Making progress

[melikou1]

Hi,

Have now been using my Auto-CPAP for 10 days.

Switched my AirTouch F20 FFM to the Dreamwear FFM. Have used for 3 nights, and is definitely more comfortable for me.

My provider has apparently bumped my beginning pressure now up to about 7 so I didn't have to go down the road of making the change myself, although I've received the providers Manual.

I've posted my last night results....I know, a random sample of one is always considered statistically incorrect, but it's what I've got so far. The Clear Airway events around 0600 are me being awake, and then drifting back off to sleep for a bit.

Any input appreciated.

2018-06-28 for posting.jpg (564.86 KiB) Viewed 413 times

[Pugsy]

When did they make the change to the 7 cm minimum? Today maybe? The report from last night is still showing 4 cm minimum.
I would't be surprised if that cluster of CAs/centrals at 4:30 wasn't also some SWJ sleep/wake/junk where you were awake or semi awake.

I would be real interested in seeing what that new minimum of 7 cm does. I think it will clean up a good bit of the obstructive stuff which is the OAs, hyponeas, FLs, & snores.
Not much we can do about the awake/semi awake centrals except hopefully get back to sleep quicker. That will come with time and experience as you get more used to having the mask and machine on.

[melikou1]

Sorry, braindead about 4 cm minimum...was looking at starting pressure.

So the cmH20 Pressure is the only setting I would need to adjust?

[melikou1]

When did they make the change to the 7 cm minimum? Today maybe? The report from last night is still showing 4 cm minimum.
I would't be surprised if that cluster of CAs/centrals at 4:30 wasn't also some SWJ sleep/wake/junk where you were awake or semi awake.

I would be real interested in seeing what that new minimum of 7 cm does. I think it will clean up a good bit of the obstructive stuff which is the OAs, hyponeas, FLs, & snores.
Not much we can do about the awake/semi awake centrals except hopefully get back to sleep quicker. That will come with time and experience as you get more used to having the mask and machine on.

Sorry, braindead about 4 cm minimum...was looking at starting pressure. As well as remembering to quote you so you see.

So the cmH20 Pressure is the only setting I would need to adjust?

[Pugsy]

I like to keep any changes made to a minimum unless it is critical to change more than one thing at a time.
Remember Science 101...keep your variables to a minimum.

Yes...the minimum starting pressure is the only change that I would do at this time.
I think 7 cm would be a good minimum since you are pretty much spending most of the night up there or a little higher anyway.
It should help reduce some of that obstructive stuff.
We can't do anything about the centrals/CAs even if they were real with your machine. More pressure won't fix them unless they happen to be a byproduct of an arousal caused by something obstructive...which wouldn't be impossible to have that happen. I have seen it happen....clean up the obstructive stuff and the centrals reduce because they were SWJ or post arousal centrals and not "real" centrals.

If going from 4 starting point to 7 cm starting minimum is uncomfortable....try 5 or 6 minimum and work up slowly.

Also go into SleepyHead and fix the red line threshold for large leak. It defaults to the ResMed 24 L/min red line and Respironics machines don't use that number. Respironics doesn't use a fixed red line threshold but instead will have it vary with the pressure and mask used.
At your pressures with your mask...probably change that 24 L/min to something around 80 L/min.
Go to Preferences/ CPAP tab and change the 24 that you see for red line threshold or just turn it off and rely on the Events graph for Large Leak flagging. See the LL on the Events graph? That's large leak per the machine and if you don't see a flag up there there were no large leaks despite what the statistic might say. The statistic percent over red line is working off that 24 and for a Respironics machine that number is too low.

[melikou1]

I like to keep any changes made to a minimum unless it is critical to change more than one thing at a time.
Remember Science 101...keep your variables to a minimum.

Yes...the minimum starting pressure is the only change that I would do at this time.
I think 7 cm would be a good minimum since you are pretty much spending most of the night up there or a little higher anyway.
It should help reduce some of that obstructive stuff.
We can't do anything about the centrals/CAs even if they were real with your machine. More pressure won't fix them unless they happen to be a byproduct of an arousal caused by something obstructive...which wouldn't be impossible to have that happen. I have seen it happen....clean up the obstructive stuff and the centrals reduce because they were SWJ or post arousal centrals and not "real" centrals.

If going from 4 starting point to 7 cm starting minimum is uncomfortable....try 5 or 6 minimum and work up slowly.

Also go into SleepyHead and fix the red line threshold for large leak. It defaults to the ResMed 24 L/min red line and Respironics machines don't use that number. Respironics doesn't use a fixed red line threshold but instead will have it vary with the pressure and mask used.
At your pressures with your mask...probably change that 24 L/min to something around 80 L/min.
Go to Preferences/ CPAP tab and change the 24 that you see for red line threshold or just turn it off and rely on the Events graph for Large Leak flagging. See the LL on the Events graph? That's large leak per the machine and if you don't see a flag up there there were no large leaks despite what the statistic might say. The statistic percent over red line is working off that 24 and for a Respironics machine that number is too low.

Done...thanks for the guidance. Now to see how things go tonight. At least last night I wasn't waking up 2 and 3 times during the night like has been the average over the past few months.