Changing minimums

After 4 months on APAP, I had been sleeping great and Sleepyhead showed minimal events. The past few days I haven't slept very well and checked my sleepyhead report and it showed more events (AHI over 5). I bumped up my minimum from 11 to 12 and AHI's back down to minimum ( under 1). My questions is does it happen often that you need to change your minimum pressure and do you eventually change it back? I don't have a cold, haven't gained weight, not taking any new medications so I'm not sure what changed.

Sleeping position may have changed or maybe more REM stage sleep and either one of those could cause a need for a little more pressure.

Thanks. My pressure graph on sleepyhead, prior to last night, showed my pressures all over the place. This morning it showed an even up and down, breathing pressure.

First rule; don't argue with success!

D.H. wrote: ↑

Wed May 23, 2018 11:44 am

First rule; don't argue with success!

What?

dreamingofdreaming wrote: ↑

Wed May 23, 2018 11:54 am

D.H. wrote: ↑

Wed May 23, 2018 11:44 am

First rule; don't argue with success!

What?

That's a poor question to ask D.H. Jim About most things.

APAP's work best set at a controlled range of about 4 cm, using Sleepyhead as a guide on what's happening. Without seeing what's going on it's hard to suggest, 12 to 15 cm would be good to start, but using a nasal mask you want to keep your leak rate under control, many people just let their treatment leak out of their mouths. Sleepyhead info at bottom of my sig.

dreamingofdreaming wrote: ↑

Wed May 23, 2018 11:54 am

D.H. wrote: ↑

Wed May 23, 2018 11:44 am

First rule; don't argue with success!

What?

You reported that raising the minimum cut your AHI way down. Whether or not I would have recommended doing that matters less than the fact that it's working. If your AHI is where below 1, then leave it there unless that ceases to be the case.

dreamingofdreaming wrote: ↑

Wed May 23, 2018 11:01 am

. My questions is does it happen often that you need to change your minimum pressure and do you eventually change it back?

Your body has a lot of variables that subtly effect your sleep, so there's nothing precision about the whole 'treating your body' thing in medicine... (part of the reason that all lab results have a range of "yeah, it's ok in there somewhere"). Things change... you just need to tweak on it.

Your machine is less responsive than some others, and thus needs to be watched a bit more closely.

All that said, a little extra starting pressure won't hurt anything... so yeah, you may need to raise the pressure for unknown reasons, but it's unlikely there's a *need* to lower it afterwards... other than a possible desire to just keep the minimum as low as possible.

Thank you. I did notice when I was looking at my reports for the past few weeks that I see some events that show up OA's & H's and my pressure wasn't changing from those events. I was wondering about the responsiveness of my machine.

dreamingofdreaming wrote: ↑

Wed May 23, 2018 12:44 pm

Thank you. I did notice when I was looking at my reports for the past few weeks that I see some events that show up OA's & H's and my pressure wasn't changing from those events. I was wondering about the responsiveness of my machine.

Mine does go higher, sometimes. I did raise the floor from 13 to 13.5 a while back. That seems to have made me more comfortable. I don't think it changed my numbers though.

dreamingofdreaming wrote: ↑

Wed May 23, 2018 12:44 pm

Thank you. I did notice when I was looking at my reports for the past few weeks that I see some events that show up OA's & H's and my pressure wasn't changing from those events. I was wondering about the responsiveness of my machine.

Here's an example of what you're seeing:

https://www.youtube.com/watch?v=lzCCgNLya_g

The algorithm's haven't changed in the latest versions of the machines, so that demonstration is still applicable.

Thank you. I guess when it's time for a new machine, I'll be looking for something else.

It is my understanding that different algorithms match up to individuals differently. Each brand has its particular bell curve of OSA population that it aims for the middle of. Brands, for proprietary and patent reasons, "listen" for slightly different things to make the decision about raising and lowering pressure. If your breathing isn't "saying" what the machine is "listening" for to decide to raise pressure, it won't. So it may be that another brand will respond in a somewhat different way for you, yes. But it also may be possible, much as you have already done, to find a way to get good treatment with a change in the adjustment choices for minimum pressures with the machine you have. The spin on advantages and disadvantages to algorithms may change depending on who makes the comparison video. Although my personal experience is that ResMed is more comfortable and responsive for me, I would like to believe that there are those who find other brands' approaches better for them. Problem is, we as patients, unfortunately, are rarely ever in a position to find out what machine or brand works best for us, so we are often stuck using the tool at hand to get the job done as well as we can.

I use both the ResMed VAUTO 10 and the Respironics 760 with very close results at the same settings. Both have different advantages. I started with the Respironics and was glad I did because I needed to travel on battery power and the 12 volt made that simpler. I was able to buy the ResMed from a forum member and it is my every night at home machine. I feel a little more comfortable with The ResMed but not enough to ditch the Respironics when I need it's convenience. You can usually adjust the settings to get the therapy you need.