Clueless on my values but I think they're good?

[djams]

It's noteworthy that all those things are actually more likely to drive the pressure up than a random OA with nothing else going along with it.
A lot of time people think that when they get an OA that the machine will rapidly increase the pressure in response and try to blow the airway open. The machine can't do that fast of a response and it wouldn't anyway. By design and specific when there is an OA going on the machine sits back and waits until the airway is back open and then it tries to decide if it needs to increase the pressure more.

Thanks-this kind of information is invaluable to me as a newbie!

Were you by chance on your back when that happened at 00:48ish?

I definitely fell back asleep on my side. Working hard on that. If I was on my back, I rolled over in the first 4 minutes. It's possible, was on my back when I woke up. And supine is my habitual position, as you're aware.

[CPAPSteve]

okay now that I'm back from vacation here are my stats from the Airsense 10 for Him on July 22nd and then the most recent report from the Airsense10 for her dated July 29th.

All settings exactly the same and the environment i slept in is the same (back to my trusty bedroom). I did take 1mg of Klonopin last night b/c I was so burnt out from driving and unpacking our vehicle but I don't think that should cause any changes to apneas or sleep disturbances.

The only difference here really then is the algorithm of the regular unit vs.the for her setting.

What is surprising is the 0.00 AHI!

For references sake here I included my worst night data for comparison. I started treatment on July 5th if anyone cares.

[Pugsy]

Makes you want to keep using the For Her mode doesn't it?

The variation between the 2 modes...actually within normal variations even if different modes weren't use and nothing was change.
I might get AHI of 0.0 one night...next night 1.2..next night 3.4 (usually more Centrals most likely from poor sleep secondary to pain) and then back to 0.0 again and never change a darn thing.
We don't sleep the same each night and so we can't expect the same results every night.

[CPAPSteve]

What I do find with the for her model is that I tend to wake up less than the unisex version.

Granted I have only had the unit less than a week to use so it is tough to say. I guess I could flip back and forth between the two over time and probably won’t notice a difference.

I was shocked to have an AHI of 0.0. Didn’t think it was actually possible.

Pugsy would it be a safe Ask to ask my clinician to bump my minimum pressure up to 10 and allow my max to go to 20? She made mention to me that based on my empirical data that my numbers have many times jumped to 16.0 and she was considering changing the upper pressure. What value it was to be was not disclosed. I have already accessed the clinician menu but I want to follow procedure to allow them to advise and make changes.

[Pugsy]

would it be a safe Ask to ask my clinician to bump my minimum pressure up to 10 and allow my max to go to 20? She made mention to me that based on my empirical data that my numbers have many times jumped to 16.0 and she was considering changing the upper pressure. What value it was to be was not disclosed. I have already accessed the clinician menu but I want to follow procedure to allow them to advise and make changes.

Sure...wouldn't hurt a thing. I leave mine at max 20...the machine only goes up if it has a reason. Sometimes I see 18...sometimes the highest it goes is 12. I just let the machine sort it out since I sleep through it anyway.
If the pressure changes disturbed my sleep or caused a problem then I would maybe limit the max.
And a little more minimum isn't going to hurt anything unless it triggers aeraphagia and if it does then just back off.

[djams]

I was shocked to have an AHI of 0.0. Didn’t think it was actually possible.

Funny, same thing happened to me last night. I knew it was possible, but didn't think I'd ever see it. And our charts are eerily similar. Just some RERA's near the end of the night.

Maybe our machines decided to take a night off from "apnea-hunting"

[palerider]

I was shocked to have an AHI of 0.0. Didn’t think it was actually possible.

Funny, same thing happened to me last night. I knew it was possible, but didn't think I'd ever see it. And our charts are eerily similar. Just some RERA's near the end of the night.

Maybe our machines decided to take a night off from "apnea-hunting"

Easy enough to tell, just zoom in to see the individual breaths in sleepyhead, then scan along looking for any flatlines that are 10 seconds or longer

[CPAPSteve]

yeah, I'll be going to bed soon so I will see what values I come up with again tomorrow. Feel kinda bad that I've abandoned my original CPAP (Airsense 10 autoset) and stole my spouse's for her unit.

That being said I'll see what magical numbers show up tonight. I've been shovelling dirt and cement for the greater part of the day in 85+ degree weather so I know I'm pooped. No sleeping aids for me tonight.

[djams]

I was shocked to have an AHI of 0.0. Didn’t think it was actually possible.

Funny, same thing happened to me last night. I knew it was possible, but didn't think I'd ever see it. And our charts are eerily similar. Just some RERA's near the end of the night.

Maybe our machines decided to take a night off from "apnea-hunting"

Easy enough to tell, just zoom in to see the individual breaths in sleepyhead, then scan along looking for any flatlines that are 10 seconds or longer

Hah. Simple as that, huh? I'll choose to trust the machine.

[djams]

That being said I'll see what magical numbers show up tonight. I've been shovelling dirt and cement for the greater part of the day in 85+ degree weather so I know I'm pooped. No sleeping aids for me tonight.

I'll be interested. Both of my very low AHI nights came in conditions like this. Busy outdoors all day in the heat. But in the 100's for me.

[CPAPSteve]

Okay here is my latest charts for the night.

It is worth noting that at the start of the night the machine was configured by the clinician to have a minimum of 9 with a max of 16. Today for the sake of playing around and trying to better understand minimum pressures and "events" that I woke up briefly at 9:30ish and changed my minimum pressures to 12 cwt.

Why 12? Because based on the past hypopnea and apnea events and flow limitations it would see that my APAP machine wants to jack the pressure up to 13-16 cwt. Now if my understanding is correct the minimum so be very close to the 95% pressure because the intent is to apply therapeutic pressures to prevent A and H's from even occurring in the first place.

What I am trying to accomplish here is trying to narrow the operating band of my unit to:
1. Avoid A and H's as much as possible (not that I had a lot to begin with)
2. The machine has a faster response time to A and H events
3. My clinician last week considered bumping up my upper pressure values since she noticed that when I do have events that the pressures are getting up near my set max limit.


I've attached my chart for reference.

[palerider]

Now if my understanding is correct the minimum so be very close to the 95% pressure because the intent is to apply therapeutic pressures to prevent A and H's from even occurring in the first place.

Ignore the 95% pressure, trying to set a minimum from an auto based on that is what neophytes and people with poor understanding (or maybe just lazy ones) do.

The 95% number is just a max with any short term spikes cut off.

What you want is to look at your pressure curves, and see where they keep jumping up... and set the min a little above that.

3. My clinician last week considered bumping up my upper pressure values since she noticed that when I do have events that the pressures are getting up near my set max limit.

There's rarely any point in setting the max to anything lower than the max possible pressure.

[CPAPSteve]

Thanks Paleider - that being said... if I understand what you’re saying about the pressure curves and where they begin to rise then I believe my min pressure should be around 11-13 cwt.

Thanks

[Pugsy]

I wouldn't set the minimum any higher than 11 to start with. Use it a few nights and see what happens.
Often if the minimum is a bit higher the machine won't need to go as high.

I agree with PR ...ignore the 95 % numbers when trying to establish a minimum pressure. Instead look more at the median average or the overall average as a guide.

When I was first starting cpap therapy...had been on it maybe 6 months and I had been using 10 cm minimum and 20 max (sometimes I would see near 18 cm during REM where my OSA is worse)..and I was getting AHI between 1 and 2 consistently and sleeping good and feeling decent.
So I decided time for another experiment...
I decided to increase the minimum by 0.5 cm and use it at that for a week...so over a period of 6 weeks I got up to 13 cm minimum...still would see the increase to sometimes 18 in REM...90% numbers would sometimes be 17 and sometimes be 12 but long term over 6 months...around 12 and the overall average was a little less than 12 cm.

So after 6 weeks and using the minimum of 13 for a week I looked back at the past 6 weeks.
At 13 minimum the AHI was still between 1 and 2...hours slept was roughly the same...how I slept and felt really didn't change either.
So I couldn't see that I gained anything with more minimum and went back to the 10 cm minimum.

Just thought I would share that experiment with you. Sometimes more pressure simply doesn't reduce the events after a certain point. This was back before centrals were flagged and back before we had flow rates to zoom in on and see what was happening. I suspect that the bulk of my 1 to 2 AHI was likely SWJ events but I didn't know it and had no way to know it back then.

[CPAPSteve]

okay that is good to know.

As of this morning when I briefly woke up to look at SH data I thought hmmm, why not try to use a 12cwt minimum.

That being said I will revert back to 11 for now and see what my clinician says about the upper pressures tomorrow even though I know it probably can be set to maximum the machine can handle.

Thanks!