Tweaking Numbers

So I've finally decided to start tweaking my numbers, in an effort to better control my AHI. I am currently using PR System One Auto, leaks are well controlled, just switched to my Quatro FFM due to a cold, otherwise had been using a nasal mask. AHI is consistently in the 6-8 range, with some nights higher, and an occasional night lower. I've been using aPAP for a little over 2 1/2 months now. I am still very tired during the day.

Previous Settings:
min pressure 8
max pressure 20
Aflex at 2
average 90% pressure of 13.0
average pressure of 10.4

Last night I changed the settings to
min pressure 10
max pressure 19
Aflex at 3
my pressures and AHI were actually right in between the previous two days, so no change.

I'm wondering now what to adjust, how far to adjust, and if I should expect to see changes after just one night. I'm tempted to lower my max pressure again tonight, but I'm not sure if that's the right thing to do. I hate to put this off until my cold is gone, as colds/congestion tend to linger in my sinuses/lungs. I Just really want to start feeling some improvement in regards to the sleep apnea.

I personally would wait at least a week before tweaking again. If AHI is still consistenly over 5 then I would increase the minimun pressure a bit and leave the max at 19.
Good Luck. You are not too far off the mark.
By the way, how is your AI?

I have the same machine and FFM that you are using and also on a quest for what the right pressure would be. The difference is my non-FFM is a Swift FX nasal pillow mask. I also have been between the two masks due to cold and sinus fun that is often rather stubborn.

In my case, I started with a CPAP and changed to an APAP which I am running a range of 7 - 13. The lower value is what my sleep clinic recommended I change my CPAP to during a telephone conversation and really the lowest I feel comfortable with. The upper is somewhat arbitrary. I narrowed it potentially cover for wild pressure swings and runaway conditions that I had seen reported from time to time.

I had started at an upper of 12 and immediately saw that I was hitting the top and staying there for longish periods. I bumped to 13 and was good for a couple of nights with the Quattro then hit the top one night and pretty much stayed there for a while. The sleep was pretty good but I did feel could be a bit better. I bumped it one more to 14 and tried it again with the Quattro.

Yikes.

I woke 3 times in the night utterly TEARING the mask off.

I haven't repeated that nor do I want to. I lowered the max again to 13 and, interestingly enough I have been able to clear my sinuses enough to easily use the nasal pillows. If I get stuffy again, I'll use the Quattro but will sure approach that upper value with significant caution. There wasn't anything obvious in the data (aggregate or detailed waveforms) so I have NO idea what might have caused that sensation and my sleep clinic isn't forthcoming with any thoughts either.

Anyway, after a little over a week of trying to be rigorous, I am finding that the Quattro tends to have the machine running at higher pressure on a given night than the nasal pillows and I find that my AHI is typically lower (usually <1) with the pillows. No leaks to speak of.

Good luck and I shall follow your progress carefully.

Thanks for the responses so far. I appreciate all input I can get at this point.

I see I made a typo in my first post--I lowered the upper limit to 18, not 19.

My AI is averaging right around 5.

Mike, how long did you wait between pressure setting changes?

That may have been where I ran afoul.

My lower pressure.... always 7. After I raised from my initial setting from the sleep clinic of 5 on the CPAP, I immediately did rather better. Went from a lot of nights WAY under 4 hrs to consistently above that by a bit. While both my average pressure and 90% pressure both run above that setting of 7, there are significant portions of each night right at 7 and the MaP column for 7 (which I think means between 7.0 and 7.9) are big percentages. Typically at that pressure, I am not getting any events logged. The upper has been a bit different....

First I was trying to be rigorous and use just one mask. Since I too am in the midst of a sinusy mild bronchitis kinda thing, I decided to use the FFM as my single mask to suit all for a while to get pressure sorted. What I had done, in my impatience to get "dialed in" so I can get some sleep and feel really better was to watch the data for a couple of nights looking to see if I was running any appreciable time stuck at the upper limit (13). I was. Note that I did NOT see it at those pressures with the nasal pillows and you may be seeing the same thing between the FFM and nasal mask. Anyway, while I was TRYING to be rigorous with the single mask, for whatever stupid reasons, I couldn't get comfy with the FFM a couple of nights so, managing to get sinuses clear enough to use it, I did. That aside, I did force myself back to the FFM and stay with it for fewer variables.

After those two nights with significant time at 13, I popped it up to 14. That may have been my downfall. Not enough time at the higher pressures before upping it. Maybe after I build more data, I'll try again with FFM and see where the chips fall.

Horrid.

You should wait about a week between changes but I am wondering what your titrated pressure was (sorry if you mentioned it before - I can't remember). Your new minumum of 10 cm may be too low if it is more than 1 or 2 below your titrated pressure.

I have my minimum at my titrated pressure. I also like a narrow range to have my maximum set at 3 cm above my minimum. This narrow range may not be a good idea for you just yet while tweaking pressures but your minimum should be at or maybe 1 cm below your titrated pressure.

That is unless your titration sleep study was not good and they didn't get a good pressure for you. In that case, just keep doing what you are doing but wait about a week between change.

My prescribed pressure (on cpap) was orignally 11. When I actually got the aPAP, the RT called the doc, and they set the auto to min 6 and max 20. A few weeks later, I upped the min to 8, and that's where I've been. But, here's the tricky part. During my sleep study, they escalated me from 5 to 11 cm. At the "higher pressures" (quoting the PSG report) they observed hypopneas, so they switched me to bi-pap at 14/11 (with no episodes noted, and my only significant amount of time in REM). The sleep tech thought I should feel much better upon awakening, since I had "slept so well." I did not feel any different than most other mornings, and that continues to be the case. I guess that, combined with the higher-than-they-should-be AHI numbers, has led me to try tweaking my own numbers. My PCP, who Rx'd my machine, knows very little about cpap (was not even familiar with auto), and I have never seen the sleep doctor. I kind of feel like I'm on my own to try to figure this out. I'm just so thankful to have a helpful forum like this to come to.

jbn3boys.... I feel your pain. I am in a very similar position exacerbated by only having a home sleep test and 3 nights with a loaner APAP to "determine my pressure".

I too have been extremely thankful for this forum, the information, and the help people have been willing to share.

jbn3boys wrote:So I've finally decided to start tweaking my numbers, in an effort to better control my AHI. I am currently using PR System One Auto, leaks are well controlled, just switched to my Quatro FFM due to a cold, otherwise had been using a nasal mask. AHI is consistently in the 6-8 range, with some nights higher, and an occasional night lower. I've been using aPAP for a little over 2 1/2 months now. I am still very tired during the day.

Previous Settings:
min pressure 8
max pressure 20
Aflex at 2
average 90% pressure of 13.0
average pressure of 10.4

Last night I changed the settings to
min pressure 10
max pressure 19
Aflex at 3
my pressures and AHI were actually right in between the previous two days, so no change.

I'm wondering now what to adjust, how far to adjust, and if I should expect to see changes after just one night. I'm tempted to lower my max pressure again tonight, but I'm not sure if that's the right thing to do. I hate to put this off until my cold is gone, as colds/congestion tend to linger in my sinuses/lungs. I Just really want to start feeling some improvement in regards to the sleep apnea.

Do you have the software? Can you post the daily details report? Tweaking using averages from the display is suboptimal. Averages are often meaningless. I always want to see the daily details report and not much else.

I do have the software, so I have access to the daily reports. However, I do not know how to post them, other than typing the information in. If you tell me which information you are looking for, I can type it in. How many days worth of information would you like me to post?

Maybe post three of the daily details graph (just one page for each day).

Here are instructions for posting: viewtopic/t42733/viewtopic.php?f=1&t=41 ... rt#p369163

I am headed out for some very nice partying the next four days, but I am sure others will be around and comment.

When you open up your report... there is a copy button. Go to the page that you want to display and press copy.

Open up Paint. Do an Edit-Paste or use CTRL-V.

Then file save as... call it something and leave it as a jpg (picture).

Get a photobucket account.

Upload the picture that you just created and post the IMG or URL tags (found near the bottom of the screen) in your post.

Where is the best place to get the software for the System One?

packitin wrote:Where is the best place to get the software for the System One?

I got mine at cpap.com

I'll be back soon to post some graphs.

pm uncle_bob

he used to have it listed in his signature