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+--- Thread: Should I Increase Minimum Pressure? (/Thread-Should-I-Increase-Minimum-Pressure--25592)
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Should I Increase Minimum Pressure? - Diggers4pg - 06-29-2019
54 Days in and I feel I'm really doing well. I've been at 10.5 minimum for the last 2+ weeks, and I'm wondering if it is time for an increase. I have noticed over the last week that my AHI is increasing almost daily and my 95% pressure is also increasing. My hypopnea was the highest last night at 2.51 (at this pressure), but its been bouncing around over the last 2 weeks between .5 and 1.5. Flow limitations had been getting consistently lower until this week where there is a higher bounce.
I'm not doing anything differently this week than I have previously - possibly a little nasal stuffiness due to changing allergins in the air.
I would appreciate some guidance as to whether I should leave it alone or go higher.
Thank you!
RE: Should I Increase Minimum Pressure? - mesenteria - 06-29-2019
Your machine seems to be happy holding you just above 15 cm. Your max setting, according to the information at the sidebar at left, is in auto 20 cm. It leaves me wondering why you'd want to second-guess the machine.
Instead, I see clusters of events, almost always indicative of arousals or sleep position (chin tucked to the extent it is closing off your airway and fighting the machine's purpose, or you're on your back. Or.....both.) You might want to consider a cervical collar to help to prevent chin-tucking, if that's all this is about, or a way to prevent yourself from rolling onto your back.
Please wait for others to contribute their thoughts. I'm new at this, quite possibly missing or misinterpreting something they'll find rather obvious.
RE: Should I Increase Minimum Pressure? - Sleeprider - 06-30-2019
The Dreamstation does not respond to the flow limitations you are having, and is allowing hypopnea to occur. You apparently need a higher pressure, and I think you would be much better treated by a Resmed Autoset or even a true bilevel.
RE: Should I Increase Minimum Pressure? - ajack - 06-30-2019
If it was my chart, I'd follow basic titration protocol and raise min pressure 1cm at a time till the obstructive and partial obstructive events subsided. This should do the job for you.
http://c398534.r34.cf1.rackcdn.com/DOCUMENTS/1079754_TitrationProtocol_RefGde_Canada.pdf
RE: Should I Increase Minimum Pressure? - Gideon - 06-30-2019
As SR said you have a bunch of hypopneas, flow limitations, and RERAs. These are best treated with Pressure Support (PS) or the difference between EPAP and IPAP. You are using flex which is terribly inefficient at achieving this (unlike ResMed EPR) but you can try an EPR of 2 if you are not there already.
With your machine slowly and methodically increase your pressures to eliminate these.
As SR said long term look for a ResMed AutoSet or an auto BiLevel to best treat your apnea
RE: Should I Increase Minimum Pressure? - Sleeprider - 06-30-2019
Diggers4pg, the Dreamstation, does not have EPR, and if you're using flex, set it at 1 or 2, not 3. I'd move to a minimum pressure of 12. and see what happens.
RE: Should I Increase Minimum Pressure? - Gideon - 06-30-2019
My bad, I meant to say flex =2 not EPR
RE: Should I Increase Minimum Pressure? - LANEWBEE - 06-30-2019
(06-30-2019, 10:07 AM)bonjour Wrote: As SR said you have a bunch of hypopneas, flow limitations, and RERAs. These are best treated with Pressure Support (PS) or the difference between EPAP and IPAP. You are using flex which is terribly inefficient at achieving this (unlike ResMed EPR) but you can try an EPR of 2 if you are not there already.
With your machine slowly and methodically increase your pressures to eliminate these.
As SR said long term look for a ResMed AutoSet or an auto BiLevel to best treat your apnea
I understand hypopneas and FLs can be eliminated by higher pressure, but how about RERAs? How do RERAs have anything to with obstructive airway or lower pressure?
RE: Should I Increase Minimum Pressure? - Diggers4pg - 06-30-2019
Since I didn't have any other replies last night that I saw before I went to bed, I took into mind what you said. I have a small rectangular pillow that came with my bed set and just made sure I had it positioned under my chin whether I was sleeping on my side or on my back. Granted, I didn't sleep fantastic because I was thinking about the pillow, but the results show that it definitely made a difference. Please see below.
I am definitely going to look into a collar. After reading the additional replies I will probably also change the flex and the min pressure. I'm going to go by the baby food principle and change one thing at a time to see what works.
What I can't change at this point is my machine. I'm on insurance and I'm stuck with this one for a while and will have to make the best of it.
RE: Should I Increase Minimum Pressure? - Gideon - 06-30-2019
RERAs are a series of Flow Limitations that end with an arrousal. That arrousal is bad.
Flow Limitations are bad.