Auto CPAP management

palerider wrote:

TedVPAP wrote:

palerider wrote:

TedVPAP wrote:It is not surprising that moving up the lower bound will push the 90% number higher since you raised the floor.

that's not what it means.

http://adventures-in-hosehead-land.blog ... de-to.html

Not sure if there is a disagreement. Replace my word of bound with limit. Then is it clear?

no.

raising the minimum doesn't have any direct correlation with the 90% number.

Yes you are correct. I was sitting at work today and realized I screwed-up. It is the pressure at which you are at or below 90% of the time.
I like the stat as it clearly demonstrates the advantage over using a fixed pressure.

Thanks everybody. The explanation that is it <= 90% makes perfect sense that the 90% would creep up as I raised the minimum.
Now I will look into the other suggestions on my move from set pressure to auto to see if I can sleep a little better.
I welcome any other feedback on that subject. I thought auto would allow lower pressures except when needed but I'm just not sleeping that great.
thanks!

Pugsy wrote:

twdc33 wrote:Any ideas why this might be? I

90/95% numbers can vary widely for any number of reasons. Mainly because we don't sleep the same each night for any number of reasons plus they are easily skewed high by the least little bit of time at a higher pressure.

Since you used fixed cpap pressures for a long time it doesn't surprise me that you don't feel like the sleep is as good with the auto adjusting pressures.
Plus you started out at a much lower pressure than you were used to. So your body has been used to one thing and you throw in a bunch of new stuff for it to get accustomed to....might be better to go back to the way it was (or close to it) and ease into changes.

Try setting the machine in apap mode to minimum of 14 and maximum of 14. That will allow it to function like your fixed pressure but still turn on the FL flagging (which is turned off in cpap mode).
See how you do and then if you want to try apap mode try it with a really tight range something close to what you were used to using...like minimum of 13 and max of 15....and gradually open up the range after spending a few nights at the new settings to get the body used to the new settings based on what you see or don't see on the software reports.

Quit worrying about the 90% number...it's just a number that varies a lot and doesn't mean much of anything except maybe long term....like 6 months or more long term.

What is the FL number?

FL...Flow limitations.
Minor flow reductions that don't meet the criteria for a hyponea or obstructive apnea. Think of them as babies trying to grow up to be full fledged OAs or hyponeas. You don't want them to grow up.
In auto (apap) mode FLs and snores play and important part of the auto adjusting algorithm as they are warning signs that the airway is trying to collapse.
So Respironics flags them in auto mode but didn't bother in cpap mode which I think is a bit stupid because there's a reason that auto mode tries to kill them..
But they didn't ask me so we live with it. Easy to turn on the flagging by using auto mode either functioning like a fixed with min to equal max or a tight range.

You might be able to use less pressure parts of the night and make use of the auto adjusting capabilities but you don't have to jump right in to the deep end immediately. Your body is used to one way of expecting things to feel and happen and sometimes the adjustment takes a bit of time.
You can try what you have been using for so long and gently ease into an auto adjusting range if you want to try it. While most people work upwards to find a pressure need you are used to a higher pressure. Nothing says you can't work down if you want to. And you don't have to do it in one night or even one week or one month.

Remember the number one goal...gotta get good sleep in the first place and if this new way of doing things is disrupting the sleep...back off and go back to the way it was and make teeny tiny adjustments if you want to investigate the way auto adjusting pressure works.
Some people are just sensitive to the least little change and nothing wrong with that.
Make small changes and give each small change a few days for the body to adjust.

Pugsy wrote:FL...Flow limitations.
Minor flow reductions that don't meet the criteria for a hyponea or obstructive apnea. Think of them as babies trying to grow up to be full fledged OAs or hyponeas. You don't want them to grow up.
In auto (apap) mode FLs and snores play and important part of the auto adjusting algorithm as they are warning signs that the airway is trying to collapse.
So Respironics flags them in auto mode but didn't bother in cpap mode which I think is a bit stupid because there's a reason that auto mode tries to kill them..
But they didn't ask me so we live with it. Easy to turn on the flagging by using auto mode either functioning like a fixed with min to equal max or a tight range.

You might be able to use less pressure parts of the night and make use of the auto adjusting capabilities but you don't have to jump right in to the deep end immediately. Your body is used to one way of expecting things to feel and happen and sometimes the adjustment takes a bit of time.
You can try what you have been using for so long and gently ease into an auto adjusting range if you want to try it. While most people work upwards to find a pressure need you are used to a higher pressure. Nothing says you can't work down if you want to. And you don't have to do it in one night or even one week or one month.

Remember the number one goal...gotta get good sleep in the first place and if this new way of doing things is disrupting the sleep...back off and go back to the way it was and make teeny tiny adjustments if you want to investigate the way auto adjusting pressure works.
Some people are just sensitive to the least little change and nothing wrong with that.
Make small changes and give each small change a few days for the body to adjust.

Thanks Pugsy. Sounds like excellent advice. I appreciate you pitching in. Sleep well...

TedVPAP wrote:I like the stat as it clearly demonstrates the advantage over using a fixed pressure.

all the 90/95% number is good for is as a 'max' pressure with any short term spikes thrown out.

much like discarding the highest and lowest judges scores in the olympics

palerider wrote:

TedVPAP wrote:I like the stat as it clearly demonstrates the advantage over using a fixed pressure.

all the 90/95% number is good for is as a 'max' pressure with any short term spikes thrown out.

much like discarding the highest and lowest judges scores in the olympics[/quote

but it reminds me that I am no longer at 19cm-H2O 100% of the time. Instead I am less than 17.5 95% of the time. I wish I would have switched to Auto-CAP years ago.

I am still not sleeping well. I set the machine on 14 minimum pressure (which used to be the constant with CPAP), 20 max.
My AHI and other disturbances are several times higher. Still low compared to some, but since I seem to have insomnia as well, waking does not
bode well.

twdc wrote:

Pugsy wrote:FL...Flow limitations.
Minor flow reductions that don't meet the criteria for a hyponea or obstructive apnea. Think of them as babies trying to grow up to be full fledged OAs or hyponeas. You don't want them to grow up.
In auto (apap) mode FLs and snores play and important part of the auto adjusting algorithm as they are warning signs that the airway is trying to collapse.
So Respironics flags them in auto mode but didn't bother in cpap mode which I think is a bit stupid because there's a reason that auto mode tries to kill them..
But they didn't ask me so we live with it. Easy to turn on the flagging by using auto mode either functioning like a fixed with min to equal max or a tight range.

You might be able to use less pressure parts of the night and make use of the auto adjusting capabilities but you don't have to jump right in to the deep end immediately. Your body is used to one way of expecting things to feel and happen and sometimes the adjustment takes a bit of time.
You can try what you have been using for so long and gently ease into an auto adjusting range if you want to try it. While most people work upwards to find a pressure need you are used to a higher pressure. Nothing says you can't work down if you want to. And you don't have to do it in one night or even one week or one month.

Remember the number one goal...gotta get good sleep in the first place and if this new way of doing things is disrupting the sleep...back off and go back to the way it was and make teeny tiny adjustments if you want to investigate the way auto adjusting pressure works.
Some people are just sensitive to the least little change and nothing wrong with that.
Make small changes and give each small change a few days for the body to adjust.

Thanks Pugsy. Sounds like excellent advice. I appreciate you pitching in. Sleep well...

Pugsy, FLOW LIMITATION: Was .04 with old machine now it is .4 for the last 20 days with the new one.

twdc33 wrote: Pugsy, FLOW LIMITATION: Was .04 with old machine now it is .4 for the last 20 days with the new one.

What brand non auto cpap were you using to get .04 FL numbers?
It wasn't Respironics because their non auto cpaps don't give any numbers at all for FLs.
Since it must have been a different brand you can't really compare the numbers because different brands can have different definitions and different algorithms. Apples and oranges comparison so not quite fair.

Pugsy wrote:

twdc33 wrote: Pugsy, FLOW LIMITATION: Was .04 with old machine now it is .4 for the last 20 days with the new one.

What brand non auto cpap were you using to get .04 FL numbers?
It wasn't Respironics because their non auto cpaps don't give any numbers at all for FLs.
Since it must have been a different brand you can't really compare the numbers because different brands can have different definitions and different algorithms. Apples and oranges comparison so not quite fair.

It was Respironics system one. Maybe the FL readings in Sleepyhead for it are an artifact. Are the new FL numbers significant in any way?

twdc33 wrote:FLOW LIMITATION: Was .04 with old machine now it is .4 for the last 20 days with the new one.

For me, as long as my FL + AHI < 1 I feel good.

twdc33 wrote:It was Respironics system one. Maybe the FL readings in Sleepyhead for it are an artifact. Are the new FL numbers significant in any way?

Flow limitation numbers aren't available unless in auto mode on Respironics machines.
SleepyHead only reports what the machine gathers.
And the new numbers aren't significant anyway. Less than 1 per hour average...not a big deal unless all within a short period of time and in a very dense cluster and then if it happens often we might do something.