Would someone take a look at my data?

I've had my CPAP (ResMed 10 Autoset) for about 4 months. Had my follow-up with my sleep doc about a month ago and he was satisfied, but I didn't get the impression he looked too deep into the data or wanted to mess with it - "good enough" was good enough. So...I'd love if someone would look at my data and suggest any adjustments.

Should I post Sleepyhead screenshots? Data files from the SD card?

Thanks!

Here are screenshots of a few typical nights:

Could you omit the Mask Pressure graph and maybe include the Flow limitation graph from a night of your choice?

Off hand it looks like the minimum pressure is not quite optimally set. Technically it is probably "acceptable" but if it were me I would probably want to try to reduce the clustering of OAs and hyponeas a little.

How are you doing in terms of sleep quality and how you feel? Any major problems?

also, could you not shrink the screenshots? they're too small to read the numbers, and trying to blow them up just results in fuzz.

https://sleep.tnet.com/reference/tips/imgur

Ok, here are all three again without resizing:





As far as how I feel goes...I'd say the biggest impact so far has been that my mood and concentration are generally better and getting out of bed in the morning is usually not quite as miserable. I still seem to need a lot of sleep (preferably 9+ hours) and when I get less I'm noticeably tired, especially toward the end of the work day. I come home and want to collapse.

Thanks so much for your help.

The flow limitation graph is a bit "busy" but not horribly so. I have seen worse and I have seen better.
It may or may not be clinical significant at this time.

In general the pressure once it goes up to around 10 cm it never seems to really come back down much and goes up and down from there.
If it were me I would maybe try to reduce the OAs and hyponeas a little and more minimum pressure is probably what is needed. I am not sure just how much more but probably something around 10 to 12 cm minimum.
Since that is a pretty big jump from 5.2 cm minimum I think I would try going up in 1 or 2 cm increments if it were me. It would be a little easier adjustment to go up slowly and maybe wouldn't need as much as first initially thought.

It's not something that is critical as the AHI is probably technically acceptable when going by the "less than 5.0" standard...it's pushing it a bit.
That AHI and the flow limitation graph points to the airway trying to still collapse to some extent and if it were me I would probably at least try to reduce those factors if I could.

I will try increasing it over the next few nights.

What about pressure relief? I currently have it set at 1. Might turning it off completely improve things?

Your EPR is set to 1 and that's really not a huge amount of reduction. Just 1 cm on exhale and I doubt that reduction will alter the overall average pressures all that much. You could try reducing it which would mean turning it off but if you like EPR I see no reason to not use it and just increase the pressure because I think that it's going to take more of an increase than the 1 cm EPR is giving you on exhale only.
Your choice and you can make that choice solely on how things feel to you while awake. Comfort.
If we aren't comfortable we don't sleep so great and sleeping is the primary goal. It's a choice though and one you can experiment with to see what happens.

Pugsy wrote:Since that is a pretty big jump from 5.2 cm minimum I think I would try going up in 1 or 2 cm increments if it were me. It would be a little easier adjustment to go up slowly and maybe wouldn't need as much as first initially thought..

here's one place where we do differ in suggestions, I feel that since he's spending most of his night at over 10 already, and the machine ramps up to those pressures very quickly when flow limits start, I'd say just go ahead and set pressure minimum at 10, and see how things work

but you know me, gung ho and all that

palerider wrote: but you know me, gung ho and all that

Yeah...I know

I once went from 10 cm minimum to 13 cm minimum...It was a big jump and uncomfortable for me and I caused problematic sleeping for me. So I backed down and went up in 0.5 cm increments over a few weeks and it was a much easier adjustment and I slept better.

If someone is totally comfortable with making a big step forward then hey...go ahead and do it but not at the cost of poor sleep or not being able to get to sleep in a reasonable time frame.
What we end up using during the night doesn't mean that we necessarily wouldn't have a problem starting out that way. I use 22 cm a lot...I sure wouldn't want to start the night anywhere near that number. There is a reason I love my high dollar machine...it lets me start out the night REALLY low and that is SO much more comfortable than higher. My awake breathing time on the machine is important to me even though I don't spend much time awake.

Plus...there is always the remote chance that if the pressure was more optimally set that the pressure might not go so high anyway.
I doubt that we will see that happen here based on what the pressure appears to be doing...but you never know till you try.
I really don't care myself. I just mention it and throw it out there because for some people that big of a jump would cause some problems sleeping and if it did...it hurts nothing at all to go up more slowly.

Pugsy wrote:

palerider wrote: but you know me, gung ho and all that

Yeah...I know

I once went from 10 cm minimum to 13 cm minimum...It was a big jump and uncomfortable for me and I caused problematic sleeping for me. So I backed down and went up in 0.5 cm increments over a few weeks and it was a much easier adjustment and I slept better... it hurts nothing at all to go up more slowly.

I completely agree, and understand, but in this case, the only time his pressure is below 10 (at least on those three nights) is before he goes to sleep... then zoop, up high, and on a couple of occasions, it gets back down to 10.

as you say though, going up slow won't hurt anything, though.

Since auto is a range, there's plenty of wiggle room.

Ok! I had my first night at 10cm. AHI still 4.04. With 9.4cm a couple nights earlier, AHI was 2.88. So, probably an improvement over where I was, but I would still love to get consistently under 2, since I've read a number of reports of people saying that's when they really noticed major improvements. Too much to ask? Suggestions?




Thanks so much for all your help. Great to have knowledgeable people who are willing to lend a hand out of kindness.