Help! Understanding the smart code

[doc47]

Greetings all, I just joined the forum even though I've been doing cpap therapy for several years. I've never learned how to evaluate my therapy. Over the last few months It has become obvious that I'm having more events. I have an Intellipap travel machine and have increased the pressure from 10 to 16 psi (slowly) and still not getting good results. I have changed from cpap mode to apap with what seems to be worse results. My smart code report for last night showed 3.5 apnea/hypopnea events per hour. I'm foggy brained with a headache today. From what I've recently read I should change back to straight cpap and maybe raise the pressure? Any of this jump out to anyone as flawed? thanks

[doc47]

By the way I should mention I use a full face mask. thanks

[Julie]

What are your prescribed pressures? And what else did the smart code say (about other features)? How well do you think your mask fits?

Your having raised your pressure that high, slowly or otherwise, is a bit worrying, but not knowing more than that about pretty much anything else makes it hard to guess at what's happening.

Do you take meds? Sleep thru the night? How many hrs?

You can download Sleepyhead free here and it'll work on Macs too - and it's not hard to use for basics.

[doc47]

What are your prescribed pressures? And what else did the smart code say (about other features)? How well do you think your mask fits?

Your having raised your pressure that high, slowly or otherwise, is a bit worrying, but not knowing more than that about pretty much anything else makes it hard to guess at what's happening.

Do you take meds? Sleep thru the night? How many hrs?

You can download Sleepyhead free here and it'll work on Macs too - and it's not hard to use for basics.

Thanks, I just tried to download and use sleepy head but my machine is older and doesn't have a card.

I don't have to take any meds and normally just wake up once. 8-9hrs.

Last Day
% Days at least 4 hours 100%
Day Count 1
Days at least 4 hours 1
95th Percentile Pressure
90th Percentile Pressure
AHI 3.5
Pressure Plateau Time 7%
Leak Time 10%
NRI 3.75
EPI 1
SmartCode FMOC-57C-3V8D

While Breathing Hours Last Day 6.3
I can't find a mask that doesn't leak some. I've gone from partial to nasal pillows to full face. I can't keep my jaw shut even with chin straps. Some nights no leaks, others 20%.

I'm wondering if switching to apap was a mistake and will try cpap again tonight. I fear my only solution will be surgery. When you say 16psi is a bit worrying, what do you mean? Thanks

[library lady]

I'm not sure what she meant, but that is a very high pressure; I don't think many people start that high... I'd suggest lowering it myself, but as a relative newbie (9 months in) I don't have enough expertise to understand pressure needs all by themselves, so wait for more replies from those in the know.

As for your leaks, every mask has an intentional leak rate, but extra leakage can exist, especially with FF masks with the larger footprint on your face. I was able to control my leaks with mask liners - have you tried those? The main brands are Pad-A-Cheek (http://www.padacheek.com) and RemZzzs, ( https://www.cpap.com and at most DMEs). Also, when a mask cushion starts to wear out more leaks will occur, so you might benefit from a new cushion.

[Julie]

Hi - I meant just that if you were prescribed a pressure of 10 based on a lab sleep study (or even an at-home one), and you're up to 16 but unsatisfied, maybe you need to look into other places for answers - when did you last have your thyroid checked? Other labwork? Vit D levels, etc. etc. Not everything's about OSA.

Have you gained weight in the recent past? That can make a surprising difference.

And you do want to be careful about raising your pressure because you can run into other problems (i.e. centrals).

I hate to suggest another study, but if you can't see your stats apart from Smart Codes and aren't feeling better, you need to find out why.