Flat High Pressure Peaks

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
Dogjudge
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Flat High Pressure Peaks

Post by Dogjudge » Mon Mar 02, 2015 11:30 am

This should be easy to explain, so I'm not going to post the Sleepyhead data.

High pressure limits and pressure peaks.

I would guess that if you get a peak that's flat for short periods of time (say 10-15 minutes), that could be minor issues.

What I'm noticing with quite a few of my graphs is that the pressure will go up to the maximum setting and then stay there for an hour, or more. It would seem logical that would be caused by the limitation not allowing the machine not to go any higher even though the machine wants to go higher. Correct?

Looking at one of the graphs for one of my worst nights, I went from 11:30 to 1:15 with the pressure at the top limitation.

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LSAT
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Re: Flat High Pressure Peaks

Post by LSAT » Mon Mar 02, 2015 11:45 am

You don't say what your pressure is set at, but from what you say...the upper pressure should be higher. Why not set it at 20 and see what happens. The machine will only take the pressure to what it needs to stop an apnea.

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Pugsy
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Re: Flat High Pressure Peaks

Post by Pugsy » Mon Mar 02, 2015 12:08 pm

Dogjudge wrote:What I'm noticing with quite a few of my graphs is that the pressure will go up to the maximum setting and then stay there for an hour, or more. It would seem logical that would be caused by the limitation not allowing the machine not to go any higher even though the machine wants to go higher. Correct?
Correct. The machine wants to go higher but can't. No way to know how much higher though without opening up that maximum number. There are times we might want to limit the maximum though...like if higher pressures caused aerophagia or centrals or caused a lot of awakenings or leaks.
So sometimes there has to be a trade off or compromise...but not always. It all depends on the person and why the machine is wanting to go higher and what happens when it does go higher.

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Dogjudge
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Re: Flat High Pressure Peaks

Post by Dogjudge » Mon Mar 02, 2015 12:19 pm

High pressure is currently at 11. Low is at six.

Doctor appt. for the 16th. 6 month follow up. In a two week period I might get one night of 8 hours restful sleep. The rest are typically waking 3-4 times per night.

Don't know what the "norm" is, but hypopnea events seem to correlate to those bad nights the most. Maybe 30 events in a night. Even when my AHI numbers are around 2, I'm still waking up. I'll still have maybe 20 hypopnea events.

Looking forward to the 16th.

JDS74
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Re: Flat High Pressure Peaks

Post by JDS74 » Mon Mar 02, 2015 12:39 pm

With the upper pressure limit of 11 cm H2O and the strings of hypopneas correlating to the flat line upper pressure,
it seems as if the machine is trying to correct an hypopnea condition and can't.

So setting the upper limit to something like 13 cm H2O as an experiment will help provide more information to diagnose the problem.

At the time of the pressure limit events, can you tell what the pressure was before it pushed up to the limit? If your pressures are in the range of 6-8 and then the events move it up to 11 cm H2O, your range may have a too low bottom limit. Moving the lower end of the range up just a little might also help.

I assume your machine is an Auto (as listed) and not an Auto-BiPap. With the Auto BiPap a different solution might make more sense.

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Dogjudge
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Re: Flat High Pressure Peaks

Post by Dogjudge » Mon Mar 02, 2015 12:56 pm

Image

Example from the other day. I then raised it to 11.5, but it's still topping out in a similar fashion. I didn't post yesterday because I was awake for 3 hours twice, and only slept about 4 hours total, maybe. So there was a lot of time without the mask. I'd wait 1/2, or so, trying to go back to sleep before I'd take the mask off and simply get up.

Went to bed at 9:30, because the night before I had only gotten about 4 hours sleep and I was simply exhausted. Felt as if I was fighting to stay awake.

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Pugsy
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Re: Flat High Pressure Peaks

Post by Pugsy » Mon Mar 02, 2015 2:21 pm

A little more minimum pressure might be a better way to address whatever it is the machine wants to try to prevent and it looks like maybe hyponeas.
Often when the minimum pressure is doing a better job preventing the airway collapses the machine doesn't have to resort to the higher pressures to try to fix whatever is happening.
More minimum pressure to better prevent rather than trying to fix a problem after the fact with more maximum.

Your AHI is primarily Hyponea in origin....more minimum pressure would likely do a better job than increasing the maximum.
Prevention vs fixing.
Something to talk to your doctor about.

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Dogjudge
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Re: Flat High Pressure Peaks

Post by Dogjudge » Mon Mar 02, 2015 3:44 pm

Pugsy,

Thanks.