Respironics APAP pressure test probes close up

ywp wrote:Does this inflate the 90% and max. pressure it reports ?

Probably. But not enough to worry about.

And, how does this relates to the little red dots on the flow chart on sleepy head. I thought the red dots were the test pulse?

Those red dots are Pressure Pulses (PP) that the machine uses to determine whether your airway is obstructed or clear when you've stopped breathing for around 6-7 seconds. The System One also uses PPs to determine whether it is having trouble detecting breathing under some circumstances---including large leaks.

The PPs are NOT the same thing as the saw-tooth test pressure increases. The saw-tooth increases are part of a "hunt-and-peck" algorithm for proactively determining whether you need more pressure. In other words, the saw-tooths allow the machine to decide you need additiopnal pressure before you start having clusters of events.

A word about 90 % pressure numbers.
It is just a number. If it is slightly increased by the pressure probes it doesn't matter in the grand scheme of things.
The 90% number isn't the holy grail of numbers anyway. It is a night by night number that sometimes gets elevated a lot due to sometimes the machine needing to go higher for some reason.

Look at the June 7 report where I had a marked increase in pressure needs likely in REM sleep. That 90% pressure number is 15.5 cm but my other report for Oct 6 the 90% number was 11.0.
What does this tell me? It only tells me that sometimes I need more pressure on some nights and some nights I don't need much increase in pressure at all. That's all it says. It is just a number. Nothing more and nothing less.
It isn't the magic number that I would need to use if I was doing CPAP mode. I have seen 90% up to 18 cm. No way do I need anywhere near that amount of pressure all the time. 90% number is just a number that sometimes will happen to be near what I would want to maybe use if I did cpap mode.

I know what your settings and reports look like on your different machines, but for those who don't, can you tell us again the settings you use and what pressure you would use if you were doing Cpap?

DoriC wrote:I know what your settings and reports look like on your different machines, but for those who don't, can you tell us again the settings you use and what pressure you would use if you were doing Cpap?

These reports were from when I was using the APAP machine and settings were 10 cm minimum and 20 cm maximum and AFlex of 2 since these are Respironics reports.
I don't know what I would use at straight cpap. It would be an impossible situation. For the nights like the Oct 6 night...heck 10 cm would probably do the trick but for the nights that my REM events need more pressure I would either have to use 16 to 18 cm if I wanted to prevent those events or use a lower pressure and just let those events materialize. I sure don't want to use 15 cm or more pressure all night to maybe prevent a handful of events.

Since my crystal ball is broken I never know when the super duper REM events want to play a visit. They typically show up 3 nights a week but I never know when. There is no pattern to the nights other than when it happens the 90 minute mark is almost always present. Sometimes also the wee hours of the morning also show up but for sure mostly the 90 to 120 minute mark.

I have only played with straight cpap for a couple of nights and that was with the S9 VPAP in straight cpap mode so I could get an idea what EPR felt like.
I used 10 cm with EPR of 3 one night...truckload of events showed up.
Then I used 13 cm with EPR of 3 and I had a nice uneventful report.
I don't know if that night would have been one of the nights that I didn't need any pressures in the 16 range though.
Since I only tried it one night I don't know if that night was just one those nights where nothing exciting was going to happen anyway.

Given my situation with the widely variable pressure needs my doctor said that APAP was a much better choice for me. If I didn't have the wide variable pressure needs then I suppose I would use somewhere between 10 and 13 cpap and it would depend on if I used EPR and what amount or if I used the Respironics and AFlex since AFlex doesn't have nearly as much reduction in pressure as EPR does. I have never tried cpap mode on the Respironics machine. I have used a tight range of 8 to 10 and had a truck load of events. That was back when I first started therapy and the RX was 8 cm. I only spent 6 minutes in REM during the titration study. No wonder they didn't get the pressure right. Also I probably had one of my "good" nights when I simply didn't have any of those events that need the higher pressures.

So I can't really answer your question because in my situation it has too many "what ifs".
I never wanted to try cpap mode because I didn't want to use 16 or 17 cm all night and I didn't want to risk having those super duper REM events happen if I used the lower pressure. I didn't want to risk the desats and morning headaches.

So what if you are having the sawtooth pattern and not sleeping well?

Sawtooth means what? Do or not do anything about it? Or do or not do anything based on the other data?

Thanks.

Pugsy- so glad you explained the PR sawtooth pattern. I've seen it and I didn't know what it was either. Thought I maybe needed more pressure for more stability, despite that I have relatively few events. Now I can ignore it. Thanks for the info!

Darth Lady wrote:Pugsy- so glad you explained the PR sawtooth pattern. I've seen it and I didn't know what it was either. Thought I maybe needed more pressure for more stability, despite that I have relatively few events. Now I can ignore it. Thanks for the info!

there is a little backwards meaning to the sawtooth pattern too... if you're having some disturbance in your sleep, it won't do it, but if everything is calm and smooth, then it starts getting restless and poking you "are you ok? how 'bout now, now 'bout now, *poke prod*"

Punchyandtired wrote:So what if you are having the sawtooth pattern and not sleeping well?

Sawtooth means what? Do or not do anything about it? Or do or not do anything based on the other data?

The spikes sort of mean that the machine tried a higher pressure and wasn't impressed with the improvement.

You might try a slightly higher minimum pressure and see if it helps, but consider it an experiment and drop back if it doesn't improve things.

Punchyandtired wrote:So what if you are having the sawtooth pattern and not sleeping well?

Sawtooth means what? Do or not do anything about it? Or do or not do anything based on the other data?

Thanks.

If all you are seeing is a sawtooth pattern and the pressure doesn't rise and stay at a level for a while, then its just the algorithm doing its thing. In this case, its better to just go on a straight pressure and eliminate the hunt-n-peck completely.