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Sleepyhead showing obstructions
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zonk Offline

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Machine: A10 AutoSet
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Sex: Male
Location: Australia

Post: #11
RE: Sleepyhead showing obstructions
(11-26-2015 01:21 PM)kaiasgram Wrote:  Assuming DumfriesDik is new to PAP therapy we also want to advise gradual and small adjustments and watch to make sure centrals don't start popping up with the pressure increases.
5 years Smile
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11-27-2015 01:24 AM
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kaiasgram Offline

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Machine: S9 VPAP Auto
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Sex: Female
Location: Northern California

Post: #12
RE: Sleepyhead showing obstructions
(11-27-2015 01:22 AM)DumfriesDik Wrote:  
(11-26-2015 01:21 PM)kaiasgram Wrote:  Assuming DumfriesDik is new to PAP therapy

I have been using an S8 Escape for five years, so not new to therapy, but new to an auto machine. Only had it a couple of weeks.

Ah, OK.

Actually I would still make gradual changes, giving yourself time to evaluate more than one night at a time. You will definitely want to narrow your pressure range and increase the minimum pressure.
11-27-2015 02:14 AM
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Terry Offline

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Machine: Philips Respironics RemStar Auto with A-Flex (560P)
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Post: #13
RE: Sleepyhead showing obstructions
(11-26-2015 01:21 PM)kaiasgram Wrote:  I definitely would not bump the minimum up that high. I wouldn't go higher than the median pressure which was 8.5. Even then -- the median pressure means that half the time the pressure was above 8.5 and half the time it was below 8.5.

The only reason that 8.5 was the media was because the machine was running wide open and the minimum was 4.

All of the OP's apneas were at 8.5 and above and a number of them appear to be at more than 12.
11-27-2015 11:20 AM
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Terry Offline

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Machine: Philips Respironics RemStar Auto with A-Flex (560P)
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Post: #14
RE: Sleepyhead showing obstructions
(11-26-2015 01:21 PM)kaiasgram Wrote:  I definitely would not bump the minimum up that high. I wouldn't go higher than the median pressure which was 8.5. Even then -- the median pressure means that half the time the pressure was above 8.5 and half the time it was below 8.5.

The only reason that 8.5 was the median, was because the machine was running wide open and the minimum was 4. Median is only useful when the range is correct.

Nearly (?) all of the OP's apneas were at 8.5 and above and a number of were at more than 12.

I can only guess how disturbing it was to have the pressure spend the night cycling between 4 and 14.
(This post was last modified: 11-27-2015 11:25 AM by Terry.)
11-27-2015 11:25 AM
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PaytonA Offline
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Post: #15
RE: Sleepyhead showing obstructions
No harm in increasing the minimum to 8.5 and run with it for a while to see if it needs to be increased again.

The median is 8.5 because half of the pressure values were higher than that and half were lower. End of story.

Best Regards,

PaytonA
11-27-2015 01:04 PM
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DariaVader Offline
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Post: #16
RE: Sleepyhead showing obstructions
looks like it raises to above 6 immediately and never goes back down to 4 at all. it also looks like the machine is responding too slowly to flow limitations causing oas while the pressure is still rising. This can be helped by raising the bottom end. I would say no lower than 7.5 and probably 8 or 8.5 will end up being the best.

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
11-27-2015 02:42 PM
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kaiasgram Offline

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Post: #17
RE: Sleepyhead showing obstructions
(11-27-2015 01:04 PM)PaytonA Wrote:  The median is 8.5 because half of the pressure values were higher than that and half were lower. End of story.

Right. Of the three common measures of central tendency, only the mean (the mathematical average) is sensitive to the high and low ends of the range. The median and the mode are not sensitive to the high and low ends. Coffee
11-27-2015 10:39 PM
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zonk Offline

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Posts: 7,908
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Machine: A10 AutoSet
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Post: #18
RE: Sleepyhead showing obstructions
(11-27-2015 01:22 AM)DumfriesDik Wrote:  
(11-26-2015 01:21 PM)kaiasgram Wrote:  Assuming DumfriesDik is new to PAP therapy

I have been using an S8 Escape for five years, so not new to therapy, but new to an auto machine. Only had it a couple of weeks.
What was the pressure setting on the Escape?
11-28-2015 02:27 PM
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inmyelement Offline

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Machine: Phillips respironics bipap auto sv advanced system one
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CPAP Pressure: 4.0 cmH20 to 12.1 cmH2O
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Post: #19
RE: Sleepyhead showing obstructions
I'm on an auto adapt machine also. My min is set at 4 cmH2O and my max is set to 12.1 cmH2O. I have an AHI of 52 on bipap and with my machine only .4. The low pressure on it of 4 shouldn't affect you. The machine I have, a Phillips respironics system one, is automatic. It automatically takes four minutes of your normal breathing pattern and saves it. It will use those when you have apneas and adjust itself to make you have normal breathing patterns. It compensates so that you are breathing at least at 90% as effective as your normal breathing pattern. Most people with central apnea do worse at higher cpap settings. The higher the pressure, the more apneas (from what I have read and personal experience on cpap and bipap studies). I wouldn't mess with any of the settings. The machine is adaptive and adapts to your needs. I would wait for another study so they can see if the settings aren't right. With them knowing your lowest and highest pressures already, setting your machine to them, I doubt there will need to be any further adjustments because the machine automatically adjusts itself based on your normal breathing patterns.
(This post was last modified: 11-28-2015 06:52 PM by inmyelement.)
11-28-2015 06:46 PM
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DeepBreathing Offline
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Machine: Resmed S9 VPAP Adapt
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Post: #20
RE: Sleepyhead showing obstructions
G'day inmyelement, welcome to Apnea Board.

Your machine is an ASV which operates on a very different algorithm than Dumfriesdik's S9 Autoset. His machine will raise pressure in response to obstructive apneas, hypopneas or flow limitations. It will record central apneas but can not respond to them.

If an Autoset starts at too low a pressure it often can't increase pressure fast enough to suppress all the events, which is why a minimum setting of 4 is often not a good idea.

In the case of your own machine, unless it's set up as a non-ASV then you should have a full set of pressure parameters, not just minimum and maximum. Typically you'd be prescribed min EPAP, Max EPAP, min PS, max PS, and possibly max IPAP.

DeepBreathing
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11-29-2015 02:39 AM
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