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+--- Thread: More pressure? (/Thread-More-pressure)
More pressure? - Perickson - 04-23-2022
Captured last night (see attached image) - pretty rare, but does this imply should have more pressure?
Currently set >5, <15 etc. Most nights obstructive is fractional - like .2 or .5 and AHI is ~<5, but during this ~half hour... even so SpO2 wasn't terrible (mostly >90) during this period...
RE: More pressure? - OpalRose - 04-23-2022
Can we assume that since you say this chart is "pretty rare", that you don't see much in the way of Obstructives?
What I do notice is that there are a couple episodes of positional apnea, one cluster at around 4:00 and another at 8:00am. This is probably due to "chin tucking", where you are sleeping in such a way that your head is dropping and tucking into your chest. This cuts off your air. This can happen on your side or back.
What is your pillow like? A tall fluffy pillow can also cause you to chin tuck. Try a thinner, flatter pillow.
With that said, your pressure is not optimized. A minimum pressure if 5 is too low.
Your median pressure is around 12cm, so try moving the minimum closer to that.
I suggest minimum 10cm, maximum 20cm. The machine won't go that high unless it needs to. Also, start using EPR. Start at 2 for now. This will help with flow limitations.
Note that these settings may need more adjustment.
It's important though that you're aware of the positional sleep issue and try to correct that. Some use a soft cervical collar to keep head and neck aligned. If this chart isn't the norm for you, then you may not need that.
One more thing... follow the link in my signature line on how to organize your chart.
Leave off the calendar and pie chart. Use the F12 key to take a Standard Screenshot.
RE: More pressure? - Geer1 - 04-23-2022
Depends on your definition of pretty rare. You will always have good nights and bad nights and you never target treatment to deal with bad nights/bad breathing. You target treatment to deal with the majority of breathing and let the odd bad periods have their effect.
As mentioned this clustering of apnea is indicative of positional apnea and if it was a regular occurrence it is worth trying to treat. If it happens rarely it could just be you sleeping in a strange position on your pillow with head in a kinked position etc.
As mentioned there is probably room to improve your settings. Your flow limitations are significant and what appears to be driving the pressure increases, higher min pressure may help that but using EPR will probably have a more significant effect. For now I would try increasing min pressure to 7 cm and EPR to full time with setting of 2. Then post a full nights data showing the results including flow limitation chart. 10 minimum as specified by Opalrose may be warranted, I only recommended 7 because EPR alone may drop pressure ranges used significantly.