Noob to CPAP and Group. AHI in the 50's...

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Pugsy
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Re: Noob to CPAP and Group. AHI in the 50's...

Post by Pugsy » Tue Nov 24, 2015 6:52 pm

Oh those numbers.

Here's the short version.
EPAP ...that's the starting point for treating the obstructive apneas...very similar to the minimum pressure setting in apap mode. It still needs to be high enough to hold the airway open and prevent the airway collapse for the bulk of the night. It needs to be able to get to where it needs to be quickly enough. Too low and too many OAs will slip past the defenses.

PS is the difference between inhale and exhale. With your machine the lowest it can be is 3 but it can go to 15 when it needs to in order to breathe for you when you experience a central apnea...so we need it wide open but the machine only uses what it thinks it needs to use.

If your EPAP was 10 with PS of 3 then you would experience 10 EPAP and 13 IPAP but when a central happens the machine could in theory make that PS of 3 go to PS of 15 and then you would have EPAP 10 and IPAP of 25....that's the big pressure bursts you sometimes feel when drifting off.
It may or may not utilize the full 15 PS.

Here's the long version.
For a different machine than yours (sorry I lost my ResMed one) but the basics are the same.'
http://www.isetonline.org/yahoo_site_ad ... 190318.pdf

The minimum PS choice of 3..it could also be 4 or 5 and while 5 might be okay if your EPAP was 5..it might not feel so good if EPAP was 10.

So essentially we let the machine do its thing for the centrals and help it out in terms of OAs with that EPAP number which needs to do its job of holding the airway open most of the time.

Clear as mud?

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Re: Noob to CPAP and Group. AHI in the 50's...

Post by metsfan302 » Fri Nov 27, 2015 6:45 am

I guess I should wait to make an adjustment again, but looks like with that change I just can't get my AHI below 5. However under 10 is great for me, and my sleeps are alot more rested thats for sure with this new to me Asv!

Image

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Re: Noob to CPAP and Group. AHI in the 50's...

Post by Pugsy » Fri Nov 27, 2015 9:03 am

I wouldn't wait too long if it were me.
Based on the various experiments we made with the apap machine and trying lower pressures to see if the centrals reduced and the increase in OAs when we went lower...I am not surprised that your EPAP needs to be a little more. I was hoping that you could get by with lower EPAP but that doesn't appear to be the case.
You get the same "pressure needs change" speech as apap users...the 2 main factors for varying pressure needs to deal with OAs are supine sleeping or REM sleep or maybe a little of both.

I would go up slowly though and in small increments and give each change a minimum of 4 or 5 nights.
Small increments around 0.5 cm which with the S9 happens to be either 0.4 or 0.6 since it doesn't offer 0.5.

With your apap you needed a minimum of 12 I think it was to do a good job preventing the OAs...so it wouldn't surprise me if you needed EPAP 10 or 11 or 12 with the Adapt but go slow. It will be an easier adjustment and we might get lucky and not need quite as much as you did with the apap.

And yes...less than 10 AHI is still a huge improvement over what it was but we can still try to reduce the OAs a little more.

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Re: Noob to CPAP and Group. AHI in the 50's...

Post by metsfan302 » Fri Nov 27, 2015 9:45 am

So epap should go from 9.0 to say 9.4 or 9.6

How about the min ps I have it at 4.0 / max 16
Any additional adjusts on those?

Thanks!

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Re: Noob to CPAP and Group. AHI in the 50's...

Post by Pugsy » Fri Nov 27, 2015 9:54 am

Change EPAP only..that's what we are using to deal with the OAs.
Don't change PS...that's what is used to deal with centrals primarily and secondary help to OAs with the IPAP that PS generates. It's always going to be at least 4 cm above whatever EPAP is doing.
You don't want PS to be too great all the time (like PS of 10 to 15) because that can actually trigger centrals...makes us sort of hyperventilate.
You want PS to be comfortable and low most of the time and have it go high only when breathing for you.

Besides...rule number one when making any changes....only change 1 thing at a time so that you can better evaluate results.

I would go with a 0.6 change and see what happens and as the AHI comes down closer to 5 then maybe try 0.4.
Fine tuning things.
You do need to give each change a few nights to see what the trend is. This is especially true with ASV machines.

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Re: Noob to CPAP and Group. AHI in the 50's...

Post by metsfan302 » Sun Nov 29, 2015 11:12 am

My last night - Go figure I forgot to put back in my SD card so its not detailed

Image

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Re: Noob to CPAP and Group. AHI in the 50's...

Post by Pugsy » Sun Nov 29, 2015 8:40 pm

metsfan302 wrote:My last night - Go figure I forgot to put back in my SD card so its not detailed
It's the aliens ...they do that because you left the card out so they give you some really, really good results but nothing to look at just to mess with you. I can't count the number of times they did that to me...they trick me into forgetting to put the card back in the machine and then they give me some awesome looking snip of a report to look at. It's when you want to see the details the most that you don't have them.

Or like recently...I forgot to pull the data card before some older data got written over...so I have my share of those blank sheep pages myself just recently.
I am just lazy and don't pull the card at least once a week...makes me sometimes wish I had devoted some time to learning how to do the Flash Pap WiFi thingy with one of those special SD cards but geezz...I look at the directions and immediately my eyes roll back in my head and I have "too much work" seizure

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Re: Noob to CPAP and Group. AHI in the 50's...

Post by metsfan302 » Mon Nov 30, 2015 4:19 am

Yea I am going to get the wifi card. Those directions though. Atleast there was no mention of a tin foil hat

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Re: Noob to CPAP and Group. AHI in the 50's...

Post by metsfan302 » Mon Nov 30, 2015 6:28 am

It's the aliens ..

well you would think I would not forget to put the SD Card back into the machine after that, nope

or

The alien's took it out again

Last Night
Image

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Re: Noob to CPAP and Group. AHI in the 50's...

Post by Pugsy » Mon Nov 30, 2015 6:41 am


You might want to utilize the 2 card system to fool the aliens.
One card in the S9 at all times...don't remove that card until you have the other card in your hand to slide immediately into the slot.

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Re: Noob to CPAP and Group. AHI in the 50's...

Post by metsfan302 » Mon Nov 30, 2015 7:26 am

you are wise beyond your years - if thats the right statement.

I just ordered a wifi card - should be here by weeks end.

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Re: Noob to CPAP and Group. AHI in the 50's...

Post by metsfan302 » Sat Dec 05, 2015 6:49 am

Here is a screenshot of last night, it was about the same the past week. Was not sure if I can fine tune any setting?

Its set at -

Epap - 9.6

Ps- 4-15

Image

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Re: Noob to CPAP and Group. AHI in the 50's...

Post by metsfan302 » Fri Dec 18, 2015 4:49 am

Was unsure to make a new thread or jujst keep posting to this one....

Looking to "fine tune" my settings, I am alot better off then I use to be thats for sure, but feel can get the ahi even lower?

Current settings are on the screenshot

Image

Any idea's?

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Disappointed

Re: Noob to CPAP and Group. AHI in the 50's...

Post by Disappointed » Wed Jan 13, 2016 4:41 pm

sorry to hear your having a hard time.
I had a study done .....stop breathing 43 times an hour.
after two weeks my average is 12 per hour
I can usually sleep 5 to 6 hours a night.
I felt great before I found out I had sleep apnea.
Now I'm extremely tired all the time.
I'm told this will change and I'll feel good.......hope so.

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Re: Noob to CPAP and Group. AHI in the 50's...

Post by Mudrock63 » Wed Jan 13, 2016 5:11 pm

Hang in there, Metsfan. I think we've been at this about the same amount of time. After much tweaking, I'm down to 5.0-6.0 AHI/night. Still working at it. I was stuck in the 9.0-11.0 AHI range for a while. Still felt way better than I did without treatment. Still plugging away, trying to get it down as far as I can.

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