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RE: Assistance getting sub 5 AHI on new machine - Gideon - 02-26-2020

Try and get some Flex in.


RE: Assistance getting sub 5 AHI on new machine - Damiansd - 02-27-2020

Lord Bonjour, you rock.

Cervical collar worked a treat.

APAP 8-15 C-Flex 1

[attachment=20376]

Still a high number of RERAs, so over the next few nights I will trial upping the C-Flex to 2 and 3.

Thanks again,
Damian.


RE: Assistance getting sub 5 AHI on new machine - Damiansd - 02-28-2020

Last night: Auto 8-15, Cflex 2. 
Change was Flex 1 to 2.

[attachment=20432]

And started doing some data analysis for correlations. I wanted to see how each factor may be linked. Looking for correlations. I'll keep tracking this for a bit to see if it is consistent. I need to do multiple days between changes to verify things properly.

[attachment=20434]

Once median pressure settles I'll adjust my lower limit to it. Too early at this point. 

All other input welcome.

D.


RE: Assistance getting sub 5 AHI on new machine - Sleeprider - 02-28-2020

Raising minimum pressure should help to clean out hypopnea and some OA The Philps machines are not very good at getting ahead of those events, and hypopena is the most common thing we see with minimum pressure too low. Take it up in 0.5 cm increments and settle where you feel good and events are reduced. For now, minimum pressure 8.5.


RE: Assistance getting sub 5 AHI on new machine - Damiansd - 02-29-2020

Thanks for the assist SleepRider, that's looking much better.

[attachment=20486]

Still getting a lot of RERA, so I think I'll bump the Flex up to 3 to see if it helps. It aint no Resmed...

Thanks all,
Damian.


RE: Assistance getting sub 5 AHI on new machine - Sleeprider - 02-29-2020

Keep at it. The RERA should reduce next. I think you're heading to 9.0 if you're still comfortable. I don't think Flex is the answer to the RERA because the Philips does not give more pressure relief with higher Flex, it just changes the timing. i would just move the pressure needle 0.5 and we can try a flex experiment later. You might even fine that setting the minimum and maximum pressure at 9.0 is better than Auto mode at 9-15. I agree this is getting very close.


RE: Assistance getting sub 5 AHI on new machine - Gideon - 02-29-2020

You are getting all the help you can from flex, the difference between 2 and 3 will be your perception of comfort. Minor bumps in pressure is what you have to work with and SR is extremely good at this. Follow his lead.


RE: Assistance getting sub 5 AHI on new machine - Damiansd - 03-01-2020

Thank you both.

Last night was an AHI of 1.1.

I'm travelling at the moment, so no graphs. End of the week I'll come back with those. 

With respect to Flex, may I lower it or do I still need the 'support' that Philips don't provide properly?

D>


RE: Assistance getting sub 5 AHI on new machine - OpalRose - 03-02-2020

I always used a Flex setting of 1 or 2.  It is there for your comfort, but Respironics machines just don't do a good job at exhale pressure relief compared to ResMed's EPR.

If you are using Flex 2, you can try 1 and see how it feels, or if it affects your numbers.  I think you need it either way.


RE: Assistance getting sub 5 AHI on new machine - Damiansd - 03-02-2020

Thanks Opalrose. I'll reduce to flex 1 tonight and see how it goes.

Last night was 1.4 but no graphs for a few days. Pretty happy with the awesome help all have provided. I'm definitely very close and beyond this is just nitpicking.

Regards,
Damian