First night on Auto

Last night was the first night with my Auto. It was also my first night with the Hybrid. My ComfortFull 2 is putting pressure on my bottom teeth and it makes them sore. I'm not definitely changing to the Hybrid, but I'm going to give it a try.

My detailed results from last night are below. I also posted my last night on my M-Series Pro.

My titrated pressure was 10. I set the Auto range 8 - 14.

What's 90% pressure? I know I've seen the answer here but I can't find it.

Any recommendations on reducing Hybrid leaks?

Any other suggestions?


Night of April 9 - April 10 with Hybrid





Night of April 5 - April 6 with ComfortFull 2



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CPAPopedia Keywords Contained In This Post (Click For Definition): auto

Both reports look good, your cpap Pro has fewer AHIs.

Your auto looks like it's set for 8 (not 7 minimum), and you spent most of your time at 8.

The 90% pressure means that you spent 90% of the night at 9 or below. And you can see that you only hit 10 for 18 minutes, and that is where most of your AHIs happened.

And looks like 9 was your best pressure.

You need to look at the Hybrid tips to help with leaks -- which don't look horrible other than a couple of incidents.

Thanks, Linda - I double-checked my machine and my minimum pressure was 8. I corrected my post.

If I spent most of my time at 8, should I set the bottom pressure to 7? Should the bottom pressure be below what I spend most of my time at?

I don't think you want to be changing settings every night ... unless your doing absolutly terrible. You are doing fine and need only tweak a little at a time. Consequently, you should collect at least a weeks worth of data before considering any more tweaks. I would set up a schedule to make changes on Fridays so that if the changed settings don't go well they will not affect your weekday ... unless of course you are retired or don't work on weekdays like most others do.

If it were me (I'm not a doctor!) I'd set the autopap's range: 9 - 20 or 10 - 20.

rested gal wrote:If it were me (I'm not a doctor!) I'd set the autopap's range: 9 - 20 or 10 - 20.

Rested Gal, why do you think she should up it to 20 when she didn't even hit 14?

Sandy,

My first concern is the soreness of your bottom teeth. Maybe the Comfortfull 2 is either not the right size, not adjusted right, or not the right mask for you.

I would not worry about the leak rate with the Hybrid, unless you feel leaking. The Hybrid has a high exhaust rate (seen as leaking). 40l/m is not bad for the hybrid. For adusting any mask, I suggest you do it while your machine is on at a pressure of 10 (your pressure- and laying down as if you are sleeping.

I think the higher AHI with the Hybrid is because you lowered the pressure to 8 and not because of the change in mask, or at least not a big reason because of the Hybrid.

There is a gap in the auto scan, I wonder if you were awake then and the mask was off, when you put it back on where you awake for a while etc. It may pick up on swollowing etc.

For a fair comparsion of the Hybrid, use a pressure of 9 or 10. maximum to 14.

Rested gal sorry to disagree with you, but I do not like leaving the upper limit open, in case of centrals kicking in. For myself personally, my events go higher after 16. (Mind you I set a higher minimum, as well, not sure if this had anything to do with it.)

Sandy do the events wake you up.

SleepySandy wrote:Thanks, Linda - I double-checked my machine and my minimum pressure was 8. I corrected my post.

If I spent most of my time at 8, should I set the bottom pressure to 7? Should the bottom pressure be below what I spend most of my time at?

Well, to me, I would look at the bottom of the Daily Events Per Hour chart. It shows events at pressure 8. So I don't think I would want to set it at 7. You had the least events at 9. Then they climbed drastically at 10.

You can run the pressure at 8 to 14 for a few more nights, but I still think your sweet spot is 9. I would narrow my range to 8 minimum/9 maximum. Or just a straight 9 to see how I do and feel. But that's just my opinion.

Hi everyone

This is long - I tend to give too much detail but I never know what details to leave out. Plus, I'm super-duper tired which makes me ramble. So, thanks in advance for reading.

Thanks so much for the input. I took Dreamstalker's advice last night and didn't make any changes to my pressure range.

However I can't give a good report about last night. I have severe anxiety which isn't properly medicated and it's greatly affecting my sleep. I slept in blocks last night - sleep 2 hours / up 2 hours / sleep 1 hour / up 1 1/2 hours / sleep 2 hours. I haven't even bothered to download my card yet. I'm too tired

Selfseeker wrote:My first concern is the soreness of your bottom teeth. Maybe the Comfortfull 2 is either not the right size, not adjusted right, or not the right mask for you.

It's really weird because it isn't tight and the seal is inflated all the way around. I went to the DME on Monday and took the mask along. It fits the way it's supposed to (I trust this RT and his knowledge) and the bottom hits where the Respironic's info says it's supposed to. I also went to my dentist yesterday with my mask to see if he could make a bottom nightguard for me to displace the pressure. He said the pressure is coming from the relatively stiff skirt of the mask. I think it's that plus the weight. And maybe I smoosh it during the night. I don't know. I do know my teeth are hyper-sensitive.

I wanted to explore the bottom night guard possibility because I really like my results with the ComfortFull 2. My leak rate is super-stable and my AHI is really low. I struggled greatly with the fit of the UMFF and leaks around my eyes.

The dentist isn't sure a bottom night guard would work so he wants me to see if the Hybrid will provide good results without the sore teeth. The RT has also asked me to provide feedback on the Hybrid. Unfortunately, I wasn't able to get it to cooperate last night. It kept whistling and I couldn't get it to stop. I can't sleep with a whistle happening so I gave up and switched masks. But, my sleep was awful so I won't be putting much stock in whatever results I do have from last night.

Selfseeker wrote:There is a gap in the auto scan, I wonder if you were awake then and the mask was off, when you put it back on where you awake for a while etc. It may pick up on swollowing etc.

The gap was my bathroom trip. I usually have 1 a night. I turn the machine off and disconnect the hose from the mask (the mask stays on). On this night, I fell back to sleep right away. I agree that the events could be tied to falling back to sleep, but I didn't see them much after my bathroom trips when I was on straight CPAP.

Selfseeker wrote:Sandy do the events wake you up.

Not enough that I actually "wake up". When I do sleep through the night I wake up to go to the bathroom.

Linda3032 wrote:Well, to me, I would look at the bottom of the Daily Events Per Hour chart. It shows events at pressure 8. So I don't think I would want to set it at 7. You had the least events at 9. Then they climbed drastically at 10.

Linda, your passion about my results is very sweet.

While I had a super-high AHI at 10, I had tons of events at 8. I don't understand why my pressure stayed at 8 when I was clearly having events. Can someone explain to me how this works? I would think the pressure would go up and stay up. This puzzles me. Clearly, I don't understand Autos yet.

I dug into the raw data yesterday and I had:
5 Hypopneas at 8
2 Hypopneas at 9

7 Apneas at 8
2 Apneas at 9
2 Apneas at 10

It seems that the recommendations to set my minimum to 9 make sense.

Linda3032 wrote:

rested gal wrote:If it were me (I'm not a doctor!) I'd set the autopap's range: 9 - 20 or 10 - 20.

Rested Gal, why do you think she should up it to 20 when she didn't even hit 14?

rested gal - I have the same question. What benefit are you thinking raising the top pressure would provide?

Based on the feedback and the high number of events at 8, I'm thinking I'm going to deviate from Dreamstalker's advice and raise the bottom pressure to 9 tonight.

As always, I'll appreciate any further advice offered.

Linda3032 wrote:

rested gal wrote:If it were me (I'm not a doctor!) I'd set the autopap's range: 9 - 20 or 10 - 20.

Rested Gal, why do you think she should up it to 20 when she didn't even hit 14?

SleepySandy wrote:rested gal - I have the same question. What benefit are you thinking raising the top pressure would provide?

Now that you've done a download and have seen that the machine is behaving itself for you...not taking off up into the stratosphere with you...it won't matter if you take the leash off the top.

It also doesn't really matter if you leave the top right where it is on 14, since it's probably never ever going to hit 14 for you.

Personally, I'd want even more room up there, so I'd know what it did need to use just in case it ever did use 14. It probably won't touch 14 with you, though; so 14's as good a top as 20.

Now that you've seen a download, you could pull any of these out of the hat to use as the top pressure setting - 14, 15, 16, 17, 18, 19, or 20. Doesn't matter which one, since none of them are going to be used.

What really matters, imho, is that the minimum pressure be up to where it prevents apneas easily -- and is comfortable enough for you to sleep with it.