New Here and need support/advice

Pugsy wrote:If apap pressures of 8 to 15 are getting the job done...and he isn't going to have to give up his current machine....how about just smiling and saying "thank you" and continue doing what you have been doing?

I don't know where the doc is coming up with the 15 or greater than 20 pressure needs...maybe something in the 95% pressures is leading him in that direction. It would be really helpful to see a couple of typical reports and that would mean don't include any reports while he had the cold symptoms because when we are ill the reports and pressure needs aren't typical and we can't base normal needs on report from when we have been sick (with any illness not just upper respiratory illnesses).

I am very thankful that he seems to be getting better. He was scheduled for another "check up - sleep study" to determine if he can and will go back to work...basically a follow up. I can't help it that I am still curious what was so alarming to this doctor.

I'm going to try and post the screenshot but I really have to apologize because I don't think I have this down. I am still learning. He was on the very tail end of the cold on this night but still, with that, he reported having a very good night.

If the doctor is basing the 15 cm recommendation off the machine's software reports I think I see why he is saying the 15 cm...the 95% pressure is up close to 15 but I am also betting that he doesn't really realize the whole definition for a 95% number (be it pressure or leak or whatever). The complete definition is....where the machine is at OR BELOW for 95% of the night. People often forget or tend to overlook the "or below" part of the definition. I am betting this is where the doctor has come up with that number.

I don't even see the need for 15 cm if going to straight cpap mode at this point...maybe something around 11 or 12 if going to fixed cpap mode which is more in line with the median pressure.
15 cm is going to be overkill for the majority of the night. If his AHI was a lot higher...yeah but it's next to nothing right now.

I don't see any need to change anything if most reports look like this one....and being the rebel that I am...I wouldn't be going with 15 cm fixed for sure. I would quietly thank the doctor and go home and proceed to do what I wanted to do.
Now if the changing pressures were disturbing his sleep or causing leaks...then yeah...maybe a little more pressure but based on what you have said ....I wouldn't change a thing if it were me and this was my report or my husband's report. Unless the reports are a whole lot worse than this...there's simply nothing to fix nor is there anything to be gained by using 15 cpap...and there's a whole lot of potential problems with using 15 cm all night with comfort being one of the biggies.

Pugsy wrote:If the doctor is basing the 15 cm recommendation off the machine's software reports I think I see why he is saying the 15 cm...the 95% pressure is up close to 15 but I am also betting that he doesn't really realize the whole definition for a 95% number (be it pressure or leak or whatever). The complete definition is....where the machine is at OR BELOW for 95% of the night. People often forget or tend to overlook the "or below" part of the definition. I am betting this is where the doctor has come up with that number.

I don't even see the need for 15 cm if going to straight cpap mode at this point...maybe something around 11 or 12 if going to fixed cpap mode which is more in line with the median pressure.
15 cm is going to be overkill for the majority of the night. If his AHI was a lot higher...yeah but it's next to nothing right now.

I don't see any need to change anything if most reports look like this one....and being the rebel that I am...I wouldn't be going with 15 cm fixed for sure. I would quietly thank the doctor and go home and proceed to do what I wanted to do.
Now if the changing pressures were disturbing his sleep or causing leaks...then yeah...maybe a little more pressure but based on what you have said ....I wouldn't change a thing if it were me and this was my report or my husband's report. Unless the reports are a whole lot worse than this...there's simply nothing to fix nor is there anything to be gained by using 15 cpap...and there's a whole lot of potential problems with using 15 cm all night with comfort being one of the biggies.

Yes now I see what you are taking about exactly. God thank you so so much. We will see what tonight and tomorrow bring and I have to agree with you....if it ain't broke...

I have to admit that I am not impervious when it comes to these alarmist doctors sometimes.

BTW...the mask covers, lotion and all that you all have recommended have been SUCH a help. I cannot thank you all enough:)

next time you post a screenshot, remove the AHI chart, it's pretty useless

pugsy, how about a little more base pressure? most of the night was spent above the base, but not a lot above it, it might cut down events a little more, though things are, as sleepyhead says 'pretty darn good'.

palerider wrote:pugsy, how about a little more base pressure? most of the night was spent above the base, but not a lot above it, it might cut down events a little more, though things are, as sleepyhead says 'pretty darn good'.

I wouldn't unless the changing pressures bugged me. Or if that tiny cluster bugged me maybe.
It's probably a REM cluster and coming from someone who has seen a lot of REM clusters..unless I saw them often like that and more than 1 per night or uglier than that...I wouldn't worry about them.
Meaning I wouldn't do anything based on this report. He's coming off being sick for one thing and the other is that if it is REM related it may or may not be something that happens often.
And yeah while he does spend most of the night up there a little bit it once it goes up there it sort of stays up there with not a lot of huge bouncing around going on.

So on this report...with an AHI that is really pretty darn good and prior reports of AHI being less than 1.0...I wouldn't do anything.
I don't like to do anything based on 1 report anyway. Especially when someone has been ill.
It is something to consider if the clusters bug someone and they are persistent or occur more often...one of those little "tweaks" that someone could do once they have a good handle on their own therapy.

I would want to see more reports when totally well from the upper respiratory illness before offering more than sitting on the fence. Would it hurt anything? Of course not. Would it help anything? I don't know...did I ever tell you about my experiment with minimum of 10 and taking it to 13 minimum when on APAP? The AHI never changed at all. From 9 to 10 appreciable improvement in AHI but between 10 and 13 (used 0.5 cm increments for 1 week at each setting) the AHI never changed beyond what would be a normal variance anyway. More doesn't always mean an appreciable reduction...and my AHI back then was not nearly as low as her husband's AHI here.

Sandramae wrote:
Yes now I see what you are taking about exactly. God thank you so so much. We will see what tonight and tomorrow bring and I have to agree with you....if it ain't broke...

I have to admit that I am not impervious when it comes to these alarmist doctors sometimes.

It's hard to believe that you might know nearly as much about this as the doctor by now, but I believe this to be the case.

Observe your husband carefully. If his health is improving, and his AHI is low, why on earth jack the pressure up sky-high?

And--this is very important--insist on getting a copy of the sleep study they just did. Insist.