Lots of events at max pressure

[zzrrrp]

Do you have a copy of your sleep study? Did it specify an optimal pressure setting?
Was there any mention of Central Apneas in it?
How did you end up with a range of pressures?
Your minimum pressure does seem a bit low to me, but depending on what your sleep study (titration) says, and how you happened to get that pressure range prescribed is what I have questions about.


Den

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I do have a copy of the study. Due to a bit of stage fright, my total sleep time at the study was 3.2 hours, 13 minutes of which were REM. I did not have a split study; no titration was performed. The basis of my diagnosis was an extrapolated AHI of 46.2 during REM (an effective AHI of roughly 11, assuming 25% REM sleep). No recorded central apneas.

[Wulfman...]

Do you have a copy of your sleep study? Did it specify an optimal pressure setting?
Was there any mention of Central Apneas in it?
How did you end up with a range of pressures?
Your minimum pressure does seem a bit low to me, but depending on what your sleep study (titration) says, and how you happened to get that pressure range prescribed is what I have questions about.


Den

.

I do have a copy of the study. Due to a bit of stage fright, my total sleep time at the study was 3.2 hours, 13 minutes of which were REM. I did not have a split study; no titration was performed. The basis of my diagnosis was an extrapolated AHI of 46.2 during REM (an effective AHI of roughly 11, assuming 25% REM sleep). No recorded central apneas.

OK.
Due to what I see in your nightly report(s), I would recommend switching to straight pressure (somewhere between 8 an 10 for now) and see how that goes. Your Flow Limitations are driving your pressures erratically during the night and that could be very disrupting to your sleep (quality).


Den

.

[VVV]

13 minutes of which were REM

Typically, pressure requirement in REM are higher than in the other sleep stages. 13 minutes is not a lot of time to do a proper titration that accounts for REM periods. This suggests that they titrated your pressure settings too low.

I think if you set your pressure at min 8, max 20, you will start to get a better idea of your pressure needs.

I would recommend switching to straight pressure

That's exactly bassackwards Wulfman. When you are trying to find an ideal pressure setting at home with your CPAP, you start with a min/max range. Trying to do this with straight pressures will take more, maybe many more, nights of experimenting. You may actually never find the best setting using straight pressures in your experiments.

I know you operate off a paradigm of, "straight pressure is best for me, so it must be best for everyone else".

The popularity of APAPs belies your paradigm.

[VVV]

zzrrrp

BTW, Congratulations on hitting the ground running with your therapy and already posting good screenshots here and understanding a good bit about what is going on.

[Wulfman...]

13 minutes of which were REM

Typically, pressure requirement in REM are higher than in the other sleep stages. 13 minutes is not a lot of time to do a proper titration that accounts for REM periods. This suggests that they titrated your pressure settings too low.

I think if you set your pressure at min 8, max 20, you will start to get a better idea of your pressure needs.

I would recommend switching to straight pressure

That's exactly bassackwards Wulfman. When you are trying to find an ideal pressure setting at home with your CPAP, you start with a min/max range. Trying to do this with straight pressures will take more, maybe many more, nights of experimenting. You may actually never find the best setting using straight pressures in your experiments.

I know you operate off a paradigm of, "straight pressure is best for me, so it must be best for everyone else".

The popularity of APAPs belies your paradigm.

Considering the OP's breathing patterns, using a range of pressures will be a disaster. And, I've witnessed enough of those on the forum to know what I'm talking about.
Ranges of pressures are not for everybody and optimal pressures can be determined using straight pressures.

AND, the "popularity" of APAPs doesn't have a damn thing to do with it. I ALWAYS recommend a person getting an APAP if possible. The ultimate proof is in "SLEEP QUALITY"!


Den

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[palerider]

Edit: The thing that jumps out at me are the Flow Limitations. Increasing the upper pressure may be problematic with them.

yes, it might make them go away and give the OP better sleep.

[palerider]

Considering the OP's breathing patterns, using a range of pressures will be a disaster.

if, as you *ASSUME* the OP will be bothered by the machine behaving as it's designed, and modifying the pressure to suit the situation.

not everybody is bothered by that. possibly not even a majority.

the OP certainly didn't complain about it.

[Wulfman...]

Considering the OP's breathing patterns, using a range of pressures will be a disaster.

if, as you *ASSUME* the OP will be bothered by the machine behaving as it's designed, and modifying the pressure to suit the situation.

not everybody is bothered by that. possibly not even a majority.

the OP certainly didn't complain about it.

But, obviously he was concerned about what he saw in his report. SOME things are just obvious and need to be pointed out.

It's his therapy, he can set the machine however he wishes.

One thing I do know is that there have been numerous situations over the years where I've ended up helping users OFF of the forum getting their therapy straightened out after the "pressure range" advocates have gotten them thoroughly messed up.


Den

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[Hang Fire]

the "pressure range" advocates

The doctors that set the range at 4-20 I would guess.

[Hang Fire]

Edit: The thing that jumps out at me are the Flow Limitations. Increasing the upper pressure may be problematic with them.

yes, it might make them go away and give the OP better sleep.

+1

[Wulfman...]

Edit: The thing that jumps out at me are the Flow Limitations. Increasing the upper pressure may be problematic with them.

yes, it might make them go away and give the OP better sleep.

Or "worse" sleep.

But, that's why I was asking the OP about the pressure range and whether there may have been any Centrals noted in the sleep lab report......to limit the upper pressure range.


Den

.

[Wulfman...]

the "pressure range" advocates

The doctors that set the range at 4-20 I would guess.

I was referring to the ones on the forum.


Den

.

[Hang Fire]

I've ended up helping users OFF of the forum getting their therapy straightened out after the "pressure range" advocates have gotten them thoroughly messed up.

Well, I am sure they will soon chime in by the dozens and tell us how you got them on a straight CPAP pressure and their lives thereafter blossomed.

[Julie]

Den - sometimes you can't win for trying!

[Hang Fire]

Den - sometimes you can't win for trying!

Unfortunately, Den thinks this is about winning.

It is not. It's about helping the OP optimize his therapy.