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Too Late?
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GTOdude Offline

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Posts: 94
Joined: Dec 2015

Machine: RemStar Auto APAP
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFIT P10
Humidifier: Unsure
CPAP Pressure: 7-14
CPAP Software: SleepyHead EncoreBasic

Other Comments: Other Dx: cabg x3 '94. Hypothyroid '15 and other maladies.

Sex: Male
Location: Central Valley, Left Coast

Post: #21
RE: Too Late?
Here is a snapshot attachment out of Sleepyhead last night. I included what I thought might be important.

I slept like hell. No improvement. Had to take 1/2 an Ambien to fall asleep. Except to go to church, I haven't hardly got out of my chair today.

Knowledgeable ones, your opinions and suggestions please.

Mark
12-13-2015 07:00 PM
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Sleeprider Online
Wiki Editor
Advisory Members

Posts: 3,400
Joined: Dec 2014

Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Where they make Respironics

Post: #22
RE: Too Late?
GTO, Whoever "titrated" you blew it! Raise your minimum pressure to 8 and your maximum pressure to 20. You're way high on obstructive apnea and hypopnea. Let the machine find the sweet spot. The low pressures (6.0) don't prevent many events at this point and you continue to have events when you top-out at 10.0. I suspect you'll see a maximum pressure somewhere around 14, but the machine should not go higher than what you need, we just want to see what that is.

Loads of RERA early and late may be semi-awake sleep state, or could be the pressure changes and inadequate pressure. We'd like to see the pressure respond to your needs in a smaller range to be less disruptive, but the main thing is to allow it to go high enough to treat you. One thing I notice is that you don't have a lot of flow limitations or snores which would normally cause pressure increases to prevent OA and H. This sometimes happens, and an increase in minimum pressure is usually the solution. You might adapt in time to the settings you're using, but when the machine is pegged on your high pressure limit, it's usually best to increase that limit and see if that solves the problem.

What is your A-flex setting?

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(This post was last modified: 12-13-2015 10:54 PM by Sleeprider.)
12-13-2015 07:49 PM
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OpalRose Offline

Monitors

Posts: 3,181
Joined: Nov 2014

Machine: PR System One REMstar Auto 560 with A Flex
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10 For Her
Humidifier: REMStar heated humidifier with heated hose
CPAP Pressure: Auto Cpap 10-13 AFLEX 1
CPAP Software: SleepyHead EncoreBasic

Other Comments: Started CPAP Therapy October 23, 2014

Sex: Female
Location: Northeast Ohio, USA

Post: #23
RE: Too Late?
GTOdude, agree with above advice. Your start pressure is too low, and if you look at your pressure graph, you can see your max pressure setting is too low. It's hanging out at 10cm for a good part of the night.

Make those pressure changes, and see if there is an improvement.

When you post another screenshot, just include Events Graph, Flow Rate Graph, Pressure Graph, and Leak Rate Graph, and include the info at the left.
Dreaming

OpalRose
(This post was last modified: 12-13-2015 08:00 PM by OpalRose.)
12-13-2015 07:58 PM
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CHanlon Offline

Advisory Members

Posts: 292
Joined: Mar 2012

Machine: ResMed S9 Autoset
Mask Type: Nasal mask
Mask Make & Model: ResMed Activa LT
Humidifier: ResMed Hi5
CPAP Pressure: 12 -20
CPAP Software: ResScan SleepyHead

Other Comments: Mirage Activa LT nasal mask

Sex: Male
Location: Ontario, Canada

Post: #24
RE: Too Late?
Agree with both of the above - your top end pressure is too low. I notice that most of the events are actually hypopneas, which would indiate to me that the CPAP treatment is having a positive effect - those hypopneas would likely be full out obstructive events without the machine. But since the machine has maxed out the upper end, it can't adjust high enough to eliminate the event completely.
12-13-2015 08:09 PM
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GTOdude Offline

Preferred Members

Posts: 94
Joined: Dec 2015

Machine: RemStar Auto APAP
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFIT P10
Humidifier: Unsure
CPAP Pressure: 7-14
CPAP Software: SleepyHead EncoreBasic

Other Comments: Other Dx: cabg x3 '94. Hypothyroid '15 and other maladies.

Sex: Male
Location: Central Valley, Left Coast

Post: #25
RE: Too Late?
(12-13-2015 07:49 PM)Sleeprider Wrote:  GTO, Whoever "titrated" you blew it! Raise your minimum pressure to 8 and your maximum pressure to 20. You're way high on obstructive apnea and hypopnea. Let the machine find the sweet spot. The low pressures (6.0) don't prevent many events at this point and you continue to have events when you top-out at 10.0. I suspect you'll see a maximum pressure somewhere around 14, but the machine should not go higher than what you need, we just want to see what that is.

Loads of RERA early and late may be semi-awake sleep state, or could be the pressure changes and inadequate pressure. We'd like to see the pressure respond to your needs in a smaller range to be less disruptive, but the main thing is to allow it to go high enough to treat you. One thing I notice is that you don't have a lot of flow limitations or snores which would normally cause pressure increases to prevent OA and H. This sometimes happens, and an increase in minimum pressure is usually the solution.

What is your A-flex setting?
Wow! Ive drilled thru the sleep study over and over and yes, I agree they messed it up. I will change the machine settings tonight. Hope that doesnt blow nasal pillows off my face! Oh and A-Flrx is 2.

Mark
12-13-2015 08:12 PM
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OpalRose Offline

Monitors

Posts: 3,181
Joined: Nov 2014

Machine: PR System One REMstar Auto 560 with A Flex
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10 For Her
Humidifier: REMStar heated humidifier with heated hose
CPAP Pressure: Auto Cpap 10-13 AFLEX 1
CPAP Software: SleepyHead EncoreBasic

Other Comments: Started CPAP Therapy October 23, 2014

Sex: Female
Location: Northeast Ohio, USA

Post: #26
RE: Too Late?
If you feel you have trouble breathing out against pressure, change AFEX to 3. But I would try with 2 first.

You should be fine with the settings. Remember, the APAP won't go higher that what is needed.

OpalRose
12-13-2015 08:18 PM
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GP49 Offline

Preferred Members

Posts: 33
Joined: Apr 2015

Machine: ResMed S9 Adapt
Mask Type: Full face mask
Mask Make & Model: ResMed Mirage Quattro
Humidifier: ResMed H51
CPAP Pressure: 8-20
CPAP Software: Not using software

Other Comments:

Sex: Male
Location: USA

Post: #27
RE: Too Late?
Post about your car in the Off Topic forum. Get a conversation going. There must be at least a few Pontiac enthusiasts here and after a short while, you'll have enough posts!
12-13-2015 10:16 PM
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Sleepster Offline
Wiki Editor
Moderators

Posts: 4,995
Joined: Feb 2012

Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #28
RE: Too Late?
(12-13-2015 07:00 PM)GTOdude Wrote:  I slept like hell. No improvement. Had to take 1/2 an Ambien to fall asleep. Except to go to church, I haven't hardly got out of my chair today.

I think your numbers look good because you are using the machine all night, your leaks are under control, and your AHI is not too high, especially for a beginner.

Is the pressure bothering you? I would hate to see you raise the pressure and then stop using the machine because the high pressure is bothering you. I suggest maybe changing it from the 6-10 range it's on now to something like a 8-12 range.

Things will get better for you if you persist.

Sleepster
Apnea Board Moderator
www.ApneaBoard.com


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
12-13-2015 10:24 PM
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GTOdude Offline

Preferred Members

Posts: 94
Joined: Dec 2015

Machine: RemStar Auto APAP
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFIT P10
Humidifier: Unsure
CPAP Pressure: 7-14
CPAP Software: SleepyHead EncoreBasic

Other Comments: Other Dx: cabg x3 '94. Hypothyroid '15 and other maladies.

Sex: Male
Location: Central Valley, Left Coast

Post: #29
RE: Too Late?
(12-13-2015 10:16 PM)GP49 Wrote:  Post about your car in the Off Topic forum. Get a conversation going. There must be at least a few Pontiac enthusiasts here and after a short while, you'll have enough posts!
Lol I just may do that!
12-13-2015 10:56 PM
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Ghost1958 Offline

Advisory Members

Posts: 957
Joined: Aug 2014

Machine: PRS1 Series Sixty Auto Aflex
Mask Type: Nasal mask
Mask Make & Model: F&P Eson
Humidifier: PRS1 with Heated Hose
CPAP Pressure: 10.5 min 16 max
CPAP Software: SleepyHead EncoreBasic

Other Comments: Moderate to Severe SA Obstructive. Rapid O2 desat off the machine.

Sex: Male
Location: KY

Post: #30
RE: Too Late?
Agree your pressure is too low min and max.
If aflex is 2 id set min pressure to 8.5 and max at 16 for now.
Leave it a week at that so things can settle then go from there.
If min 8 or 9 is to much set aflex to 3.
Aflex wont end your exhale more than 2 cm under your running pressure anyway, no matter if you set it for three but will make exhaling feel pretty effortless.
12-14-2015 12:17 AM
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