HELP!!

TDog · Post by **TDog** » Sun May 11, 2008 2:59 pm

Hi all, looking for some input from some of the seasoned vets around here:

I've been on cpap for about 2 weeks now. My RX called for a pressure of 12, but that was causing what I've come to find out were centrals. I found these worse than OA's because I never was aware of waking with OA's. With CA's, I'd wake up gasping. Anyway, I've been trying to find that "sweet spot" and I just can't seem to find it.

Here are my #'s from last nite:

Pressure:9
Leaks: .06
AHI: 6.4
AI: 1.4
HI: 4.9

These are pretty typical at pressures between 9-10. Anything over 10 and my AHI starts to shoot up. I can't believe going any lower would help. I am using a ResMed Elite 8 & a Mirage Liberty. Any thoughts? Thanks!

alnhwrd · Post by **alnhwrd** » Sun May 11, 2008 8:14 pm

The Elite adjusts in .2 cm increments I believe. You could try taking it to 8.8 for a week, see what results you get, then go up or down from there. The other option would be to see if you can get an APAP for a couple weeks and see what pressure you spend most of your time at.

The other question is, how do you feel? If you are feeling good, maybe you can just wait for a couple of weeks more and see if there is any improvement. My numbers went down spontaneously at about three months. Sometimes its best not to change settings too much or too often, or to change more than one thing at a time.

TDog · Post by **TDog** » Sun May 11, 2008 10:03 pm

I *think* I feel a little better, but no dramatic improvement. I was told my apnea was "severe" so I guess an AI of 1.4 is not bad, I've read on here that resmed machines tend to have high HI #'s that can throw off your AHI so maybe I'm doing better than I think. I don't know...this stuff can be really overwhelming.

goose · Post by **goose** » Sun May 11, 2008 10:19 pm

When you make a change try to leave it that way for a minimum of a week unless something is terribly wrong. Personally, when I make a change I leave it that way for a month and watch the data.

I was titrated at 5 and was gasping for breath at that.....
Then it was set to 7 so that I wasn't gasping but the AHI was steady at 11. Not making much progress to my estimation, so....

I got an APAP (talked the dr. into an updated prescription) and set the range between 7-15 and found that at the higher pressures, centrals were starting -- similar to your experience. so I set it to 10, left it that way and my AHI has been averaging about 2.5 for about 9 months or so -- I played with some pressures for a few months, but settled at 10.
If you are comfortable at 9 and you're feeling better, I'd leave it there for a while and see if the numbers come into line....

I don't know the Resmed machines, but if it will adjust in .2cm increments, make your changes fairly small once you get it close....

Good luck!!! Take care
cheers
goose

alnhwrd · Post by **alnhwrd** » Mon May 12, 2008 1:01 am

I think the definition of Severe OSA is 30+ events an hour, so on the plus side you are doing yourself a whole bunch of good right where you are at. I've laid down, tossed and turned for a half hour without sleeping, gotten up and checked my stats and had AI 0.0, as expected, but HI 3.3 with my Elite. So I tend to put a little more trust in the AI numbers. Having said that, I do seem to feel a bit better when both numbers are low.

Bottom line, I don't think there is anything wrong with sitting where you are for a week or two and seeing where your numbers go. Give yourself a chance to get more comfortable with the treatment, let your body and mind get used to sleeping this way. Then I would try small changes, leaving it at each new setting for at least a week like Goose said. Let the forum know how things works out for you.

TDog · Post by **TDog** » Mon May 12, 2008 7:59 am

Thanks for the replies. Last night, my AI was 1.4 but my leak rate went up to .26/l and my HI went up to 15 something. I do recall waking a couple times to mess w/my mask in the night.

Can someone help me out with the whole leak rate thing? What is an "acceptable" leak rate? The Liberty mask has a flow rate of 35 or so at my pressure setting. So how does my .26/l leak rate last night correspond to that? I do have the correct mask selection on the S8.