can too high of pressure prevent treatment?

[zackds]

im sure even reading what im saying here, the disconnect is still there because of the format
but now that i know the difference a machine and mask can make for someone

And, I'm sure many people here understand.

Sorry it was such a long trip, but glad you made it.

thank you, youre among the ones i wanted to thank
i also hope pugsy sees my above post
i dont know how to tag two people in one post
or if you can

[Pugsy]

I saw your post above and to be honest I couldn't quite decide where I fit.
I bowed out early in your experiments because you were getting advice from so many others that I felt it best if I stepped back and let you follow the others since you didn't seem to have the patience to follow my ideas.
That's why I didn't say much for a long time. Too many cooks in the kitchen kind of thing.
Plus I got the feeling that you didn't trust me..that's okay...My way of doing things and being ultra cautious at least at the beginning isn't always for everyone. I can be aggressive if the need is proven but I never could get what I needed as "proof" that I needed to be more aggressive.

When we first chatted your priority was getting an idea of the label and learning for sure or not if you had OSA or not.
That's what I was trying to do...establish need first and the worry about tweaking for optimal pressures second.
You wanted to establish need and treat at the same time and sometimes it just can't easily be done ESPECIALLY if someone isn't sleeping well because of the potential for SWJ events to cloud the label making.

You are still searching for validation of the label...your machine isn't going to likely give you a nice clear cut label proof that you want. I just haven't seen clear cut black and white proof. I have seen some maybe stuff.
It's not responding enough to make some assumptions that would need to be made. We have to shrug our shoulders and move on and accept the fact that the machine can't give us the label we want.
We have to rely on subjective feelings and that takes time and a lot of experiments. Which you finally got around to accomplishing.

At any rate the proof is in the pudding....you are sleeping better and feeling better now...and that's the primary goal here.

If you really, really need written proof as for need....a sleep study is the only way to maybe get it.

[zackds]

I saw your post above and to be honest I couldn't quite decide where I fit.
I bowed out early in your experiments because you were getting advice from so many others that I felt it best if I stepped back and let you follow the others since you didn't seem to have the patience to follow my ideas.
That's why I didn't say much for a long time. Too many cooks in the kitchen kind of thing.
Plus I got the feeling that you didn't trust me..that's okay...My way of doing things and being ultra cautious at least at the beginning isn't always for everyone. I can be aggressive if the need is proven but I never could get what I needed as "proof" that I needed to be more aggressive.

When we first chatted your priority was getting an idea of the label and learning for sure or not if you had OSA or not.
That's what I was trying to do...establish need first and the worry about tweaking for optimal pressures second.
You wanted to establish need and treat at the same time and sometimes it just can't easily be done ESPECIALLY if someone isn't sleeping well because of the potential for SWJ events to cloud the label making.

You are still searching for validation of the label...your machine isn't going to likely give you a nice clear cut label proof that you want. I just haven't seen clear cut black and white proof. I have seen some maybe stuff.
It's not responding enough to make some assumptions that would need to be made. We have to shrug our shoulders and move on and accept the fact that the machine can't give us the label we want.
We have to rely on subjective feelings and that takes time and a lot of experiments. Which you finally got around to accomplishing.

At any rate the proof is in the pudding....you are sleeping better and feeling better now...and that's the primary goal here.

If you really, really need written proof as for need....a sleep study is the only way to maybe get it.

i understand your backing off
i felt it when you did it as well
and i knew that was why
i dont blame you either
and it wasnt that i didnt trust you
i just was flailing my arms
desperate for anything other than
right now im trying to cut my machine off each time i wake up
like you said
so i can see exactly why im waking up
whether its spontaneous or breathing related
i think thats some of the best advice ive gotten so far
also, i want to get an oximeter to check if that correlates as well

it seems like if i have a problem though, it comes from the breathing waxing and waning before i wake up
like this screen shot from last night
and my machine seems to just put right along
not doing anything
i woke up once last night with my heart racing
which hasnt happened in a bit

[zackds]

oops i tried to show where i cut the machine off after that event
but yea i cut it off right after where it cuts off there

[Pugsy]

Sorry but that image is simply not useful to me.
Not zoomed in enough for one thing and can't see the break in therapy line to be able to see the breathing right before the break in therapy line.

The break in therapy line has to be at the far right of the graph so that the breathing immediately before the break in therapy can be evaluated.

Something more along this line of zooming in and with break in therapy at the far right of the graph.
I don't have many breaks in therapy so this is the best I can find with any sort of flags and those are user custom flags...not machine flagging. This is all arousal breathing...something woke me up...don't know what because even if I looked at the breathing immediately before what you can see here it doesn't really offer much idea as to why because the flow rate showed nice normal breathing. My best guess..maybe arousal from pain in my situation.

[zackds]

Sorry but that image is simply not useful to me.
Not zoomed in enough for one thing and can't see the break in therapy line to be able to see the breathing right before the break in therapy line.

The break in therapy line has to be at the far right of the graph so that the breathing immediately before the break in therapy can be evaluated.

Something more along this line of zooming in and with break in therapy at the far right of the graph.
I don't have many breaks in therapy so this is the best I can find with any sort of flags and those are user custom flags...not machine flagging. This is all arousal breathing...something woke me up...don't know what because even if I looked at the breathing immediately before what you can see here it doesn't really offer much idea as to why because the flow rate showed nice normal breathing. My best guess..maybe arousal from pain in my situation.

ok here it is zoomed in a bit
im not sure if this is the time i woke up with my heart racing but
im thinking it was around this time
i cant say i gasped for breathe or anything when it happened
or if i ever even have gasped for breathe
i know when i didnt have the machine it happened more often
and i would take a larger than normal inhale upon awakening
but thats all

[zackds]

another one from earlier in the night

[zackds]

some from last night
very low ahi but am having these waxing and waning breathing events
before i wake up to shut the machine off
could my pressure be too high?
theyre marked as reras
and sometimes theres a central in there
looks like i woke up about 7 times
and my machine seems to not want to do anything

[palerider]

and my machine seems to not want to do anything

Your pressure varied from 9.5 to 11, what do you mean?

[zackds]

and my machine seems to not want to do anything

Your pressure varied from 9.5 to 11, what do you mean?

those were just the regular pressure probes
i meant the machine didnt do anything
with the waxing waning stuff

[zackds]

and my machine seems to not want to do anything

Your pressure varied from 9.5 to 11, what do you mean?

ive heard breathing is irregular during rem sleep
maybe these screenshots are just rem sleep breathing?

[palerider]

and my machine seems to not want to do anything

Your pressure varied from 9.5 to 11, what do you mean?

those were just the regular pressure probes
i meant the machine didnt do anything
with the waxing waning stuff

what do you want it to do? Respironics aren't very responsive in the first place.

[palerider]

and my machine seems to not want to do anything

Your pressure varied from 9.5 to 11, what do you mean?

ive heard breathing is irregular during rem sleep
maybe these screenshots are just rem sleep breathing?

Your quest for perfection will lead to disappointment.

[Pugsy]

Waxing and waning of the air flow isn't part of the auto adjusting pressure algorithm..I don't think.
Mainly because it usually means nothing unless the other stuff that the auto adjusting algorithm is designed to fight...flow limitations, snores, etc....is also present.

[Ariseal]

So I know many people who have already posted are speaking from their personal experiences and that can be valuable. As a technologist I will tell you that overtitrating a patient can cause induced central apneas and is one of the reasons that cpap titration is done in the lab. People are very diverse and complex and there is no hard and fast rule for pressure. Sometimes a patient with a high AHI can be fixed with a low pressure and sometimes a patient with a low AHI can take a very high pressure to fix. I am glad to hear you are finding successful results with your own use. However I do urge caution when controlling your own pressure. Please take it slow as this is something normally done in a lab.

In regards to centrals being forever, that is not always the case. Sometimes drug interactions can cause central apneas in an individual.