the respironics stops flagging Flow Limitations in CPAP mode. So it's better to keep the machine in APAP mode and set max = min = 9cm and aflex to your current setting of 1.


Started APAP 4-20, Closed range to 7.5-14, then straight 8.0 w/ Aflex 3
RDI always below 1. But sleep much much better at straight pressure.
Started on F10, Tried Quattro Air successfully. Finally settled on P10.
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#20
Okay, so taking to consideration everyone's advice here (along with the knowledge that although I was titrated to 7.0cm, Sleepyhead showed I was still having apnea at 7.0cm) I decided to try a narrow range of 7.5 - 8.5 for the past few days. I noticed the following:

1) I am sleeping much more soundly, almost feels normal
2) I am only waking once in the night instead of 3
3) I have had a steady increase in apnea

Having a narrower auto range is preventing all those crazy pressure ticks, and I am now sleeping much more soundly. So a narrow range of 1.0cm is definitely the way to go.

But I had 8 episodes of obstructive apnea last night, all of them were valid, and half of them at my top range of 8.5cm. So although I am sleeping better, I believe the pressure is still a little too low. So I am going to increment the range up to 8.0-9.0, and keep it there for the next week. I'll again report back my findings.

Here's a screen shot of last night...
[attachment=1596]
-Ailu
Reformed CPAP Outlaw
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