11-15-2014, 06:13 PM
(This post was last modified: 11-15-2014, 06:15 PM by surferdude2.)
It sounds like you may need even higher pressure than 16 cm but we can't be sure without having all the data. Increasing the pressure often increases the leakage rate so that you reach a point of diminishing returns with respect to lowering the AHI figure.
edit: And yes, the Resmed S9 figures are usually accurate enough for government work. Keep in mind that the sleep study is limited in that it was only one night's experience.
What is your 95% pressure?
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In looking at the break down you gave of your events, It looks like most of your apneas are centrals. The centrals might be the result of your increase of pressure. I would suggest that you leave that pressure alone for about a week and see if your AHI does not start to decrease. If it does, leave it alone. If not you might want to reduce your max pressure.
11-15-2014, 11:10 PM
(This post was last modified: 11-15-2014, 11:34 PM by surferdude2.)
Perhaps the small amount of major mask leakage was only during the short periods of time that the pressure came up to max while trying to prevent an apnea event. I rather doubt that but it's remotely possible but would depend on the interval between the events. Without analyzing your complete set of graphs, it's hard to guarantee that raising the top set pressure is the key but if I were you, I'd go ahead and allow the S9 AutoSet to have its head and set the top limit to the max of 20 cm and see what you see. That's just me so...but if the doctor knows how much trouble you are having and how many apnea events you are having and still won't see you for immediately, then you'll have to do whatever you think is best.
edit: I just noticed your added post and see that your pressure was under 16 cm 95% of the time. It seems that the S9 doesn't think you need any higher setting and wouldn't use it if you set it as I suggested. Considering that, and IF the majority of your events are clear airway type, then it's possible that lowering your minimum pressure will help. Maybe set the bottom at 7 cm and use the EPR at 3 for further exhaling relief to see if the events go down. It's normal to have a high score on central events when first starting treatment so the lower bottom pressure can help with that.
But still would be nice to see the graphs...