WOW....I love my new APAP + Question

BadThad · Post by **BadThad** » Thu May 03, 2007 9:56 am

I just got my REMstar Auto Monday and today I'm not tired! My first 2 nights were not great, but better than nothing, I slept OK with it. After checking my data for the first two nights, I changed my settings a little and today I feel like a million bucks! I can't wait to get home and review my data from last night.....I know I have some more tweeking to do.

Before last night I changed over to APAP with CFlex and kept the same ranges, 10-14. I liked the CFlex setting of 1 (it was off for my first 2 nights), it definately helped on my exhales.

If I see the machine hitting the max pressure a lot, should I try increasing the range by 1 and ditto for my low pressure? My prescribed range is 10-14 inH2O. In my first 2 nights I saw the machine running at 10 for like 70% of the time and 14 about 15%. I'm wondering if I should perhaps change it to 9-15 to see if it maxes out to 15 ever. Is my logic wrong here?

Guest · Post by **Guest** » Thu May 03, 2007 10:14 am

I got mine last Saturday and love it. Pressure range is set at 4 to 20 as it came from cpap.com.

I have the same question---Should I narrow the range based on results so far? What benefit would I get such a change?

My actual range has been a low of 5 and a max of 9.

Thanks to the board for suggestions.

georgiaboy · Post by **georgiaboy** » Thu May 03, 2007 10:18 am

Forgot to log in on my post, Sorry!!

blarg · Post by **blarg** » Thu May 03, 2007 10:28 am

For BadThad, generally your head's not going to explode if you bump the pressure up a notch, but there is a thing as too much. It depends on your situation and we'd be much more able to help if you show us a few reports.

GeorgiaBoy, generally 4 to 20 doesn't work very well. For the majority, the most important number is the lower end of the range, as that's the way to get rid of the events that happen before the machine can adjust up the pressure quick enough to stop them. So, if it were me, I'd bump the bottom of that range up bit by bit to see what I get. You may find you end up higher than 9 on your max once the machine can actually start getting rid of those events.

TXKajun · Post by **TXKajun** » Thu May 03, 2007 10:33 am

It may be a good idea to leave ya'lls settings alone for a week or so (georgiaboy, the low setting of 4 is an exception...I'd give blarg's suggestion a try pretty quick). Give ya'lls APAP a chance to work for a week or so and see how it goes, especially with ya'll being to new to APAP. Your bodies are going to have to do some adjusting now, at least during the first week or three, so if you're constantly changing settings, you don't get a chance to adjust to a constant. It's like trying to hit a moving target.

Just a thought. I'm not a Doctor or RT or anything like that.

Good luck!

Kajun

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georgiaboy · Post by **georgiaboy** » Thu May 03, 2007 10:46 am

Appreciate the help, we are headed to Florida on Friday for a 2 week vacation. I will give myself time to adjust before any wholesale changes.

I will bump up the low end pressure as that makes sense. Any thoughts on 5 or 6?

As a newbie I welcome the help.

blarg · Post by **blarg** » Thu May 03, 2007 11:03 am

Personally I'd go with 6. Give that a week or so to settle down, and then try 7 and so on. It helps a lot if you have the software so you can see how high the thing has to go to keep you breathing because that really says a lot about what your min should be.

georgiaboy · Post by **georgiaboy** » Thu May 03, 2007 11:14 am

I updated my profile to show software. My only choice on the menu was 1.6 but I actually have 1.8.

Will start with 6 and see what happens.

Wulfman · Post by **Wulfman** » Thu May 03, 2007 11:28 am

georgiaboy wrote:I updated my profile to show software. My only choice on the menu was 1.6 but I actually have 1.8.

Will start with 6 and see what happens.

With the software, you'll be able to see when and at what pressure your events are happening. If you're getting events at the lower pressures, move it up.

Since you've got a nasal mask, keep an eye on the (mouth) leakage, too.

Den

Goofproof · Post by **Goofproof** » Thu May 03, 2007 12:13 pm

If your mouthleaking numbers are too high, it makes data decisions almost useless. Treatment only works if it can hold yout throat open. Jim

BadThad · Post by **BadThad** » Fri May 04, 2007 5:10 pm

OK, I may be moving too fast with changes to my settings, but I felt the need to experiment and collect data....and I want this thing working well for me ASAP.

Changed my settings for last night. Went to APAP mode with 10-14 pressure range, Cflex of 2. I still working on understanding what the software is telling me, I think I understand most of it....but I'm looking for more info. Has anyone written a tutorial on Encore Pro?

http://www.badthad.com/cpap/badthad2.pdf

My AHI is around 4 with these settings. My goal, not sure if I can get there, is an AHI <1. Are my expectations too high? How am I looking? Suggestions?

Thanks

blarg · Post by **blarg** » Fri May 04, 2007 6:47 pm

Your leaks look great.

Second off, you notice that long bar where it's staying above the min pressure from about 4:30 to 5:15? That to me begs me to bump the min up a notch (with a few caviats)*. Some people naturally won't get AHI below 1, so I wouldn't worry about the numbers nearly as much as how you feel. Any reason your max is capped where it is?

* Caviats: Any centrals noted on your PSG? You'll notice that NR towards the beginning, and while it's not a huge deal unless you're having more of them, perhaps reining in the max a bit would be in order? The only time you come even close to that max is for that one area of obviously whacky events. If that's true for several nights of this range, I'd say min up one, max down one. Let settle for a week.

I'm not a doctor or trained in healthcare in any way.

hhopper · Post by **hhopper** » Fri May 04, 2007 6:58 pm

What does NR stand for in the charts?

blarg · Post by **blarg** » Fri May 04, 2007 7:01 pm

hhopper wrote:What does NR stand for in the charts?

Non Responsive Apnea.

It's an apnea that the machine increased the pressure to try to resolve but was unable to. You can't be sure they're centrals but if they come up repeatedly it's likely. They only show up in the Auto charts because Pros don't increase the pressure to try to resolve apneas.

BadThad · Post by **BadThad** » Fri May 04, 2007 7:51 pm

blarg wrote:Your leaks look great.

Second off, you notice that long bar where it's staying above the min pressure from about 4:30 to 5:15? That to me begs me to bump the min up a notch (with a few caviats)*. Some people naturally won't get AHI below 1, so I wouldn't worry about the numbers nearly as much as how you feel. Any reason your max is capped where it is?

* Caviats: Any centrals noted on your PSG? You'll notice that NR towards the beginning, and while it's not a huge deal unless you're having more of them, perhaps reining in the max a bit would be in order? The only time you come even close to that max is for that one area of obviously whacky events. If that's true for several nights of this range, I'd say min up one, max down one. Let settle for a week.

I'm not a doctor or trained in healthcare in any way.

First off, thanks blarg. That's exactly the kind of interpretation I'm looking for. I know you're not a doctor, no worry's, I won't sue. LOL

The min/max are what my prescrip had on it. I don't have a copy of my sleep studies yet, but I will. I was thinking the max is too high as well. I didn't feel too bad after that night, but I only had about 6 hours of sleep....I was a little tired the next day because of that I think.

I was thinking of sliding the whole range down by one, i.e. 13 max and 9 min. Maybe my logic is wrong, but I was thinking I need to get my average pressure right in the middle instead of riding the high or the low. That way it could dip down when I don't need it as much. I'm more comfortable at the lower pressures.

EDIT - Oh, I think that NR was me taking the mask off for a minute. I'm still getting used to this device.....almost there.
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CPAPopedia Keywords Contained In This Post (Click For Definition): AHI