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Adjustment recommendations
#1
Adjustment recommendations
Hi All,

  I have been using a Dreamstation Auto CPAP   since 2020. I'm looking for some advice on how to tune my settings.
My results are fairly consistent. I feel somewhat better with use but not great. Looking for an improvement.

  My FL and RERA and Inspiration time #'s are of particular interest to me as I feel there may be an adjustment I may be able to make to see improvement in them.

  

I figured out my multi week averages and have attached a typical nights daily view.

I typically only have Hypopneas. Zero or very near zero CA and OA's more often than not.

My Insp Time is always longer than my Exp time on both Med and 95% readings

I'm hoping there maybe something in these #'s that you guys see that may help me find that improvement.

As an aside.

Multii week  averages

AHI 2.44
CA 0.04
OA 0.12
Hypopnea 2.28
FL 0.48
RERA 1.30

                 Med       95%
Insp time    2.34       3.44
Exp  time    1.70       3.02

I have DS Auto CPAP/Humidifier with Nasal Pillows   Flex set to 3  5/15 pressures 

57 year old mail, never smoked, 6' 2  202 lbs

Thanks so much for your time and effort.

Jim


   
 

   
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#2
RE: Adjustment recommendations
Respironics machines are known for their slow reaction time.  So a starting pressure of 5cm is not going to be optimal for taming apneas.  

To treat Flow Limitation and Hypopnea, the use of EPR (ResMed) or Flex is recommended, although Flex doesn't doesn't work as well as ResMed's EPR.

I'm going to suggest that the minimum pressure be set to 8cm.
Try the Flex setting at 2.  Then repost after a couple days.

Note:  I've seen the Inspiration time longer than Expiration on some Respironics cpaps.
I think this is some sort of bug with the algorithm, but not sure.
OpalRose
Apnea Board Administrator
www.apneaboard.com

_______________________
OSCAR Chart Organization
How to Attach Images and Files.
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy
OSCAR supported machines
Mask Primer



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.
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#3
RE: Adjustment recommendations
(02-28-2023, 09:33 AM)OpalRose Wrote: Respironics machines are known for their slow reaction time.  So a starting pressure of 5cm is not going to be optimal for taming apneas.  

To treat Flow Limitation and Hypopnea, the use of EPR (ResMed) or Flex is recommended, although Flex doesn't doesn't work as well as ResMed's EPR.

I'm going to suggest that the minimum pressure be set to 8cm.
Try the Flex setting at 2.  Then repost after a couple days.

Note:  I've seen the Inspiration time longer than Expiration on some Respironics cpaps.
I think this is some sort of bug with the algorithm, but not sure.

Hi Opal,

  Thanks for the response.

 Pardon my ignorance, I am trying to pick up this stuff as we go along

You say a higher starting pressure is recommended for taming apneas.  With my current setting  I have virtually no Apnea's (CA or OA) only Hypopneas. Are the terms perhaps used interchangeably?

Regarding treatment of Flow limitation and  Hypopnea you say the use of Flex is recommended. My current flex setting is 3.  Is your recommendation to lower that to 2 because of the Increase of minimum pressure you would like me to try? 

Just a bit of confusion on my part as this is all new to me. 

Thanks again

Jim
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#4
RE: Adjustment recommendations
Sorry for the confusion...  Smile
I tend to lump Hypopnea in with CA & OA, incorrectly.
You are correct as hypopnea aren't called apneas. I do consider them just as disruptive to sleep.

Flex doesn't work the same as EPR. With EPR, you receive a true drop of pressure for each setting, example: a setting if 3 = a drop in pressure by 3cm. With Flex, you don't necessarily receive that same drop in pressure. Look at your pressure graph and you can easily see that.

My reasoning for using Flex set at 2 is due to the many folk here who experience discomfort on 3. If it doesn't bother you, then keep it at 3. You won't likely see a pressure drop of 3 though.  Many folk experiment with those settings to gauge how it "feels".

I used a Respironics machine Apap for 6+ years, with flex set at 1 or 2.  At 3, it would sometimes cut off my inspiration and switch to expiration before I was ready.
If you don't notice it or it doesn't bother you, then keep it set at 3.

I believe the minimum pressure should be raised to at least 8cm.  You are at 8.9 for 95% (and lower) of the night.  Your median pressure hovers at 5cm and doesn't do anything to tackle Hypopneas.

I probably confused you further. Smile
OpalRose
Apnea Board Administrator
www.apneaboard.com

_______________________
OSCAR Chart Organization
How to Attach Images and Files.
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy
OSCAR supported machines
Mask Primer



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.
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