Length of Time of Obstructive Apena

Lately I've been have periods of time in which my Obstructive Apena have lasted nearly a full minute.......Is a pressure increase necessary?

I think I would switch over from fixed to auto with a pressure range of 12-20 to see if the pressure you are at is sufficient.

Given your overall AHI is very low, there is probably a marked difference between laying on your side vs laying on your back, or REM vs NREM sleep. Putting your CPAP in auto mode would probably clear these up. If you are comfortable at 14.4, keep it as the low pressure.

LSAT wrote:I think I would switch over from fixed to auto with a pressure range of 12-20 to see if the pressure you are at is sufficient.

I would need to know what parameters I'm looking for to find out what is sufficient.

If it were me, I might bump pressure up a few tenths as a personal experiment, but I would do so based only on the fact that my airway was closing at all--not on how long it was staying closed. Sometimes those long ones have a slight central component--it is just that the airway closes during them so that it is reported as a pure obstructive event.

Alternatively, I might try, just as a test, less EPR (for example, 2, instead of 3) in order to see if that helped my average AHI over time. But I would file it all under minor tweaking and wouldn't worry much about it other than seeing if it helped my average AHI over the coming weeks. And even that wouldn't matter to me unless it helped how I felt in the mornings. Generally, an obstructive now and then won't destroy sleep. And for some, keeping pressure so high that nothing obstructive ever happens is enough to hurt sleep more than it helps it.

But hey, that's just me. And my opinions are, at times, nonstandard. Especially for this board.

Not a pro--only a guy on the Internet.

fdw wrote:

LSAT wrote:I think I would switch over from fixed to auto with a pressure range of 12-20 to see if the pressure you are at is sufficient.

I would need to know what parameters I'm looking for to find out what is sufficient.

I believe that the machine would have gone higher if it was not set on fixed pressure. By switching to auto and setting a max pressure at 20 after a few days you could see how often (if at all) the unit increased the pressure above 14.4. Then you could increase tour fixed pressure or stay on auto.
Sleepyhead graphs will show you this and help determine your "parameters".

LSAT wrote:

fdw wrote:

LSAT wrote:I think I would switch over from fixed to auto with a pressure range of 12-20 to see if the pressure you are at is sufficient.

I would need to know what parameters I'm looking for to find out what is sufficient.

I believe that the machine would have gone higher if it was not set on fixed pressure. By switching to auto and setting a max pressure at 20 after a few days you could see how often (if at all) the unit increased the pressure above 14.4. Then you could increase tour fixed pressure or stay on auto.
Sleepyhead graphs will show you this and help determine your "parameters".

I really like the idea of auto CPAP all the time especially during periods when I really don't need a higher pressure to keep my airway open. Just not sure I can stay on auto pap all the time.

Anyway you suggested a pressure setting of 12.0 minimum to 20 maximum which sounds exceptiable, just don't want to get blown away and get woke up...

So, if it turns out after a few days in auto pap that my maximum pressure is say 16.8, should that be where I set the CPAP when I go back to fixed?????

I had this exact thing thing. Went to the sleep doctor over it and saw the NP. She couldn't explain it. Maybe rem? No answer. One thing I found is that I was taping my mouth shut with 3M durapore when this happened. With a chin strap, I didn't see these little outburst of OSA? I use a nasal pillow. Mine were going for 30 minutes sometimes.

You need to keep in mind that without preceding events (flow limitations and/or snores) an APAP will NOT try to interrupt/stop an apnea event in progress. You have very low Flow Limitation and Snore indexes. Consequently, I doubt that using a range would have the desired result you seek.
I'd suggest trying a pressure increase or figuring out if you might have been on your back during the time of that cluster.
And, from looking at that report, I'd speculate that the cluster was "positional".


Den

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Although, it may be that the flattening of the flow curve might have been enough to cause an algorithm response, in the case of the grab supplied.

fdw wrote:So, if it turns out after a few days in auto pap that my maximum pressure is say 16.8, should that be where I set the CPAP when I go back to fixed?????

No.

fdw wrote:I really like the idea of auto CPAP all the time especially during periods when I really don't need a higher pressure to keep my airway open.

Right. That is why autopaps are favored by so many of us.

fdw wrote:Just not sure I can stay on auto pap all the time.

Why? Many of us have used it for years.

fdw wrote:Anyway you suggested a pressure setting of 12.0 minimum to 20 maximum which sounds exceptiable, just don't want to get blown away and get woke up...

If you don't need higher pressure, the machine will not raise the pressure.

You are worried about getting awoken by higher pressure? Waking up is better than continuing to sleep and suffering long apneas. But, higher pressure is not necessarily going to wake you up. My pressure is all over the place, and I rarely awaken.

LSAT: I think I would switch over from fixed to auto with a pressure range of 12-20 to see if the pressure you are at is sufficient.

Then you see how you feel the next morning and make a judgment of how you slept. Follow this up with a review of Sleepyhead details for the night to look at events, pressure, pressure changes and mask leak. You need to see this before deciding what to do on the second night. It's a type of multi-night titration.

ChicagoGranny wrote:

fdw wrote:So, if it turns out after a few days in auto pap that my maximum pressure is say 16.8, should that be where I set the CPAP when I go back to fixed?????

No.

fdw wrote:I really like the idea of auto CPAP all the time especially during periods when I really don't need a higher pressure to keep my airway open.

Right. That is why autopaps are favored by so many of us.

fdw wrote:Just not sure I can stay on auto pap all the time.

Why? Many of us have used it for years.

fdw wrote:Anyway you suggested a pressure setting of 12.0 minimum to 20 maximum which sounds exceptiable, just don't want to get blown away and get woke up...

If you don't need higher pressure, the machine will not raise the pressure.

The WHY is because I have a pacemaker/defibulator and once upon a time diagnosed with CHF. I read that people diagnosed with CHF should NOT use APAP only CPAP.

I would like to use APAP

You are worried about getting awoken by higher pressure? Waking up is better than continuing to sleep and suffering long apneas. But, higher pressure is not necessarily going to wake you up. My pressure is all over the place, and I rarely awaken.

LSAT: I think I would switch over from fixed to auto with a pressure range of 12-20 to see if the pressure you are at is sufficient.

Then you see how you feel the next morning and make a judgment of how you slept. Follow this up with a review of Sleepyhead details for the night to look at events, pressure, pressure changes and mask leak. You need to see this before deciding what to do on the second night. It's a type of multi-night titration.

The WHY is because I have a pacemaker/defibulator and once upon a time diagnosed with CHF. I read that people diagnosed with CHF should NOT use APAP only CPAP.

I would like to use APAP......By the way I'm also taking 5mg of generic Ambien

fdw wrote:The WHY is because I have a pacemaker/defibulator and once upon a time diagnosed with CHF. I read that people diagnosed with CHF should NOT use APAP only CPAP.

I am glad I asked.

If I had those problems, I would be working with a sleep doctor who corresponds with my heart doctor. I would not be getting advice from an internet forum on machine settings.

In a case like yours, forums can offer good help for things like controlling leak, comfort issues and understanding your Sleepyhead reports. I would not trust a forum for things that might affect the heart.

Good luck.

ChicagoGranny wrote:

fdw wrote:The WHY is because I have a pacemaker/defibulator and once upon a time diagnosed with CHF. I read that people diagnosed with CHF should NOT use APAP only CPAP.

I am glad I asked.

If I had those problems, I would be working with a sleep doctor who corresponds with my heart doctor. I would not be getting advice from an internet forum on machine settings.

In a case like yours, forums can offer good help for things like controlling leak, comfort issues and understanding your Sleepyhead reports. I would not trust a forum for things that might affect the heart.

Good luck.

Actually I've been on my own since my insurance does not cover sleep related issues.

FDW, can you supply a reference for this statement?

fdw wrote:The WHY is because I have a pacemaker/defibulator and once upon a time diagnosed with CHF. I read that people diagnosed with CHF should NOT use APAP only CPAP.

I am familiar with the warning regarding ASV and CHF but not with APAP and CHF. In fact ResMed says,

The study and this warning do not apply to ResMed CPAP or APAP devices.

referencing their warning regarding ASV and CHF. http://www.resmed.com/us/dam/documents/ ... AQs_v1.pdf

background: http://aasmnet.org/articles.aspx?id=5562