Will increasing pressure fix hypopneas?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
User avatar
pspearsjr
Posts: 16
Joined: Wed Aug 27, 2014 2:04 pm

Re: Will increasing pressure fix hypopneas?

Post by pspearsjr » Fri Aug 29, 2014 6:20 am

I'm still seeing improvements with the changes we made. I have never had my AHI this low. Is this as good as it gets or should I fine tune further? Do you think I should set the maximum pressure to 14 and try it?

Image

_________________
Mask
Additional Comments: RemStar Auto with A-Flex (550P)

User avatar
Pugsy
Posts: 63941
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: Will increasing pressure fix hypopneas?

Post by Pugsy » Fri Aug 29, 2014 6:50 am

It still wants to max out at 12 around the period of time when you see the snores cluster.
A little more snore clusters are seen than I personally would like.
If it were me I would increase the minimum 0.5 cm and probably the same with the maximum. You are real close to the optimal settings. Small changes now and we probably should give the changes more than one night because we don't sleep the same each night.
Not sure why the clusters but I suspect either you are ending up on your back during those times or they are REM sleep stage related.

Did you sleep decently last night? Feeling okay so far today?

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
I may have to RISE but I refuse to SHINE.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

User avatar
pspearsjr
Posts: 16
Joined: Wed Aug 27, 2014 2:04 pm

Re: Will increasing pressure fix hypopneas?

Post by pspearsjr » Fri Aug 29, 2014 7:48 am

To be honest the past few days I have felt better than I have for a long time. Yesterday was the first day I felt like going for a walk in at least a year. The past few days don't show all the success I have recently had. My new nasal pillows has allowed me to sleep all night without knocking it off and that has made a huge difference in the way I feel. Before that I would put it on at bedtime and within 1-4 hours I would take it off.

Things are looking up!

I will try .5 adjustment you suggested and sleep with it until Monday and post my results then.

_________________
Mask
Additional Comments: RemStar Auto with A-Flex (550P)

User avatar
pspearsjr
Posts: 16
Joined: Wed Aug 27, 2014 2:04 pm

Re: Will increasing pressure fix hypopneas?

Post by pspearsjr » Sat Aug 30, 2014 6:42 am

I'm still improving with your suggestions. Thinking of increasing the minimum and maximum another .5 tonight. Thoughts?
Friday Night.
Image

_________________
Mask
Additional Comments: RemStar Auto with A-Flex (550P)

User avatar
Pugsy
Posts: 63941
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: Will increasing pressure fix hypopneas?

Post by Pugsy » Sat Aug 30, 2014 8:11 am

Use this pressure a couple more nights and if the snores still show up like this....
If you are are sleeping great and feeling decent there's no urgent need to increase the pressure another 0.5 cm but you could do that if you wish and the snores will likely reduce further.
Looks like maybe those snores loosely correlate with time frames where we would expect a person to be in REM stage sleep..and/or maybe on your back.

How's the sleep been? Feeling decent?

If the pressure changes don't seem to be bothering your sleep you might open up the max a little more without increasing the minimum and see where it wants to go.
When I was using the APAP machine I used 10 cm minimum but had the max at 20 because sometimes my REM events just needed a lot more pressure but it wasn't every night. I would often see the pressure go to 18 cm or so for brief periods of time and other nights it wouldn't vary much above the 10 cm. The changing pressures from 10 to 18 never disturbed my sleep though. It does disturb sleep for some people. So it's kind of a judgement call you get to make for yourself.
A little more max (see that little bit of flat line at the max) might just take care of things or you could do another 0.5 cm minimum increase. Again there isn't an urgent need to change either if you are sleeping great and feeling great.....so you can also give things a little more time to make sure it doesn't get any worse.

You are at the point where we are just fine tuning things based on your sleep quality and what you are happy with on your reports.
I think if it were me and the pressure changes didn't disturb sleep I would just increase the max and let the machine do it's job.
Whether it is supine sleeping or REM stage sleep...just let the machine deal with it.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
I may have to RISE but I refuse to SHINE.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

User avatar
pspearsjr
Posts: 16
Joined: Wed Aug 27, 2014 2:04 pm

Re: Will increasing pressure fix hypopneas?

Post by pspearsjr » Sat Aug 30, 2014 10:02 am

The Sleep is much much better. I don't sleep on my back at all. I flip from side to side. I will keep it the same tonight and we will see how it looks tomorrow.

_________________
Mask
Additional Comments: RemStar Auto with A-Flex (550P)

User avatar
pspearsjr
Posts: 16
Joined: Wed Aug 27, 2014 2:04 pm

Re: Will increasing pressure fix hypopneas?

Post by pspearsjr » Sun Aug 31, 2014 7:13 am

Saturday night. After increasing max to 13. I was having an epic snore session that made me wake up.

Image

_________________
Mask
Additional Comments: RemStar Auto with A-Flex (550P)

User avatar
palerider
Posts: 32300
Joined: Wed Dec 16, 2009 5:43 pm
Location: Dallas(ish).

Re: Will increasing pressure fix hypopneas?

Post by palerider » Sun Aug 31, 2014 9:48 am

maybe now's a good time to get your equipment fixed?

what model cpap do you have? could you take the water tank out and look on the back, or bottom, for a sticker with a REF or model number on it? (many modern ones say REF instead of 'model')

_________________
Mask: Bleep DreamPort CPAP Mask Solution
Additional Comments: S9 VPAP Auto
Get OSCAR

Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.

User avatar
Pugsy
Posts: 63941
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: Will increasing pressure fix hypopneas?

Post by Pugsy » Sun Aug 31, 2014 12:20 pm

You have a choice about the snores. Either a little more minimum or a little more maximum. Whichever let's you sleep the best or whichever ever way you want to go.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
I may have to RISE but I refuse to SHINE.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

User avatar
pspearsjr
Posts: 16
Joined: Wed Aug 27, 2014 2:04 pm

Re: Will increasing pressure fix hypopneas?

Post by pspearsjr » Sun Aug 31, 2014 8:48 pm

I'm not sure what you mean by get my equipment fixed. I have a Respironics Remstar Auto System One and the REF says 550P on it. Are you saying I need to fix it in the software somewhere? Sleepyhead is picking up the correct cpap machine. For some reason the little icon will not show up here for it.
palerider wrote:maybe now's a good time to get your equipment fixed?

what model cpap do you have? could you take the water tank out and look on the back, or bottom, for a sticker with a REF or model number on it? (many modern ones say REF instead of 'model')

_________________
Mask
Additional Comments: RemStar Auto with A-Flex (550P)

User avatar
palerider
Posts: 32300
Joined: Wed Dec 16, 2009 5:43 pm
Location: Dallas(ish).

Re: Will increasing pressure fix hypopneas?

Post by palerider » Sun Aug 31, 2014 10:01 pm

pspearsjr wrote:I'm not sure what you mean by get my equipment fixed. I have a Respironics Remstar Auto System One and the REF says 550P on it. Are you saying I need to fix it in the software somewhere? Sleepyhead is picking up the correct cpap machine. For some reason the little icon will not show up here for it.
palerider wrote:maybe now's a good time to get your equipment fixed?

what model cpap do you have? could you take the water tank out and look on the back, or bottom, for a sticker with a REF or model number on it? (many modern ones say REF instead of 'model')
look at the bottom of your posts, you have the wrong humidifier picked, and possibly the wrong system in your equipment list on your profile here.

make sure that the cpap says "blah blah system one auto blah blah" and the humidifier says "blah blah system one".

not 60 series though.

don't feel bad though, the equipment listing here is really confusing.

proably easier just to put 'PRS1 550' in the comments section

_________________
Mask: Bleep DreamPort CPAP Mask Solution
Additional Comments: S9 VPAP Auto
Get OSCAR

Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.

User avatar
Pugsy
Posts: 63941
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: Will increasing pressure fix hypopneas?

Post by Pugsy » Mon Sep 01, 2014 9:22 am

Your equipment profile points to a humidifier that was discontinued in 2007.

Since you have the model 550 PR System One Auto I think the link to that choice is broken.
I think that the link to the combination Machine and humidifier may still work.

Try this choice. It works for me right now.
PR System One Remstar Auto Cpap with AFlex.

The correct choice for humidifier would be PR System One Heated humidifier.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
I may have to RISE but I refuse to SHINE.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

User avatar
pspearsjr
Posts: 16
Joined: Wed Aug 27, 2014 2:04 pm

Re: Will increasing pressure fix hypopneas?

Post by pspearsjr » Mon Sep 01, 2014 11:14 am

Sunday night I had increased my minimum by .5. It looks like I'm maxed out at 13 during my snore sessions. Also it appears that the Hypopneas I'm having coincide with my snoring. I slept well though.

Image[/quote]

_________________
Mask
Additional Comments: RemStar Auto with A-Flex (550P)

User avatar
Pugsy
Posts: 63941
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: Will increasing pressure fix hypopneas?

Post by Pugsy » Mon Sep 01, 2014 11:44 am

If you are sleeping well and feeling good there may not be any real need to do anything with those snores.
For whatever reason (either REM sleep or supine sleep) those little buggers are tough to prevent. Obviously the machine wants to still go higher. You may be like I was when I was on the APAP. For brief periods of time I needed 18 cm or so to hold the airway open and prevent those snore clusters and the rest of the time 10 or 11 minimum did a great job. That's why I opened up the maximum and just let the machine do what it wanted to do.
The changing pressures never bothered my sleep though so it wasn't an issue for me. For others it can cause issues...like disturbing the sleep or increase the chances for aerophagia issues. Painful aerophagia issues would take precedent over a few snores that I slept through. Sometimes we have to make compromises. if I had experienced issues with a wide open maximum I would have reined in the max a little.

Since snores and flow limitations are part of the apap algorithm and something the machine sees as unwanted it will try to increase the pressure to prevent them. It's a 2 fold response..the minimum as a baseline starting point and the maximum as to where it can go if it could go. Snores and flow limitations are signs that the airway is trying to collapse but it doesn't always collapse to the point that the real deal OA or hyponea gets flagged. If you weren't feeling better we would probably be a little more aggressive in what we did with them but at this point you have the luxury of playing a little with very minor tweaks to see if you can find a sweet spot that works most of the time. There will always be a few times that it seems like nothing wants to work well...like when I have clusters of OAs but those are rare and for the majority of the time my baseline pressures work very well.
Even now with the Adapt and its ability for rapid response times I will sometimes have some ugly clusters and even an occasional AHI in the 5 to 6 range due to some really ugly clusters but 99% of the time I don't see them. I know that sometimes I need a little more baseline pressure (EPAP for my current machine) but it is so rare that I just haven't bothered.
FWIW...I can't tell much of a difference in how I feel going on just the AHI numbers. How I feel is dependent much more on hours of sleep and quality of sleep in general.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
I may have to RISE but I refuse to SHINE.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

User avatar
pspearsjr
Posts: 16
Joined: Wed Aug 27, 2014 2:04 pm

Re: Will increasing pressure fix hypopneas?

Post by pspearsjr » Tue Sep 02, 2014 6:41 am

I did increase the top number another .5 to 13.5 last night. The pressure doesn't bother me at all so far. To me it looks like the top pressure might be stopping the snores. It looks like I'm only snoring until the machine ramps up. Thoughts?

I have always been a mouth breather but since I have gotten the nasal pillows my wife has noticed me sleeping with my mouth closed even without the cpap mask on.

Image

_________________
Mask
Additional Comments: RemStar Auto with A-Flex (550P)