Finding the Sweet Spot

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
scf
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Finding the Sweet Spot

Post by scf » Fri Dec 17, 2021 11:36 am

If I want to experiment with a constant pressure instead of using a range, how do I identify where to set it? I have been on APAP for three months for OA. Since the first night I have had 99% no OA’s. Maybe one every couple of weeks The current range, ordered by the doc is 5-11. All of my events are CA’s but after having someone on here look at my Oscar data I believe that they are false. The machine is responding to flow rate being all over the place and trying to correct what it interprets as apneas that are not real. Does this make sense?

I have musculoskeletal pain and I take some medications that impact sleep. This is not going to change so I will continue to have multiple false CA’s show up every night ( 35-60 of them). I wonder if I would sleep better if I used one pressure setting istead of constantly changing pressures.

Is my thinking completely wrong?
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Pugsy
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Re: Finding the Sweet Spot

Post by Pugsy » Fri Dec 17, 2021 12:02 pm

The machine isn't going to respond at all to CAs/centrals...no matter if real or false positives. So any pressure changes that seem to happen at around flagged CAs/centrals is just a coincidence.

Now the flow limitations it does respond to.....that's a whole different story.
Assuming the FLs aren't related to nasal congestion the machine will try to prevent FLs because it often is found that FLs are an early warning sign of impending airway collapse...or some sort of obstructive apnea event.

Now as to figuring out what fixed pressure to use to test out the theory that changing pressures are causing wake ups.
First remember that it is entirely possible that whatever the machine was wanting to kill with more pressure is maybe causing the wake up and the wake up isn't from changing pressures but instead from the whatever is triggering the more pressure.

Bear in mind that if you are someone who needs a higher pressure when on your back or during REM sleep but not at other times it is going to be extra difficult to find a "sweet spot" for a fixed pressure experiment.
Example...we will use myself because I need about 6 to 8 cm more pressure during REM than I need in non REM sleep.
In non REM sleep I can get by with about 8-9 cm pressure but in REM I need about 15 or 16.
Ideally to deal with my REM sleep (which amounts to maybe 20% of the night) I would need to use 15 or 16 cm fixed pressure...man...it's doable but sure not very comfortable and I risk all the known issues that come with higher pressures...leaks, aerophagia or whatever.

It's going to be a trial and error thing if you want to try fixed pressures. There is no hard fast rule of thumb but a starting point would probably be somewhere between overall average and the 95% number would be where I would start and fully expect it will likely need adjustment.

Also remember...even though the detailed graphs tend to make it look like pressure increases happened really fast...in most situations they don't happen very fast. Increases are gradual and usually over several minutes so they don't really go up in the blink of an eye.

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ChicagoGranny
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Re: Finding the Sweet Spot

Post by ChicagoGranny » Fri Dec 17, 2021 1:40 pm

scf wrote: ↑
Fri Dec 17, 2021 11:36 am
I wonder if I would sleep better if I used one pressure setting istead of constantly changing pressures.
More could be known if you would post a typical Daily Details chart.

The last time you mentioned settings:
Settling on a minimum pressure of 7, maximum of 11, EPR of 3, no ramp
Talk about constantly changing pressure, an EPR of 3 means a significant pressure swing with each breath.

scf
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Re: Finding the Sweet Spot

Post by scf » Fri Dec 17, 2021 9:55 pm

What made me start thinking about this was watching a LankyLefty video on you tube. It is his opinion that people do better on a constant pressure than they do on APAP. That made me wonder how one knows how to pick the setting.
I am out of town and away from my computer, but I will post some Oscar data when I get home.
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Pugsy
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Re: Finding the Sweet Spot

Post by Pugsy » Fri Dec 17, 2021 10:00 pm

Jason/LankyLefty also doesn't think people should use EPR or exhale relief either.
He's a great guy but I don't agree with everything he says. Everyone is entitled to their opinion though and you sure could give it a try and see how you do.

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scf
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Re: Finding the Sweet Spot

Post by scf » Tue Dec 21, 2021 2:39 pm

Actually I think I may have found my magic combination...the F30 mask with Amara View head gear and a Breathe Right strip on my nose. I have had two nights of uninterrupted sleep! I agree with one poster who said the nasal holes on the F30 felt too small, so I used the strips to open up the nose. It felt like I was getting about 30% more air coming in.

The F30i with the top of the head hose is a really good product, but the hard plastic attachments for the air tubes on either sideof the mask sat right on my cheekbones and made them sore. I decided to try the F30 with a different head gear and loved it from the first night.

So I will leave the pressures where they are for now and see if this lasts.

Once again, without all of the reading I do on here and all of the suggestions and solutions, I would have thrown in the towel. Thank goodness I saw the one about using a different headgear.

Merry Christmas. All of you with your expert advice have been my best Christmas gift ever!!
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