Maybe need a pressure increase?

[Ruinednose]

Long time member here, I come for help about once a year, I have a pr system 1. Lately more ahi, it's a Bipap (epap at 6 min to 8max) and ( iPap at 10 min to 12 max) sleepy head says that 95% of pressure it at 10 epap and 12 iPap. So max lvls. I don't have money for a sleep study, I just need some advice as far as what you guys think, if I increase pressure across the board by 1 point?

[Ruinednose]

Please please help, been getting 5.xx ahi index and just waking up so much throughout the night, expecially early morning

[Pugsy]

We need to see what you are seeing in those SleepyHead reports?
Do you know how to post images of your reports? What to post?

More pressure might be needed..all depends on what that AHI is composed of.

Examples of what we like to see on those images...don't need all the graphs
viewtopic/t103468/Need-help-with-screen-shots.html
How to use imgur
https://sleep.tnet.com/reference/tips/imgur

orginization of images https://sleep.tnet.com/resources/sleepyhead/shorganize

[Ruinednose]

We need to see what you are seeing in those SleepyHead reports?
Do you know how to post images of your reports? What to post?

More pressure might be needed..all depends on what that AHI is composed of.

Examples of what we like to see on those images...don't need all the graphs
viewtopic/t103468/Need-help-with-screen-shots.html
How to use imgure
https://sleep.tnet.com/reference/tips/imgur

orginization of images https://sleep.tnet.com/resources/sleepyhead/shorganize

Pugsy thank you so so so much for your help.

I'm not familiar with anything but taking screen shots and posting it on the image upload site. Here I go I'll do my best

[Ruinednose]

We need to see what you are seeing in those SleepyHead reports?
Do you know how to post images of your reports? What to post?

More pressure might be needed..all depends on what that AHI is composed of.

Examples of what we like to see on those images...don't need all the graphs
viewtopic/t103468/Need-help-with-screen-shots.html
How to use imgur
https://sleep.tnet.com/reference/tips/imgur

orginization of images https://sleep.tnet.com/resources/sleepyhead/shorganize

I think I have done it, it's last nights and also the general info

https://imgur.com/a/atY4Q

[Pugsy]

That ugly cluster at the end of the night...either REM stage sleep or you were on your back...you needed a lot more pressure for whatever that was.

In general I think you need a bit more minimum EPAP along with more max IPAP. How much more is unknown...that ugly cluster throws a monkey wrench into things.

If it were me I would increase minimum EPAP from 8 to 9
leave the PS settings where they are
and change max IPAP to 20 and see where the machine wants to go.
You might need even more minimum EPAP but I would want to see where the machine goes with the new jumping off point along with where it can go if it didn't have its hands tied with the max IPAP of 12. You have a really tight range here...open it up a bit and see what the machine wants to do.

[Ruinednose]

That ugly cluster at the end of the night...either REM stage sleep or you were on your back...you needed a lot more pressure for whatever that was.

In general I think you need a bit more minimum EPAP along with more max IPAP. How much more is unknown...that ugly cluster throws a monkey wrench into things.

If it were me I would increase minimum EPAP from 8 to 9
leave the PS settings where they are
and change max IPAP to 20 and see where the machine wants to go.
You might need even more minimum EPAP but I would want to see where the machine goes with the new jumping off point along with where it can go if it didn't have its hands tied with the max IPAP of 12. You have a really tight range here...open it up a bit and see what the machine wants to do.

OK thank you so much, so I recap, I should do (epap 6min, 9max) (iPap 8 min 20max)
Would like 16 max iPap be ok, will increasing to 20 be too much?

Also a link on how to increase it safely? Do I increase pressure with the SD card in?

I have a pr system one Bipap

[Pugsy]

If you don't know how to increase your machine settings go here and request the manual for whatever machine you have.
http://www.apneaboard.com/adjust-cpap-p ... tup-manual

I thought you said minimum EPAP was 8...so I suggested 9.
If it is 6 then try 7...a one cm increase in minimum starting pressure on EPAP....might need more but need to see what happens when the max can go higher first.

Doesn't matter if the SD card is in the machine or not unless the SD card contains Encore RX pressure settings that will overwrite whatever you might do.

Just because a machine can go to 20 or 25 doesn't mean that it will go there.
Right now you have the machine's little hands tied to tight it can't really go anywhere or do anything to prevent the airway from collapsing when it tries to collapse...or prevent that ugly cluster from happening.

Your choice as to what you want to try for the max setting but I suggest giving the machine some room to work instead of restricting the movement so much. It won't increase that pressure unless it has a real good reason to do so.

[Ruinednose]

If you don't know how to increase your machine settings go here and request the manual for whatever machine you have.
http://www.apneaboard.com/adjust-cpap-p ... tup-manual

I thought you said minimum EPAP was 8...so I suggested 9.
If it is 6 then try 7...a one cm increase in minimum starting pressure on EPAP....might need more but need to see what happens when the max can go higher first.

Doesn't matter if the SD card is in the machine or not unless the SD card contains Encore RX pressure settings that will overwrite whatever you might do.

Just because a machine can go to 20 or 25 doesn't mean that it will go there.
Right now you have the machine's little hands tied to tight it can't really go anywhere or do anything to prevent the airway from collapsing when it tries to collapse...or prevent that ugly cluster from happening.

Your choice as to what you want to try for the max setting but I suggest giving the machine some room to work instead of restricting the movement so much. It won't increase that pressure unless it has a real good reason to do so.

Thank you a million!

Yes my EPAP minimum is 6 and the EPAP maximum is 8.

The IPAP minimum is 8 and the IPAP maximum is 12.

So they each have a parameter there run in between, so should I increase the epap minimum AND maximum by 1 point?

And the IPAP just the maximum to 20?,no mess with the minimum?

[Ruinednose]

If you don't know how to increase your machine settings go here and request the manual for whatever machine you have.
http://www.apneaboard.com/adjust-cpap-p ... tup-manual

I thought you said minimum EPAP was 8...so I suggested 9.
If it is 6 then try 7...a one cm increase in minimum starting pressure on EPAP....might need more but need to see what happens when the max can go higher first.

Doesn't matter if the SD card is in the machine or not unless the SD card contains Encore RX pressure settings that will overwrite whatever you might do.

Just because a machine can go to 20 or 25 doesn't mean that it will go there.
Right now you have the machine's little hands tied to tight it can't really go anywhere or do anything to prevent the airway from collapsing when it tries to collapse...or prevent that ugly cluster from happening.

Your choice as to what you want to try for the max setting but I suggest giving the machine some room to work instead of restricting the movement so much. It won't increase that pressure unless it has a real good reason to do so.

Thanks for that link you gave me. I went and started reading, the issue is this.

Below is a picture.
https://imgur.com/gallery/g1SKr

[Pugsy]

Smart cards are used on the M series and older machines.
PR S1 models and newer use SD cards.

Leave the SD card in the machine...make your changes.
The SD card may or may not have the Encore RX settings included in the SD contents. If it does then the SD card needs to be erased but try it and see if the changes stick or not first. It may be a non issue.
SD cards didn't always have the settings to overwrite any changes you might make.
It's easy to test out though.

If you don't have the SD card in the machine you won't have any details for the software to evaluate.
So you are going to want the SD card in the machine during the night.....so you need to have the SD card in the machine.
If you take it out and make the changes and then put it back in the machine and if (big if) it does overwrite your changes you can easily see it because the machine will revert back.
If that happens then the SD card has to be erased. If it doesn't you don't have to do anything.

[Ruinednose]

Smart cards are used on the M series and older machines.
PR S1 models and newer use SD cards.

Leave the SD card in the machine...make your changes.
The SD card may or may not have the Encore RX settings included in the SD contents. If it does then the SD card needs to be erased but try it and see if the changes stick or not first. It may be a non issue.
SD cards didn't always have the settings to overwrite any changes you might make.
It's easy to test out though.

If you don't have the SD card in the machine you won't have any details for the software to evaluate.
So you are going to want the SD card in the machine during the night.....so you need to have the SD card in the machine.
If you take it out and make the changes and then put it back in the machine and if (big if) it does overwrite your changes you can easily see it because the machine will revert back.
If that happens then the SD card has to be erased. If it doesn't you don't have to do anything.

OK awesome.

Here is a day a few days ago, better ahi, not a cluster. But pressure still at highest possible max both epap and iPap for 95% of time.

Here are pictures from a few days ago

https://imgur.com/a/uefr4
Is CA something to worry about?

[Ruinednose]

Also having an issue... I cannot change the max epap... Just the max iPap. See picture below

https://imgur.com/a/lnIAz

Whatever I do, these are the only options I have

[Okie bipap]

Raising your minimum EPAP will raise your minimum IPAP. Minimum IPAP is your minimum EPAP plus your pressure support. Maximum EPAP is your maximum IPAP minus your pressure support.

[TedVPAP]

Also having an issue... I cannot change the max epap... Just the max iPap. See picture below

https://imgur.com/a/lnIAz

Whatever I do, these are the only options I have

Please look at the three links below; they explain what information is necessary and how to display it.
The important info is event flags, flow rate, and pressure.
Also keep in mind that the machine flags breathing disturbances. It doesn't know if you are truly asleep which is the only time that OSA is relevant. Breathing irregularities are more likely to occur when you are awake or near sleeping which can be mistakenly flagged. Therefore only the data when you are confident that you are asleep should be used to assess your OSA treatment.