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[Treatment] In need of guidance.
#31
RE: In need of guidance.
I wouldn't worry about them, I wouldn't count the first and last half hour and anytime you wake up.
I would get rid of the pie chart to show the summary, but at a guess, you need more minimum pressure for the OA
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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#32
RE: In need of guidance.
Sorry I'm confused about what you mean by not worrying about the first and last half hour and when I wake up? My minimum is now 12 and max 16
Also what's the significance or RERAs? What is the machine measuring to get these?
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#33
RE: In need of guidance.
last night with pressure set at 12 to 16.

http://imgur.com/a/JyaCO
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#34
RE: In need of guidance.
If it was me..from your previous chart, you have 4.6 oa/h an hour that the cpap can treat. these are the ones I'd work on.
you have 1.7 ca that the cpap can't treat. I understand these may be pressure induced and settle in time, or real centrals, If real, they would have shown up in your sleep test. but either way, I doubt anyone will approve a st or asv to treat that few.
a rera is an arousal measured by an egg, that doesn't count as an OA or H. I don't know the accuracy of a cpap to determine this

I think when you are going to sleep and waking up, the breathing patterns are all over the place and shouldn't be counted

you current chart is similar, but there is a cluster, this could be positional from sleeping on back or the chin to chest blocking the airway? from what I've read here, the foam cervical collars are good for this. you maxed out on 16cm, it's normal to have a higher pressure that the 95% number, I would also increase the minimum to try and stop some oa/h before they start. the machine only adjusts after an event or it can detect an upcoming event, like snoring or flow limit.

page 33 may give some background to how they titrate a cpap in a lab, from what I gather, they keep adding pressure till the oa and h clear.
https://www.resmed.com/us/dam/documents/...lo_eng.pdf
CPAP and AutoSet Therapy Titration Protocol
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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#35
RE: In need of guidance.
If this chart was mine and represents a normal night, I would raise my minimum to 13, quite possibly move my maximum to 17, and reduce my Cflex by 1 (from 3 to 2 or from 2 to 1).  as ajack mentioned min is to press a little harder to reduce OA, and CFlex would be to help stabilize periodic breathing and hypopnea clutters that may be associated with the CA events more that flow limitations that show 0.0.

good luck, and let us know your impression of the quality of sleep as you progress.  no use chasing the numbers around if your biggest problem is getting to sleep and staying asleep.

{rereading my post, I'll point out that you probably don't know what normal is, because this is your first night at the new settings, so remember to go slow, taking a few more days at 12-16 before taking new suggestions. As you put it, you slept better.}

QAL
Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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#36
RE: In need of guidance.
C flex is at 1 currently. Before it was off. What's the best setting?
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#37
RE: In need of guidance.
(06-05-2017, 04:45 PM)garywych Wrote: C flex is at 1 currently. Before it was off. What's the best setting?

Which one gives you the most comfort.  That would be the best, assuming a similar AHI for each.

Comfort wins
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#38
RE: In need of guidance.
yep. Cflex of 1 ok unless the movement of the machine pressure is irritating or waking you. most feel 1 is soothing while 2 is irritating, and 3 is obnoxious. of course everyone is different, except me. I am always the same.

QAL
Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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#39
RE: In need of guidance.
if the ca don't flare up, I'd use some flex.
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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#40
RE: In need of guidance.
Hi, last night was 1.7 with 3 OAs and 13 hypopneas and 0 CAs. However I woke at 2 hours and 3 hours and 5.5 hours then couldn't sleep more. At 3 hours only 3 hypopneas. I disconnected the humidifier as worried pressure was low. Seems even at 12-16 breathing is easy i.e. no resistance felt on exhalation. Will post image when have wifi. Will stay at this pressure for a few days.
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