Encore Pro Report ... What is Happening???

[BlueSky72]

Hi,

Thanks for posting. And welcome to the Forum.

You may be new to all of this ... but all opinions are welcome. That's what I think the Forum is all about.

I'm going to try the 6 to 7 range suggested by Den and see what happens. Then I'll move the range up by 1 cm at a time if/as needed.

One thing that I've come to realize after my last sleep doctor's appointment ... it's really a guessing game for the doctor too! After they've come up with a number from the sleep study, (testing plus calculations) ,,, it becomes a process of trying different settings.

Actually the lab studies showed that I pretty much stay on either my left side or right side for long periods ... unlike my husband, who sleeps like he's on a rotisserie.

I will tell you that the software is an invaluable tool. The first thing it showed me was that I had quite a bit of mask leak. I didn't have a clue! Leaking air just eliminates any therapy (at any setting) that you think your getting.

Jan

Thanks for welcoming me, Jan. You are the first person to have done that. I know about insufficient pressures because my sleep lab study was a dog, and they sent me home with a pressure setting of 11cm. No wonder it didn't work, when I needed at least 17cm (or more, I still don't know!). Even with the APAP opened out at say, 13-17cm, it still wouldn't go high enough, so after increasing by 1cm at a time, 17cm was what my RT and doctor recommended. You're right, when it comes to this sort of thing, the gap between what we know and what they know is small, and getting smaller. I am mostly happy to trust doctors with prescribing medications, but xPAP is beast that takes a lot of experience, not just training (such as it is).

You might have slightly different pressure needs on your right and left side. My sleep resembles that of your husband's - rotisserie style So, while my L side pressure need is 11cm, my supine (back) pressure need is at least 17cm. Since I can't get an APAP to work at that pressure, I have to have a CPAP pressure of 17cm all the time, even for the times when I only need 11cm. Someone may have a solution for me some time, but this is where I've gotten to in 5 months of testing and tweaking. It's great to come here and learn from people who have been doing this for years, and also newbies because we can all learn something from each other.

I have a theory that at the point that you roll onto the other side, if the pressure need is higher than the top end of the range, you're therapy-less. (That's if you haven't bumped the mask rolling over and sprung a major leak which negates everything). If this theory is right, then you'll eventually find the correct pressure by creeping up in steps, provided the leak is within acceptable levels.

Your thread got me thinking about an aspect of my current problem (Quattro mask leaks)... I have recently moved to using a softer bed (not by choice) and I think it's too soft, making me toss and turn more, increasing the odds of bumping the mask on the pillow. So maybe addressing the bed issue will help - thanks for that.

Bluesky

[janp]

With all due respects to your husbands thoughts, I'd go the other way.......set the upper pressure to 7 and THEN see if you want to try going upwards in 1 cm. increments......cause this range ain't workin' for ya.


Den

Den,

Wouldn't the start at 7 cm put it close enough to the lower 6 cm that it would be pretty much the same as my original CPAP setting?

Question - can I gather anything from the "Daily Events Per Hour"? The 90 percent column (at 10 cm) shows a big reduction in OA from the night before. 72.8 to 49.7.

Thanks.

Jan

Den,

If your still watching ... Update ...

We learned last night that the machine doesn't allow a 1 cm difference in pressure settings. The minimum is 2 cm.

So it was set to 6 min/8 max.

The results were no better.

I may be having a mask issue that is causing leaks (none are major) ... which keeps the machine from doing it's job.

Tonight I'm going to try a different mask with the same setting to see what happens.

Jan



YES! And, that's where it appears you need to be from your reports......6 with a max at 7.

You can still gather "Daily Events Per Hour" with whatever pressure settings you have set in APAP mode. You can even set the minimum and maximum at the same pressure and see whether there are any NR's or FL's, too.

Your OA was about 0.2 for the first two hours on both nights. It wouldn't be 72.8 or even 49.7 if you would keep your pressure from running away in APAP mode.


Den

[Wulfman]

Den,

If your still watching ... Update ...

We learned last night that the machine doesn't allow a 1 cm difference in pressure settings. The minimum is 2 cm.

So it was set to 6 min/8 max.

The results were no better.

I may be having a mask issue that is causing leaks (none are major) ... which keeps the machine from doing it's job.

Tonight I'm going to try a different mask with the same setting to see what happens.

Jan

Kind of "hit & miss"......(it's a busy day).

That means you must be using A-Flex.
Some people have problems with A-Flex.
You could either try C-Flex of turn off either/both. You're at a pressure range where exhale relief is hardly worth it.


Den

[janp]

Den,

If your still watching ... Update ...

We learned last night that the machine doesn't allow a 1 cm difference in pressure settings. The minimum is 2 cm.

So it was set to 6 min/8 max.

The results were no better.

I may be having a mask issue that is causing leaks (none are major) ... which keeps the machine from doing it's job.

Tonight I'm going to try a different mask with the same setting to see what happens.

Jan

Kind of "hit & miss"......(it's a busy day).

That means you must be using A-Flex.
Some people have problems with A-Flex.
You could either try C-Flex of turn off either/both. You're at a pressure range where exhale relief is hardly worth it.


Den

Den,

If a change in mask shows the same results ... I'll try going back to CPAP.

Thanks.

Jan

[Wulfman]

OK. Whatever it is that's going on during the night was only being exacerbated by the APAP/range of pressures. So, until you can determine what that is.......single pressure should not make it worse.

Den

[janp]

OK. Whatever it is that's going on during the night was only being exacerbated by the APAP/range of pressures. So, until you can determine what that is.......single pressure should not make it worse.

Den

Den,

I suspect that you're right ... however, I want to check the leakage against a different mask.

Next step is going back to CPAP.

Thanks.

Jan

[DoriC]

Jan, I just want to jump in here to say that you're lucky to have Den working with you. I was one of the lucky ones too and when I followed his advice carefully I was able to find out pretty quickly what the problems were and correct them. As he knows, when I experimented on my own too soon and too often, I always came back to his original suggestions with success, and he let me think they were my own ideas. Good luck.

[janp]

Jan, I just want to jump in here to say that you're lucky to have Den working with you. I was one of the lucky ones too and when I followed his advice carefully I was able to find out pretty quickly what the problems were and correct them. As he knows, when I experimented on my own too soon and too often, I always came back to his original suggestions with success, and he let me think they were my own ideas. Good luck.

DoriC

Thanks.

I'm headed there.

The mask change is my curiosity at play.

I'll give up one night just to satisfy it.

Jan

[Wulfman]

The advantage of using CPAP mode (single pressure) is that it eliminates a number of variables.


Den

[janp]

The advantage of using CPAP mode (single pressure) is that it eliminates a number of variables.


Den

Den,

Thanks.

Looks like I'm headed back there.

Jan