Is your machine set higher than your titration pressure?

[flatag]

I was titrated at 11 but was having regular nights of AHI in the high teens. Reducing the EPR from 3 to 0 dropped the AHI into the low teens but that is too high for my liking.

My pressure was bumped up to 13 with EPR at 3 by the Doc and that dropped my AHI to the high single digits. I reduced the EPR to 1 and my AHI dropped to between 4 -6. Tonight I'm thinking of setting the EPR to 0 and give that a go for awhile.

I try all of my adjustments for a few days to a couple weeks before making further adjustments.

I find it odd that my sleep study report says I had zero events at a pressure of 11 but at home I was having 70 or 80 a night.

I have my first "detailed" visit with my sleep doctor on Weds. It'll be interesting to find out what he has to say.

[Pugsy]

My pressure recommendation from my titration study was 8 cm. It became painfully obvious once I had my software to view my reports that 8 cm wasn't getting the job done. AHI 8 to 10. I was using APAP at the time but with a tiny range to mimic cpap and the range was only 8 to 10. The reports showed I was maxing out at 10 pretty much all night.
So I proceeded to make some adjustments and when the dust cleared I was using 10 minimum and 20 maximum. Most of the time the pressure stayed around 11 or 12 but I would see short times with higher pressures sometimes nearing 18 cm.

I happen to be someone whose OSA is markedly worse during REM sleep when compared to non REM sleep. It was determined that sometimes in REM sleep I just need higher pressures. Hence those pressure increases.
Others may have their OSA worse when they sleep on their backs.

The titration sleep study doesn't mimic what we do at home. Let's face it. It is one night in a very foreign environment.
In my case out of 8 hours of sleep I got around 150 minutes of sleep but only 6 minutes in REM stage sleep. It's no big surprise that the 8 cm didn't work out since I really didn't have enough time there to really test it. Also some nights I may not ever see a pressure needed increase. Probably for those 6 minutes 8 cm did do the job.

[sol]

I think you need to get comfortable with the mask, get leaks under control and get some decent sleep before evaluating anything else
Whats the leak? High leak can affect the accuracy of data and compromise your therapy

[ChicagoGranny]

I was titrated at 11 but was having regular nights of AHI in the high teens.

If not already using software, I would download the ResMed software, http://www.resmed.com/int/assets/html/s ... ister.html .

Get the software working and have a look at your daily details report for clusters of apneas or other problems.

If this does not give a good clue to improvement then change your machine pressure setting to min 11 and max 20 cm. (Assuming you have no tendency to central apneas.)

See what the daily details report looks like with this setting. You can post a screen shot here for help by the members.

[chunkyfrog]

Isn't it a hoot that insulin dependent diabetics are expected to self-titrate every day;
While adjusting your own air pressure totally freaks people out?

[flatag]

While adjusting your own air pressure totally freaks people out?

Who is freaked out?

[ChicagoGranny]

While adjusting your own air pressure totally freaks people out?

Who is freaked out?

Minerva, RPSGT: viewtopic/t50531/viewtopic.php?f=1&t=50 ... 2C#p572365

[chunkyfrog]

--like we care.

[SleepyToo2]

Isn't it a hoot that insulin dependent diabetics are expected to self-titrate every day;
While adjusting your own air pressure totally freaks people out?

Not a hoot to me. Darned frustrating that patients with diabetes are encouraged to self-titrate while lawyers with nothing better to do write legislation that make it illegal to protect the income of DMEs. Minerva's post (referenced above) indicates the BS that DMEs and docs swallow about how patients should not dare to adjust their dose of air. Also very naive if the writer thinks that patients don't make adjustments to their dose of medications based on how they feel. Small adjustments are not going to kill us one way or the other, especially if we are monitoring the details of our therapy.

[Bons]

When I started on cpap two years ago my prescribed pressure was 9. My 90% epap is now 8.5 on asv, and my average pressure support is 5, so my average inhalation pressure is considerably higher than my first prescribed pressure.

[KEQ5]

I was titrated out at 8cm in the sleep lab, but the S9 Autoset has been running at 10-13 for my first few sessions. So it feels hit/miss whether your sleep lab titration pressure ends up being your long-term therapy pressure.

(My S9 is set wide-open at 4-20cm. When I go see the sleep doc in 5-6 weeks, I'll have enough data to guide a tightening up of that range.)