I know I'm not a doctor.

[chriscummings83]

I know I'm not a doctor, but they gave me a pressure of +7 cflex 3.
AHI 5.7
OAI 1.3
HI 4.4
SI 15

So i bumped it up to +8 cflex 3

AHI 9.5
OAI 2.7
HI 6.9
SI 28.3


So I went with APAP, +9 to +12. It stayed at 10.5 90%

AHI - 11
OAI - 8
HI - 3
SI - .3

So I took care of the snore, but added everything else


So I dont' know how to start doing process of elimination.

[ozij]

Chris
I'm not a doctor either, nor are the majority of us responding to you.

I would go back to your prescribed pressure - and stick to it for 2 weeks. Only then - if I didn't sleep well, didn't feel well, and had bad numbers, would I start making changes. Your AHI of 5.7 - is just a bit too high - and may drop as you get used to sleeping with the APAP.

The APAP's way of diagnosing your breathing pattern and responding to it is not perfect. It may be right, it may be wrong - but you won't find out what's going on if you make changes on a daily basis. Our results fluctuated in any case.

And, if that data you reported includes some short, wakeful sessions, then the AHI may be artificially high. Take it easy, try to track your sleep quality on the prescribed pressure - and when you've gathered 2 weeks of data ask yourself (and us if you feel like it) if changes are necessary.

What it true for a majority of cases in never necessarily true of the one case that is you.

O.

[sleepycarol]

I agree with O.

[yardbird]

I agree about returning to prescribed pressure. I DISagree, however, with that c-flex setting. My pressure is +8. When I have my c-flex at 3 I have a hard time for some reason with that much pressure "relief".

I would go back to prescribed pressure and c-flex 2. If you're tolerating the original settings of +7 and c-flex 3, then I will agree with the others that you should stick with prescribed settings for a couple of weeks and don't get fixated on the numbers or you'll be "chasing" numbers and accomplishing very little

[Snoredog]

you went the wrong direction. For 7 cm pressure, Cflex=3 is too high, drop Cflex to 2 or 1.

Put pressure back down.

The OAI (Obstructive Apnea Indice) is the most important number to be watching, should use the pressure where that is the lowest.

[rested gal]

First thing I'd want to see is what kind of leak rate you've been getting all along. Especially since you're wearing a nasal mask, not a full face mask.

I'd want to be sure the leak rate is nice and low before I even started thinking about changes to pressure or changes to C-flex.

I'd want to see the graph that shows the leak line for several individual nights in a row, not just an "average" leak over time. That means having the software (EncoreViewer) and the necessary card reader, though, in order to see the "Daily Details" graph for each night.

[Guest]

My leak is right on to what the mask says. it is an average of 35.9 and the avg was 11cm. It should be lower but I adjust the mask when its on and get high leak for .2 seconds. and I take it off before turning the machine off.

As for the night on 7cm cflex 3 was 28.3

[Country4ever]

Snoredog.....may I ask why too much pressure relief might be a bad thing?

[Bookbear]

Position can make a big difference. Sleeping on your back will almost always increase your numbers, while sleeping on your side(s) will generally decrease them. That is one reason why making one change and sticking with that setting for at least a week is important.

A whole cluster of things affect our sleep... emotional state, physical state (cold/allergies/congestion), room environment (temperature, noise), what you ate for dinner, when you go to bed... lots of things. Don't expect the same numbers night after night. Focus instead on trends and averages over a period of time.

Leak data is especially important. You cannot get good therapy if you have mouth leaks (given that you use a nasal mask), and your numbers will be all over the map.

(This may ignite a firestorm, but given that your pressures are rather low, C-flex may not really be needed at all. I know people differ in their ability to tolerate air pressure, but 7 or 8 is not that hard to get used to. You might consider for one of your changes leaving off the cflex entirely and see how you do for a week or so.)

Good luck!

[Slinky]

I think this is one of the problems w/getting access to our therapy settings too soon, before we understand CPAP therapy. And I think it is mostly a North American problem. The fact that "they" (the sleep establishment) keep that information from us and fail to educate us and freely provide information makes us feel we have no control, so, when we get access to the information we are too quick to try to "take control" just to reassure ourselves we "can" and we "have". And for the really rebelious amongst us so we can "prove" to "them" that we have figured it out and have taken control.

I remember when, heaven forbid, American patients should know their BP, pulse and temp!!!! So, of course, for someone like me, that instilled a sense of distrust in the medical profession AND a determination to gain access to my information, such as BP, pulse and temp whilst in the hospital for example. I can remember taking my chart out of the holder and sitting on my hospital bed reading thru it. The nurse came in the room and "caught me" (like I was trying to hide that I was doing so - snort!). She like to have had a heart attack, grabbed my chart and took off for the nurses' desk w/it. My chart spent the entire rest of my stay down at the nurse's desk and my doctor(s) were aggravated it wasn't where it was supposed to be. And aggravated w/me for the inconvenience. As far as I was concerned: too bad, so sad. I didn't mind being inconvenienced at all.

I can remember one doctor who wanted to do a particular test. When I asked why, he told me it wasn't necessary for me to know why, that he was the doctor and it was only sufficient that he said it should be done. Needless to say, he and I parted company permanently within minutes. And, of course, that just added to my mistrust of the medical profession!

[DreamStalker]

I think this is one of the problems w/getting access to our therapy settings too soon, before we understand CPAP therapy. And I think it is mostly a North American problem. The fact that "they" (the sleep establishment) keep that information from us and fail to educate us and freely provide information makes us feel we have no control, so, when we get access to the information we are too quick to try to "take control" just to reassure ourselves we "can" and we "have". And for the really rebelious amongst us so we can "prove" to "them" that we have figured it out and have taken control.

I remember when, heaven forbid, American patients should know their BP, pulse and temp!!!! So, of course, for someone like me, that instilled a sense of distrust in the medical profession AND a determination to gain access to my information, such as BP, pulse and temp whilst in the hospital for example. I can remember taking my chart out of the holder and sitting on my hospital bed reading thru it. The nurse came in the room and "caught me" (like I was trying to hide that I was doing so - snort!). She like to have had a heart attack, grabbed my chart and took off for the nurses' desk w/it. My chart spent the entire rest of my stay down at the nurse's desk and my doctor(s) were aggravated it wasn't where it was supposed to be. And aggravated w/me for the inconvenience. As far as I was concerned: too bad, so sad. I didn't mind being inconvenienced at all.

I can remember one doctor who wanted to do a particular test. When I asked why, he told me it wasn't necessary for me to know why, that he was the doctor and it was only sufficient that he said it should be done. Needless to say, he and I parted company permanently within minutes. And, of course, that just added to my mistrust of the medical profession!

Now if only this rebelious American problem could spread back into the political landscape and the people part company with the current government elected officials of the corporations, by the corporations, and for the corporations!

[Sleepy Dog Lover]

What kind of apneas are you having? You can only get that from your sleep study. Sometimes higher pressure produces central apneas. When you have a central apnea, you don't try to breathe so the pressure doesn't help at all. Do you have the results from your sleep study? If not, get a copy of it from your doctor. That should tell you what kind of apneas you are having. I agree with everybody else, go back to your original pressure, it seems like you are making things worse by bumping the pressure. If you want to switch, I would try going down 1 cm instead of up.

edited to add: I am not a doctor either