First Sleepyhead Post

[Sonnyboy]

So I survived the night.

The doctor and the DME had said "Elite" many times, but yes, it's an Autoset, says so on the front of the machine, of course.

I slept comfortably. However, I can see that my AHI is still much too high and that I will probably need to increase my pressure from 8/16, maybe to 14/20 next. But I'm going to wait a few days before I do that. I looked at the pie chart and it showed virtually no large leaks, but the graph seems to show some. I'm going to try to use those moldable silicone earplugs tonight to fill in gaps around my nose and chin.

Also, Ramp and Climate Control are set to Auto, Pressure Relief and Smart Start to On.

Hopefully, this screenshot is properly posted. If not, I'll be tinkering with it.

Your screenshots are great for a new poster.

It would be helpful to include the left side vertical column minus the pie chart.
This will let us see your AHI, event breakdown, leak rate and other statistics.
The pie chart is not needed. You can eliminate this by going to file, preferences, appearance and then uncheck "show event breakdown pie chart".

[OkyDoky]

On your Sleepyhead post leave the left side on. It gives needed statistics and machine information. On your minimum pressure it would be a pretty big jump from 8 to 14 and it doesn't look like you need it that high just yet. I would try 10 and leave it there a few days. You do also need to raise the Maximum and if you want to raise it to 20 to see where it goes thats ok. It will not go any higher than it needs to go.

[Okie bipap]

If you want to try making your own liners, PM me and I will send you a copy of the pattern I used for my mask liners. I made the out of an old tee shirt and put them in a small mesh bag that gets thrown in with the laundry.

[palerider]

I slept comfortably. However, I can see that my AHI is still much too high and that I will probably need to increase my pressure from 8/16, maybe to 14/20 next. But I'm going to wait a few days before I do that. I looked at the pie chart and it showed virtually no large leaks, but the graph seems to show some. I'm going to try to use those moldable silicone earplugs tonight to fill in gaps around my nose and chin.

Also, Ramp and Climate Control are set to Auto, Pressure Relief and Smart Start to On.

Hopefully, this screenshot is properly posted. If not, I'll be tinkering with it.

where is the left panel?

I'd set the pressures to 10/20 tonight, and see where the top end goes. 8 is clearly too low.

leaks look ok, but without the left panel, and at that scale, it's more of a guess.

[QueSera]

The good news is that I slept, woke up with energy, and I think I finally got the screenshot right. Also, the flashair data transfer worked!

Bad news is that the AHI is still too high. I understand the pressure graph now, and I'll be making adjustments as I go along. Which graph should I be learning to read next?

I made a liner that was comfortable and eliminated red marks this morning, but today's task will be trying to close the gaps between the mask and what I suppose is an uncommonly shaped nose and face.

[Cardsfan]

I would focus on the pressure graph compared to the events graph and figure out how to get rid of those obstructions for now. And getting rid of those leaks.
If you notice between 2;30 and 3am, you top out at 18 on your pressure. At that same time you are having obstruction events. I'd raise the top pressure to 20 and see if the machine wants to go that high.
I'd also look at the bottom pressure number. If you look in the statistics section, the medium pressure used is 13.9 all night. I'd raise my bottom pressure to 12.

Always keep an eye on your clear airway events. Higher pressure and pressure changes can possibly make those increase.

Do you sleep on your back? Side sleeping helps keep the airway open. Being on your back makes apnea worse.

Your flow limit graph shows around 12;30pm some activity, when your pressure is at 18 you still have some flow limits. That's another clue to raise your upper pressure. In a perfect world, your flow limit graph would show no flow limits.

Other graphs to look at are Flow limit and Snore. Ideally, you want no snoring and no flow limits.

[QueSera]

More thanks. I have almost no snoring: amazing. I fall asleep on my side but always wake on my back; I sleep elevated because of reflux (mostly) so I'm not flat on my back. So far my number clear airway events is low, but I'll keep an eye on it.

So for now I'm going to focus on pressure and mask leaks and use those graphs to guide me to where I want to be. Every response I've gotten here has been extremely helpful, as if each one of you has shown me where one more piece of this giant jigsaw puzzle fits in.

[Cardsfan]

The idea is to slowly raise the lower pressure to the sweet spot that eliminates most of the obstructions and gets the AHI below 5. Without raising it any more than needed to do the job.

[OkyDoky]

The idea is to slowly raise the lower pressure to the sweet spot that eliminates most of the obstructions and gets the AHI below 5. Without raising it any more than needed to do the job.

Slowly, watch trends for a few nights, one good or bad night isn't a basis to make pressure changes.

[palerider]

The idea is to slowly raise the lower pressure to the sweet spot that eliminates most of the obstructions and gets the AHI below 5. Without raising it any more than needed to do the job.

Slowly, watch trends for a few nights, one good or bad night isn't a basis to make pressure changes.

agreed, however with the AHI this bad, I think I'd go ahead and raise pressure, but once we start getting into 'ok' territory, then go slowly... what do you think?

I would probably go ahead and raise both the lower and upper pressures a bit, the lower one to try and head off more things before they start, and the upper to see where the machine thinks it needs to go.

sometimes raising the lower pressure enough cuts down on the swings at the top, as you know.

[QueSera]

I changed the pressure to 12/20, a slight change. Once I understood that it can't go any higher than it needs to (it seems obvious now that I understand the process better) it's a much less scary thing to do.

The big change I'm trying tonight is that I'll be using a nasal pillow mask- Resmed, P10 I think - and taping my mouth. That should eliminate just about all leak, I hope, so I can work on my AHI more effectively.

[Cardsfan]

Remember to change the mask setting in your machine to "Pillows".
Let us know how it goes.
It will help to keep your tongue affixed to the roof of your mouth. You'll get the hang of that part. It keeps the lips from blowing open.

[QueSera]

Look! Look what happened!



I'll be keeping my pressure at 12/20 for now, and will be continuing to use the nasal pillows. I am simply astonished that I did better with the nasal pillows. I've never pulled off a mask in my sleep, but I did wake up without the tape on my mouth. (I have limited control over the muscles on one side of my face, so my lips are always 'loose,' so to speak; I was sure that was the source of the leaking.)

Well, I do still have leaking, and my CA went up, as Cardsfan said it might. I think for tonight, then, no changes (except for changing the mask in my profile here - I changed it on the machine before I used it) and I'll see what trends develop.

You guys are The Best.

[Cardsfan]

Now were cooking

Your CA index for last night was 3.92, which is BETTER than the previous night at 4.80. So that went down too.
When I was zooming in on my ideal setting, I made a daily chart of what my AHI was made up of and the setting I was at. Yours looks like this:

Date----- Pressure ---- AHI ----- Obstructive ----- Hypopnea ----- Clear Airway
-----------------------------------------------------------------------------------
2/7 ----- 10/18 ----- 13.86----- 7.73------------- 1.2 ------------- 4.8
2/8 ----- 12/20------ 4.81 ----- 0.76------------- 0.13 ------------- 3.92

I found this to be a good way to keep track of pressure changes results. If you keep the chart up, you will have an excellent view of what the pressure changes do for your therapy.
(this info is underneath the big orange AHI number)

Caffeine and alcohol can make your CA events go up. If you notice, you have a big cluster of events at 22:00. Those could be from still being awake. I'd leave the pressure there for now and work on the leaks.

[Cardsfan]

Another thing to track is your Max Pressure for each night. With your machine set at 20 max pressure, it can go as high as it wants to. You will be able to figure out what Max pressure to set your apap to by seeing how high it goes over a week or so . (the info is under the big orange AHI bar.) The more you can eventually zoom in on that ideal number, the better.

2/8= 14.6 Max. pressure

I think your flow limit chart looks better too. (less activity is better). Once you get the hang of the basic graphs, it gets easier to help yourself.
Let us know how it goes.