Always go by how you feel, there really isn't much difference between last night's data and all the other data from prior nights. Your AHI is NOT bad in any of the reports. For your pressure, your leak is NOT bad either. Sure you had a few leaks last night but that is to be expected with that high a pressure.Gregg wrote:Here's more data from the last two nights.
The first night resulted in a horrific day, following.
The second night appears to be a bright healthy day here, despite large mask leaks. And even what the machine sees as snoring.
I'm posting here so it's on the record. I'm not sure it amounts to much or if it can be useful. And I realize I've been doing the forbidden rapid succession machine adjustments. Hell, I'd grind the machine up and eat it if it helped avoid days like yesterday.
I did increase the max pressure support on the second night. As well as going from 3 to bipap setting 2. This is all on auto mode.
Rate "How you feel" from 1 to 5. Give the first night a 1 and last night a higher score. Keep in mind if you over titrate yourself with too high a pressure, you can cause sleep fragmentation which may be why you felt so lousy on 7/28-7/29. That is why you want to rate how you feel and adjust for that as final setting. Sometimes that means allowing AHI to rise and some snoring to persist.
You will notice MORE snore seen on 7/29-7/30. Pretty hard to go by just one night's comparison, but Vibratory Snore (VS) and FL appears to be what is driving up your pressure.
I would still put IPAP Max=20 and even lower EPAP Min = 8 or 10. Greater Pressure Support (PS) appears to work better for you. You want to find out if that 14 cm EPAP is accurate. From what I can tell from the reports is IPAP is pulling up EPAP due to the lower PS setting you had used. Nothing wrong with having that EPAP set at the Minimum setting. I would leave BiFlex set to 2 until you get the pressure thing sorted out which leaves you feeling the best. If you change things with a shot-gun approach you don't really learn what worked or made the difference.
You really have to give this machine the "range" it needs to move it is not like a CPAP Auto where you can narrow pressure settings down to that of a CPAP.
IF OA goes higher you increase EPAP, if HI increases you allow IPAP to go higher, once both are within acceptable levels you go by how you feel. Then you look at the individual events driving pressure shown at the bottom of the daily report.