Do I need to raise my Maximum Pressure (Clusters)

I've been doing OK for a while but recently I've noticed cluster OA's in some of the OA's they've lasted as long as 47 seconds (according to SH). Anyway I now have a Pacemaker/Defibrillator implanted back in mid October 2014 which should not have anything to do with the clusters Im beginning to see, along with the long duration of the OA's (just thought I'd let you know about the implant). That's why I ask about should I increase my pressure.

I attached 2 different graphs one with a large cluster and the other with none but just last nights results.

Thanks for any insight.
https://lh4.googleusercontent.com/-roDw ... 44430.jpeg

https://lh6.googleusercontent.com/-0yeg ... 44353.jpeg

Your links don't work.

They should work now...Thank you.

Your numbers aren't bad but you are bumping the top most of the time so it wouldn't hurt to increase top and see what happens. In APAP the machine won't higher if not needed.

Just throwing out some thoughts......

It appears to me that your OA events are occurring when your pressure is at its peak.
Now......which is the chicken and which is the egg? Pressures don't rise to treat apneas when they're in progress.
And, your "events" are almost non-existent when your pressure is lower.
Clusters could indicate that they're positional.
Your Flow Limitations are what's driving your pressures up.
I think it would be interesting if you actually LOWERED your max pressure by one centimeter......for a number of nights.


Den

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Den is much more experienced that I am. And that's the nice thing about monitoring Apap with Sleepyhead make a little change for a few days and see what results you get.

i had started a different thread before seeing this but decreasing my pressure has lowered my AHI.

fdw wrote:I've been doing OK for a while but recently I've noticed cluster OA's in some of the OA's they've lasted as long as 47 seconds (according to SH). Anyway I now have a Pacemaker/Defibrillator implanted back in mid October 2014 which should not have anything to do with the clusters Im beginning to see, along with the long duration of the OA's (just thought I'd let you know about the implant). That's why I ask about should I increase my pressure.

I attached 2 different graphs one with a large cluster and the other with none but just last nights results.

Thanks for any insight.
https://lh4.googleusercontent.com/-roDw ... 44430.jpeg

https://lh6.googleusercontent.com/-0yeg ... 44353.jpeg

I don't see any reason to change your pressures...Your numbers look great. I don't see anything I would consider a "cluster".

I see what Den is seeing and kinda agree with his assessment regarding lowering the maximum pressure 1cm, in my case from 14.0 to 13.0. My question to Den is my minimum is 12.8 should I lower or keep the same (if I should lower should it be 1cm as well?)

BTW, my last titration was 13.0 several (7) years ago, and I have EAP set at 1.0 therefore the 14.0 Maximum pressure setting.

Thanks

fdw wrote:I see what Den is seeing and kinda agree with his assessment regarding lowering the maximum pressure 1cm, in my case from 14.0 to 13.0. My question to Den is my minimum is 12.8 should I lower or keep the same (if I should lower should it be 1cm as well?)

BTW, my last titration was 13.0 several (7) years ago, and I have EAP set at 1.0 therefore the 14.0 Maximum pressure setting.

Thanks

Your call. I was just throwing out some observations.
You could also try setting the minimum and maximum at 13 .......or 13 and 14 and see what things look like.
I assume you meant EPR? You could try leaving it at 1 or turning it off.
As I've said before, these machine have many variables/options and it's a matter of tweaking to find the "sweet spot".


Den

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Wulfman... wrote:

fdw wrote:I see what Den is seeing and kinda agree with his assessment regarding lowering the maximum pressure 1cm, in my case from 14.0 to 13.0. My question to Den is my minimum is 12.8 should I lower or keep the same (if I should lower should it be 1cm as well?)

BTW, my last titration was 13.0 several (7) years ago, and I have EAP set at 1.0 therefore the 14.0 Maximum pressure setting.

Thanks

Your call. I was just throwing out some observations.
You could also try setting the minimum and maximum at 13 .......or 13 and 14 and see what things look like.
I assume you meant EPR? You could try leaving it at 1 or turning it off.
As I've said before, these machine have many variables/options and it's a matter of tweaking to find the "sweet spot".


Den


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Im lost.....or 13 and 14? Im already at 12.8 minimum and 14.0 maximum.

fdw wrote:

Wulfman... wrote:

fdw wrote:I see what Den is seeing and kinda agree with his assessment regarding lowering the maximum pressure 1cm, in my case from 14.0 to 13.0. My question to Den is my minimum is 12.8 should I lower or keep the same (if I should lower should it be 1cm as well?)

BTW, my last titration was 13.0 several (7) years ago, and I have EAP set at 1.0 therefore the 14.0 Maximum pressure setting.

Thanks

Your call. I was just throwing out some observations.
You could also try setting the minimum and maximum at 13 .......or 13 and 14 and see what things look like.
I assume you meant EPR? You could try leaving it at 1 or turning it off.
As I've said before, these machine have many variables/options and it's a matter of tweaking to find the "sweet spot".


Den


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Im lost.....or 13 minimum and 13 maximum?

Sorry.......I'm getting myself confused......your max is already at 14......DUH!


Den

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Bear with me.......

You might even be able to try 12 min and 12 max with EPR turned off.


Den

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Wulfman... wrote:Bear with me.......

You might even be able to try 12 min and 12 max with EPR turned off.


Den

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So your suggesting straight CPAP

fdw wrote:

Wulfman... wrote:Bear with me.......

You might even be able to try 12 min and 12 max with EPR turned off.


Den

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So your suggesting straight CPAP

Kinda sounds that way, doesn't it. (Yes, that's my suggestion.)
The problem (as I see it) is with your Flow Limitations. They're driving unnecessary pressure increases.

I see lots of spaces in your report where your events are pretty non-existent and your pressures are at their minimum.


Den

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