suggestions for adjusting my pressure?

[Uni]

Hi! No problems sleeping last night - I'll put the pressure up to 15 cm h2o max. I woke up today feeling more like I did after my initial in house sleep study- like my lungs were fully expanded, if you know the feeling I'm talking about...

[palerider]

Good Morning!
So last night I changed the settings to APAP minimum 9 maximum 13.

What do you all think: Should I up the maximum to 14 or leave alone?

I'd raise the minimum a little and raise the max like Pugsy said.

also, you ALMOST got the linked bbcode post right... you had:

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what you needed was:

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(note the extra ] at the end. use the preview button to make sure everything looks and works right before hitting submit.

[palerider]

Hi! No problems sleeping last night - I'll put the pressure up to 15 cm h2o max. I woke up today feeling more like I did after my initial in house sleep study- like my lungs were fully expanded, if you know the feeling I'm talking about...

for most people, there's no need to even have a max, because, like Pugsy said, unless there's something to correct, the machine won't raise pressure.

so it may be better to set the max at 20, and see what happens, rather than have less optimal sleep for however long it takes to inch up to where the machine needs to go, to cut down on your events.

[Pugsy]

I tend to be more conservative and I wouldn't raise the minimum until I saw if letting the max be more of a factor still didn't break up that little bit of clustering.
A little more maximum might be all that is needed to clean things up sufficiently.
Your choice though...me...I prefer using as little pressure as possible on that minimum that will get the job done. I would only raise the minimum if more maximum couldn't get the job done.

Besides...Science 101 when doing experiments...keep your variables to a minimum when at all possible.
One change at a time unless things are horrible and it's painfully obvious that something is never going to work well. And your report is far from horrible...you are at the minor tweaking stage.

[palerider]

I tend to be more conservative and I wouldn't raise the minimum until I saw if letting the max be more of a factor still didn't break up that little bit of clustering.
A little more maximum might be all that is needed to clean things up sufficiently.
Your choice though...me...I prefer using as little pressure as possible on that minimum that will get the job done. I would only raise the minimum if more maximum couldn't get the job done.

Besides...Science 101 when doing experiments...keep your variables to a minimum when at all possible.
One change at a time unless things are horrible and it's painfully obvious that something is never going to work well. And your report is far from horrible...you are at the minor tweaking stage.

fair enough, you know me though, always wanting to get the best sleep as soon as possible

[Pugsy]

fair enough, you know me though, always wanting to get the best sleep as soon as possible

Yeah...I know you.
Here's the deal..we don't know that more minimum is going to improve his sleep guaranteed because we don't know where that maximum wants to go yet.

I can use 9 or 10 cm minimum and let the machine go to 18 cm and have an AHI less than 2.0
I once did an experiment where I went up to 13 cm minimum...in 0.5 cm increments over a period of several weeks (kept the change in minimum for 1 week each) and you know what...the AHI never got any better at 13 than it was at 10 cm. So more minimum doesn't always do what we think it should do.
I aborted the experiment after the week at 13 cm....I just didn't want to go higher because it wasn't much fun.

Since his AHI is sometimes good and sometimes not so good...I imagine we are dealing with supine sleeping primarily. If it was REM I think we might see more clustering and no "good" nights.
But...you never know for sure and the treatment is the same no matter which is the cause.
Let the machine sort it out unless the sorting it out causes a problem and if it does then we deal with it by crossing that bridge if and when we come to it.

[Uni]

Good Morning again!

Palerider , I decided to go for changing just one variable.

I upped the Max to 15, kept the minimum at 9. I didn't have any alcohol, and I don't have a cold, so those variables aren't there either. I rarely ever drink so it isn't usually a variable. The only other variable is kids jumping into bed and pushing me into weird positions, and I'm sure I move from side sleeping to supine because that strap migrates to over ear cartilage and the pain prompts me to move. I'm not sure how to fix that, other than keep the kids kicked out of the bed so that I have room to move to my left side instead of just supine.

Definitely some aerophagia this morning but nothing I can't deal with. Better out than in, I say.

I think that any data before 11:40 pm or after 6:30 am may have been when I was awake but not sure. First clock time I saw was 7:20 am.


Thank you Again Pugsy, Palerider and LSA. Would you go up again to 17 cmH20 max, see how it goes?

[Pugsy]

How do you feel other than a bit of aerophagia after last night?
Do you feel your sleep was decent until with the exception of the distraction from the kids?

Actually with aerophagia starting to rear its ugly head I wouldn't increase the maximum at this time and instead I would increase the minimum by only 0.5 cm. You are having some minor clustering even at the lower pressures and I am wondering if maybe just a tiny more minimum will help clean things up better and maybe then the machine won't need to go quite as high...as I suspect that it is the higher max causing the aerophagia thing.
The machine may want to go there but if going there creates unwanted symptoms then we back up and try to figure out an alternate way of fixing things besides letting the machine sort it out.

I don't go so much with the AHI numbers. I go with how I feel and how I sleep first...then the AHI numbers are of secondary importance.
One of my best "miracles" and I felt totally like superwoman one day early in therapy came after a night with AHI of 10.2.
Go figure that one.

[palerider]

Good Morning again!

Palerider , I decided to go for changing just one variable.

nothing wrong with that.

[Uni]

Palerider you have a nice smile.


Is clustering signaled by the vibratory snore?
Or is it something else?

I'm feeling much better overall. I'm trying avoid afib. I'm 46, no medical problems and had an episode of lone afib in February. The only reason we could find for the episode was sleep apnea.
I don't want to be on eliquis, which may happen if I have another afib episode, so I'm doing my best to decrease the risk factor- sleep apnea. That's why I dove into the full face mask instead of even trying the nasal pillows. I'll tweak comfort after I've gotten as good as I can.

I do feel great now but not sure if that's because I'm also getting more sleep in general with vacation and holiday. After September 12 I'll be back to six hours tops a night and we will see how I feel.

I'll take your advice and up the minimum to 9.5; I also told the kids I need to sleep on my side so move over or move out.

[palerider]

Palerider you have a nice smile.


Is clustering signaled by the vibratory snore?
Or is it something else?

no, snores are snores, respironics just calls them 'vibratory'. I believe the clustering that Pugsy refers to is just when you have several events in close proximity to each other.

After September 12 I'll be back to six hours tops a night and we will see how I feel.

that's really not enough sleep for healthy living, even if you're getting great, not breathing disturbed sleep.

[Pugsy]

My butt would be dragging big time with only 6 hours of sleep. It's simply not enough no matter how "good" those 6 hours might be. We do what we have to do though but just realize that cpap can only fix so much and it can't make up for not enough hours.

[Uni]

Armed with information I am going to fight the dark anti-sleep forces: work and family. I'm telling them if they don't want me back in the hospital I need more sleep. But realistically I have to get up between 4:15 am and 5 am depending on the day. I have the resources available to force the kuds upstairs by 8, I just have to be firm with the family that damn it, I'm lights out at 9 pm.
Thanks for your continued support!

The wisest person is the one that follows your advice, right? Or something like that.

[Pugsy]

Don't do like I do...
Saturday night I was out until 5 AM yesterday morning...and due to the coffee I drank to get us home I wasn't sleepy at 5 AM. Fell asleep on the couch (no cpap) for a couple of hours...my butt was dragging big time last night.
That was a rarity though. Special circumstance. Normally I am in bed by 11 ish and up around 7ish.
Sometimes I just have to have a life outside the realm of cpap. I pay for it but I accept it.

[Uni]

Hi!
I didn't go away, just had SD card issues. I now have both an sd card that works and a computer that isn't crashing so .....

I have been taking your advice and feel much better.

I'm wondering if I should keep adjusting the minimum up by 0.5? The dreamstation auto cpap is now set at minimum 9.5 maximum 15 mm H2O.
Thank you again for your help-- I'm feeling great. Now I just need to get to bed earlier.