I down to 4 CFM, no what?

Too tall · Post by **Too tall** » Thu Mar 27, 2014 5:48 am

I've been lowering my pressure from 6 to 5 then last night to 4. Still getting AHI of less than 1 consistently. Usually less than .5. So what's the next step. I'm sleeping much better now. Since the sleep test in Oct. I've had a ablation procedure on my heart and no longer take blood thinner or the channel blocker. I know it's a long shot but I'm hoping one of these caused the apnea of 8 AHI on the sleep test and I may be able to get off of this gizzmo.

I think I'm probably borderline without it but don't know. I'll stay with it till I'm convinced I don't need it as I don't need a stroke either.

The only thing I can figure is do another sleep test and see where I'm at officially. Your thoughts. Thanks in advance. Anybody ever have an experience like this.

Julie · Post by **Julie** » Thu Mar 27, 2014 6:47 am

I'd certainly want another test asap.

alpha752 · Post by **alpha752** » Thu Mar 27, 2014 6:57 am

Yeah get another study. I don't think my machine even goes less then 4, you likely don't need it anymore if your ahi is consistently that low.

Sheriff Buford · Post by **Sheriff Buford** » Thu Mar 27, 2014 7:01 am

I agree on another test. I think we all should go back and get another test after several years of active therapy. Just to see where you are at and if we need to tweak our numbers.

The best thing about going back for another test is you can bring your own mask... yippee!!

Sheriff

Pugsy · Post by **Pugsy** » Thu Mar 27, 2014 7:59 am

I agree with the others...time for another sleep study without the machine to see what is going on for sure.
I wouldn't risk the heart issues by not using the machine without confirmation that the sleep apnea issues are resolved and the only way to get that confirmation is a sleep study with no machine.
There is therapy value in that 4 cm of pressure and there is the remote chance that the 4 cm pressure is preventing enough events to make a difference. While most people are going to need a lot more than 4 cm...there are some people who only need that little bit.

With your history...I wouldn't risk it...I would get the sleep study without the machine to make sure that the sleep apnea issues are now below diagnostic criteria levels and the machine is no longer needed.

robysue · Post by **robysue** » Thu Mar 27, 2014 8:03 am

Too tall wrote: I think I'm probably borderline without it but don't know. I'll stay with it till I'm convinced I don't need it as I don't need a stroke either.

The only thing I can figure is do another sleep test and see where I'm at officially. Your thoughts. Thanks in advance. Anybody ever have an experience like this.

Like all the rest, I'd also say it's time for another official sleep test just to find out what's going on with the untreated OSA. While it is uncommon, there are folks who have OSA and only need 4cm to control it. And it's possible that's what's happened. And the only definitive way to tell if your OSA is genuinely gone (and you don't need PAP) or your OSA is just exceptionally well controlled at 4cm is through another sleep test without the mask.

Too tall · Post by **Too tall** » Thu Mar 27, 2014 8:25 pm

Pugsy wrote:I agree with the others...time for another sleep study without the machine to see what is going on for sure.
I wouldn't risk the heart issues by not using the machine without confirmation that the sleep apnea issues are resolved and the only way to get that confirmation is a sleep study with no machine.
There is therapy value in that 4 cm of pressure and there is the remote chance that the 4 cm pressure is preventing enough events to make a difference. While most people are going to need a lot more than 4 cm...there are some people who only need that little bit.

With your history...I wouldn't risk it...I would get the sleep study without the machine to make sure that the sleep apnea issues are now below diagnostic criteria levels and the machine is no longer needed.

My thoughts also. I will take no chances. I really do suspect your opinion is correct in that I am borderline but need that little extra pressure.

Goofproof · Post by **Goofproof** » Thu Mar 27, 2014 8:42 pm

My way at looking at the problem, what does it cost you to continue using treatment, compared to another sleep test or the possible effects of non-treatment.

I would use my cpap software to confirm my pressure was optimized, noting that the leak level was correct. Using a low pressure would not work for me, I require air, but that's just me maybe. You could use a recording pulse ox and software, to insure you are mataining your O2 levels at night. Jim

Woody · Post by **Woody** » Fri Mar 28, 2014 7:44 pm

It seems that the few times this is brought up ever one blows it off but there are some throat exercises
that are suposed to help sleap apnia. Now I know most of us wouldn't get much out of the exercises like
what would it matter to me if I could do the exercises and lower my pressure 2 cm from 14 to 12. But in
the case of this poster if he is doing fine at 4 cm might not these exercises be all he needs?

Guest · Post by **Guest** » Fri Mar 28, 2014 8:12 pm

Too tall wrote:I've been lowering my pressure from 6 to 5 then last night to 4. Still getting AHI of less than 1 consistently. Usually less than .5. So what's the next step. I'm sleeping much better now. Since the sleep test in Oct. I've had a ablation procedure on my heart and no longer take blood thinner or the channel blocker. I know it's a long shot but I'm hoping one of these caused the apnea of 8 AHI on the sleep test and I may be able to get off of this gizzmo.

I think I'm probably borderline without it but don't know. I'll stay with it till I'm convinced I don't need it as I don't need a stroke either.

The only thing I can figure is do another sleep test and see where I'm at officially. Your thoughts. Thanks in advance. Anybody ever have an experience like this.

did i miss which mask you are using
and your leak rate
if you are having large leaks at 4cm your machine may not be able to detect any events

watergauge · Post by **watergauge** » Sat Mar 29, 2014 4:32 pm

Too tall wrote:I've been lowering my pressure from 6 to 5 then last night to 4. (snip)

FYI, it's not "CFM", the units are "centimeters water gauge", written "cm w.g." CFM (cubic feet per minute) is a flow measurement, a dependent variable, not a set-point. The CPAP machine is set for "cm w.g.", a pressure target, typically in the 4 to 20 cm range. No comment on your "4 cm w.g." setting.
Cheers,
WG

Too tall · Post by **Too tall** » Mon Mar 31, 2014 8:20 pm

Guest wrote:
Too tall wrote:I've been lowering my pressure from 6 to 5 then last night to 4. Still getting AHI of less than 1 consistently. Usually less than .5. So what's the next step. I'm sleeping much better now. Since the sleep test in Oct. I've had a ablation procedure on my heart and no longer take blood thinner or the channel blocker. I know it's a long shot but I'm hoping one of these caused the apnea of 8 AHI on the sleep test and I may be able to get off of this gizzmo.

I think I'm probably borderline without it but don't know. I'll stay with it till I'm convinced I don't need it as I don't need a stroke either.

The only thing I can figure is do another sleep test and see where I'm at officially. Your thoughts. Thanks in advance. Anybody ever have an experience like this.
did i miss which mask you are using
and your leak rate
if you are having large leaks at 4cm your machine may not be able to detect any events

I've used a nasal pillow and one that fits over the nose. I have an erratic leak chart but it's always been that way. I have a theory, I was taking Valium to help with sleep lwhen I did the sleep test and pretty much since I went on the cpap in oct. I think the Valium was slowing my pulse and respiratory rate gown to much. I was also taking a blood pressure lowing med and the blood thinner warfarin. I've got a routine appointment with the sleep doctor on thu and I will get his opinion.

Guest · Post by **Guest** » Tue Apr 01, 2014 2:58 am

Too tall wrote:I have an erratic leak chart but it's always been that way

that does not make your data any more accurate or acceptable

Too tall · Post by **Too tall** » Tue Apr 08, 2014 7:17 pm

yea I know that. Maybe you can tell me. what is a good chart suppose to look like? is the bottom line suppose to be straight?

djhall · Post by **djhall** » Wed Apr 09, 2014 12:55 pm

Too tall wrote:yea I know that. Maybe you can tell me. what is a good chart suppose to look like? is the bottom line suppose to be straight?

With the two lines from Respironics machines the top line is the total leak rate and the bottom line is the machine's best estimate of how much was intentional leak (above the bottom line) and how much was unintentional leak (below the bottom line). In a perfect world the bottom line would be flat and nothing would ever leak except the vent. In the real world, leaks happen. If the bottom line stays relatively close to the bottom of the chart then you are just having small leaks here and there. If you have hills, humps, mountains, then you are seeing times where there is a fairly significant amount of air escaping, perhaps the mask has shifted or you mouth breathed with a nasal mask. That becomes a problem if it gets to the point where top line starts hitting 75 or 80. Past that point the machine can't keep pumping more air to make up for the amount that is leaking and you are going to start loosing treatment effectiveness.

I down to 4 CFM, no what?

I down to 4 CFM, no what?

Re: I down to 4 CFM, no what?

Re: I down to 4 CFM, no what?

Re: I down to 4 CFM, no what?

Re: I down to 4 CFM, no what?

Re: I down to 4 CFM, no what?

Re: I down to 4 CFM, no what?

Re: I down to 4 CFM, no what?

Re: I down to 4 CFM, no what?

Re: I down to 4 CFM, no what?

Re: I down to 4 CFM, no what?

Re: I down to 4 CFM, no what?

Re: I down to 4 CFM, no what?

Re: I down to 4 CFM, no what?

Re: I down to 4 CFM, no what?