Changed machine settings to see how it would go - results

[Matty332]

Last night I changed my machine settings as an experiment. From the unbearable CPAP mode of pressure 20 to APAP mode min pressure 9.6 max pressure 20. My AHI was up by about one but that is about all. I haven't had vertigo this morning but my blood pressure is still high as usual. I feel OK, I think. I thought the high pressure was causing the high blood pressure, obviously not. Anyways, here is the data. Could anyone please interpret? I used an oximeter as well and I will post that data on this thread later when I can.

Please ignore the first 20 mins or so, I turned the machine off to go to the bathroom and adjust my mask. I also woke up near the end of the reading and turned the machine off to look at the results, then turned it back on without falling asleep.

[MaxDarkside]

Looks fairly OK to me. I see you have the "Start Pressure" set to 5, with ramp. If you feel you are not getting enough air when you mask up and turn on the machine, you could increase the "Start Pressure" a bit higher, up to 9.6 cm that you have for a min. It went chasing your apnea clusters and looks to have treated them after a few slipped through, that's good. The machine also seems to suggest that a pressure of 20 cm is not required, but somewhere around 16. That's good too. Less mask squealing and disturbing your sleep than at 20. You feel better, that may be in part why. Less pressure on your ears, so maybe that may be why the vertigo seems less. High blood pressure can be caused by so many things, not just sleep apnea. Mine has gotten no better with APAP treatment.

My 2 cents. Worth about that

[Matty332]

Hey Max,

Hmm, I will up the start ramp. I shall try these settings for another night after looking at the oximeter data. Thanks for the advice Max.

Yeah, I am going to have to go on BP meds I think. I am still overweight (although losing weight fast) so that could be why I have high BP.

I must say I simulated an apnea before going to sleep to see how the machine reacts. It gives a gentle pulsing of air and the pulse slowly increases until your airway is opened. Such a gentle machine. I thought it would just ramp pressure straight up!

[MaxDarkside]

I don't know what the machine's rules are when detecting an apnea when still ramping. I guess you may have discovered that it will test, but not necessarily break the ramp rule. When not ramping, I see on some irregular breathing, not yet an apnea, it will raise pressure. Other times it will test the apnea first, pulses... try to see if it's an open airway one ("central") before changing pressure, because it should not raise pressure on open airway events. In that case after the apnea event concludes then it will raise pressure at some calculated rate.

[Matty332]

Here is the ox report from last night. Does it look OK?

[MaxDarkside]

Pulse-Oximetry looks pretty good to me. If that were mine, I'd give a thumbs up and carry on with my day unconcerned. Overall, If I could, I'd give myself a bit more time asleep, if possible.

[avi123]

Matty, you keep posting new posts and never go back to go over your previous posts, and also reply to posters there who are asking you questions.

Here is an example:

viewtopic.php?f=1&t=79745&p=725491#p725491

[greg-g]

It's really a good case of why APAP is better than CPAP. You may find occasionally you need a pressure of 20, but for most of the time 12 is fine.
Personally I would be using a pressure of 12 - 20.
Do you need the ramp?, a lot of people are started with ramp to help getting used to the pressure, but then turn it off. The ramp isn't causing any problems though as long as you don't feel starved of air.
I think the oximetry looks fine with an average value of about 95 and nothing below 90. You may find it interesting to expand the time scale on the oximetry and see how it correlate's with the high resolution breath data.
Your snore is quiet high, but I have no experience with that.
Do you sleep on your back?

[Matty332]

Hey Max, thanks for that. That is reassuring. You are right - I need more sleep definitely!!

Avi, fair call. I shall aspire to check older threads and conclude them more often. I just seem to have a lot of issues to sort (like everyone else I suppose) and my memory is not as stellar as I'd like it to be.

Greg, Yeah I do use the ramp. So 12 - 20 is good numbers? I shall try that tonight. So 95 O2 sat is okay? I do remember when I first started CPAP my Oximetry was usually up around the 98-99 mark which worries me but my heartrate was always alot higher from anxiety then. Perhaps my now lower normal heartrate means slightly less oxygen but it seems to average O2 sat 95. I should find out about the snore thing. Usually it isn't as high. Yeah I always sleep on my back due to the mask. Is sleeping on the side better? I suppose I could buy one of those special side sleeping CPAP pillows..

thanks again all

[Julie]

Sleeping on your back provokes the most apneas - which is why so many go to some crazy lengths to sleep any other way if possible.

[robysue]

I'd suggest NOT changing the pressure range every night. Sure, bump the min up to 12 if you want. But then leave it there for at least a few days---a week is better. The nachine scored data is best for looking at trends, and a single nigth is not a trend.

[Pugsy]

I agree with Robysue. Don't go changing things willy nilly. Minimum of 12 is probably okay but there is no huge critical need to use it and given that your vertigo may be related to pressures....I would be tempted to leave the minimum where it is or maybe try 11...keep it as low as possible. If you do want to increase the minimum...go up slowly from where you are now and if the vertigo returns then back off. In your situation your minimum is close enough to what pressure is needed that the machine can do a good job.
Don't worry about short drops in O2 to 95 or even a bit lower. Now if you drop below 90 and stay there for a while...then we worry. It is normal to have some fluctuations in O2 levels during sleep anyway...even without OSA diagnosis.

Don't go chasing extremely low AHI numbers at the expense of creating vertigo and leaks and generally crappy sleep. It isn't worth it. Also remember to mentally remove any central index numbers from your AHI when you are evaluating things. We don't treat centrals with pressure with your machine anyway so they have to be tossed out the window when evaluating pressure needs.

[padster]

Yeah, I am going to have to go on BP meds I think. I am still overweight (although losing weight fast) so that could be why I have high BP.

It's worth avoiding BP meds if possible. If you've already cut or minimised your sodium/sugar/carb intake and are avoiding anything stress related ... try to (1) exercise for at least half an hour each day (2) sleep for 8 hours or more (3) stop all alcohol for a week ... and then see how your BP is doing. If you havn't been able to achieve these 3 points in the past, it may be quite a challenge to change your lifestyle to accomplish it, but it's definitely worth it if it will allow you to stay away from drugs which you may have to take for the rest of your life.