titration accuracy

[gawnfishin]

I am fairly new to cpap again after a long hiatus of 12-15 years. I wanted an Automatic titrating machine but wound up with an S9 Elite instead. The pressure was set to 6. The first night i felt like i was sucking air to breathe. I changed it ti 7 and found it alot easier the second night. My AHI at the sleep study was 7.1 The first night in CPAP it was 7.8. The second night at the higher pressure my AHI was 6.8. I again raised the pressure to 8 and the AHI dropped to 4.8. Last night I raised it to 8.2 and the AHI was 2.8 I will leave it there for a week or so to see what happens over time. My question is, if it takes a while for changes in pressure to take effect and a trend in AHI is what I should be adjustments on then how can a fixed machine be dialed in after only a one night titration study in a sleep lab? Once I have a machine (it is being rented for 10 months by my insurance co. then I own it) can i get it swapped fro an auto titrating machine if I can get the Dr. to write the correct perscription?
I downloaded and put data into Sleepyhead but do not fully understand the charts.

[Julie]

Depending on the actual model of your machine, you may well have an auto... but autos can be set to plain Cpap, whereas Cpaps cannot do auto, and you may just have to switch the mode in your machine... do you have a clinician's manual?

And you said your AHI was 7 at the PSG? If so, you might not even need a machine at all, but may have what's called 'positional apnea', the kind that more or less disappears if you don't sleep on your back and maybe do wear a soft cervical collar to keep your head up and airway open... if you can experiment with both of those over a week or so, and see what numbers you get (SleepyHead software's free to DL from the first 'Pugsy's Tutorial' note on the main pg).

[Wulfman...]

I am fairly new to cpap again after a long hiatus of 12-15 years. I wanted an Automatic titrating machine but wound up with an S9 Elite instead. The pressure was set to 6. The first night i felt like i was sucking air to breathe. I changed it ti 7 and found it alot easier the second night. My AHI at the sleep study was 7.1 The first night in CPAP it was 7.8. The second night at the higher pressure my AHI was 6.8. I again raised the pressure to 8 and the AHI dropped to 4.8. Last night I raised it to 8.2 and the AHI was 2.8 I will leave it there for a week or so to see what happens over time. My question is, if it takes a while for changes in pressure to take effect and a trend in AHI is what I should be adjustments on then how can a fixed machine be dialed in after only a one night titration study in a sleep lab? Once I have a machine (it is being rented for 10 months by my insurance co. then I own it) can i get it swapped fro an auto titrating machine if I can get the Dr. to write the correct perscription?
I downloaded and put data into Sleepyhead but do not fully understand the charts.

You didn't mention whether or not you're using EPR and if so, what the settings are. That can make a big difference in AHI at the pressures you're using........EPR drops 1 centimeter of pressure for each of its settings.......1 = 1cm., 2 = 2cm., 3 = 3cm.

Personally, I don't put much faith in "Auto" machines when using them in ranges of pressures.


Den

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[TangledHose]

His equipment profile says Elite - that is a straight cpap machine.

Sounds like you are on the right track moving up to 8.2.....leave it there for a few nights and check your numbers, see how it goes, but it sounds like you are getting there. You'll have to experiment over time to find the pressure that works best and doesn't cause excessive leaks or Aerophagia.......8 cm is somewhat moderate, good starting place.

[kteague]

Do you have the detailed report from your diagnostic and titration studies? There may be some clues in there.

[Wulfman...]

His equipment profile says Elite - that is a straight cpap machine.

Sounds like you are on the right track moving up to 8.2.....leave it there for a few nights and check your numbers, see how it goes, but it sounds like you are getting there. You'll have to experiment over time to find the pressure that works best and doesn't cause excessive leaks or Aerophagia.......8 cm is somewhat moderate, good starting place.

I think he filled in his profile while I was typing my post because when I initially posted my response and I had to edit it because the equipment was there when I hit submit. But he did seem to wonder about the virtues of the Autos.


Den

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[TangledHose]

Yeah, I thought that might have been the case - no worries