New User looking for analysis of Data

[rotts4u]

Ok here is last night. I just now noticed that I set it at 12/13 not 12/12. I stayed up late so the hours of use are less but the numbers do look better than the last week so that must be better.

[Wulfman...]

Yes, definitely better.
I'd suggest setting the minimum and maximum pressure to the same number (preferably 12-12) for a few more nights.
THEN, after those nights at the same setting, reduce the EPR from 3 to 2 for a few more nights.

Reasoning: Some people have apneas at the point of the end of their exhale and the beginning of their inhale cycles. EPR reduces the "effective" pressure by one whole centimeter for each number setting. This may give us an idea as to whether this option may affect your therapy settings
I'm seeing "events" at the points of your pressure changes. I would like to see flat pressure lines so any "event" markers may show us some sort of pattern or clue as to their origins.

If you could also increase your minimum Ramp pressure and/or reduce Ramp time, that might help, too.


Den

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[rotts4u]

Thanks Den. Ill make those changes tonight. I had already increased the min from 4 to 6 and reduced the ramp from 20 to 10min.

[rotts4u]

Ok here is the first night with the suggested settings. I think you can see the settings on the left and I also lowered the ramp to 5 min.

[Wulfman...]

I don't know about you, but it looks "better" to me.
There's a couple of little clusters, but nothing that looks "serious" in my opinion.
There appear to be very few snores or flow limitations (according to the numbers in the summary) or hypopneas (showing in the report).
So, what apneas you're having seem to be mostly of the "frank" variety.......some of which could be positional.

I would let these setting "ride" for a few more nights to see what happens. Then, maybe reduce the EPR by one number.

How do you feel? I know it may be a little early to judge, but that's going to be one of those things on which we determine the effectiveness.


Den

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[rotts4u]

Thanks for the feedback Den. As far as how I feel I feel so much better since I went on the CPAP its hard for me to say that one night is better than another compared to where I was before.

I am no longer tired in the afternoons and I wake up refreshed and ready to go !!

[rotts4u]

Here is the first night on the 12/12 settings.

[rotts4u]

Night two of the same settings. Overall it doesn't look any better in terms of AHI. Maybe someone can see other changes that I don't yet understand Should I change anything else yet?

[Pugsy]

Den will encourage you to use a fixed pressure...either keep the 12/12 fixed and maybe reduce EPR if you can comfortably do that. The reduction in pressure during exhale sometimes allows some events to happen when someone is at a fine line in terms of therapy effectiveness. You are at that point with current settings...need either a little more pressure to start with or compensate by reducing EPR a little because that will effectively raise the average pressure a little.
Right now with your 12/12 setting and EPR of 3...you are dropping down to 9 cm on exhale. That 9 cm on exhale may be responsible for a few of those OAs happening. You could try reducing EPR to 2...then your exhale pressure would be 10...and maybe that would be enough to clean up that AHI a little more. It isn't horrible but I would want to clean it up a little more if it were me.
So you can go at it 2 ways....reduce EPR if you can comfortably do it and if you can't then increase to maybe 13/13 and see what happens. You may not be comfortable reducing EPR much and if you aren't....don't because it will affect quality of sleep that that's very important. If you feel like you are suffocating you can't sleep well. Going down to 2 may not be a problem...but down to 1 or turning it off cold turkey might...try it while awake to check it out.

I really don't like to have multiple cooks in the kitchen and Den is one type of cook and I am another.
I have a little different take on things and I think those clusters look like REM clusters (first hand experience with them) so I have set back to let you try Den's cooking first. See how you like it.
Then if you wish I would be happy to offer my recipe for you to try and then you can decide which recipe tastes better to you. Den likes the way his stuff tastes...and that's fine and I like the way my stuff tastes but the person to please is you.
We both get the job done...tummy full and keep the OSA events to a minimum we just go about it with a little different take on things. So I won't butt in unless you ask and want to taste my recipe.

[Wulfman...]

Night two of the same settings. Overall it doesn't look any better in terms of AHI. Maybe someone can see other changes that I don't yet understand Should I change anything else yet?

Good. I like to look at reports that aren't "cluttered" with pressure changes and having to try to unravel those complications.

What I'm seeing are somewhat evenly spaced apnea events......around 1 - 2 hour intervals......which could indicate REM periods. (or, you're possibly on your back at those times)

Here's a couple of options. If you want to continue to use an EPR setting of "3", then move your pressure settings up to 13-13. Or, the other option is to decrease the EPR from "3" to "2" and leave your pressure settings where they are.


Den

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[Wulfman...]

Den will encourage you to use a fixed pressure...either keep the 12/12 fixed and maybe reduce EPR if you can comfortably do that. The reduction in pressure during exhale sometimes allows some events to happen when someone is at a fine line in terms of therapy effectiveness. You are at that point with current settings...need either a little more pressure to start with or compensate by reducing EPR a little because that will effectively raise the average pressure a little.
Right now with your 12/12 setting and EPR of 3...you are dropping down to 9 cm on exhale. That 9 cm on exhale may be responsible for a few of those OAs happening. You could try reducing EPR to 2...then your exhale pressure would be 10...and maybe that would be enough to clean up that AHI a little more. It isn't horrible but I would want to clean it up a little more if it were me.
So you can go at it 2 ways....reduce EPR if you can comfortably do it and if you can't then increase to maybe 13/13 and see what happens. You may not be comfortable reducing EPR much and if you aren't....don't because it will affect quality of sleep that that's very important. If you feel like you are suffocating you can't sleep well. Going down to 2 may not be a problem...but down to 1 or turning it off cold turkey might...try it while awake to check it out.

I really don't like to have multiple cooks in the kitchen and Den is one type of cook and I am another.
I have a little different take on things and I think those clusters look like REM clusters (first hand experience with them) so I have set back to let you try Den's cooking first. See how you like it.
Then if you wish I would be happy to offer my recipe for you to try and then you can decide which recipe tastes better to you. Den likes the way his stuff tastes...and that's fine and I like the way my stuff tastes but the person to please is you.
We both get the job done...tummy full and keep the OSA events to a minimum we just go about it with a little different take on things. So I won't butt in unless you ask and want to taste my recipe.

Personally, I don't really see much difference (at this point) in our "cooking" strategies. I believe we both see some of the same things, looking at his reports.


Den

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[rotts4u]

Thanks for both sets of fast input. Frankly I seem very tolerant of the machine and pressure so far. In fact at 12 it still seems low to me meaning I was expecting it to be a lot more annoying and I hardly notice it at all. Maybe I was expecting it to feel like a artificial respirator and of course it doesn't. I have not tried the exhale adjustment other than 3 as that is where it was in the beginning. I may play with that next to see if I feel any difference and or up the pressure if that doesn't do it. And yes I mostly sleep on my back but do roll a couple of times from side to side as well. The mask really doesn't interfere with that much either.

Ill go to 2 tonight on the EPR and see what that does.

[Wulfman...]

Thanks for both sets of fast input. Frankly I seem very tolerant of the machine and pressure so far. In fact at 12 it still seems low to me meaning I was expecting it to be a lot more annoying and I hardly notice it at all. Maybe I was expecting it to feel like a artificial respirator and of course it doesn't. I have not tried the exhale adjustment other than 3 as that is where it was in the beginning. I may play with that next to see if I feel any difference and or up the pressure if that doesn't do it. And yes I mostly sleep on my back but do roll a couple of times from side to side as well. The mask really doesn't interfere with that much either.

Ill go to 2 tonight on the EPR and see what that does.

Oooooooh. That does explain some things. (maybe I missed it or forgot it if you mentioned it before)

It would be interesting to see what the reports look like if you could keep yourself on your sides and off of your back for a night or so.
Don't know if that's possible, but it's a thought.


Den

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[Pugsy]

I don't really see much difference (at this point) in our "cooking" strategies. I believe we both see some of the same things, looking at his reports.

Yes...we see the same things...REM or supine and the need for more pressure in some way...I would just go about cooking things a little differently. That's all.
I will step back and keep my mouth shut unless I am needed.
I really truly don't care which way someone goes...your preferred method or mine as long as they are happy and doing well.
Let's just hope he doesn't end up with what I need to kill those little buggers..whatever causes them.

[rotts4u]

Ok last night I changed the EPR from 3 to 2 and put the ramp back in for a bit to ease the transition early on. I tried it for a few minutes earlier in the day just for a trial and I felt the difference in exhale pressure or resistance.

So here is the data after one night. Also I checked my machine and it appears that 12 is the highest minimum pressure that I can dial up to. So if I raise the pressure it will have to be 12/13 unless there is a setting that will disable the min max options somewhere I didn't notice.
I really appreciate both sets of input so please feel free to keep commenting. I don't think its a matter of right or wrong perhaps different things work for different people such as myself that sleeps on my back too much !!