Question on data

[mets123]

I don't feel very rested in the morning. I have attached some screenshots. My question is it still seems I still have cluster events and flow limitation problems. I also see my ahi varies quite a bit. What can I do in order to get more restful sleep and improve my data. I am concerned going higher with the pressure as I had aerophagia in the past.
Thanks for your time.

[mets123]

One more screenshot.

[mets123]

Felt like I slept fairly well yesterday. My screenshot shows I had a lot of leaks. I was not aware of the leaks,does it effect my overall ahi since the leak rate was so high? I am using the f30 and some nights sleepyhead shows low amount of leaks and then like yesterday it shows higher leaks. Really is crazy since I really don't adjust the headgear much from day to day.
Thanks for your advice.

[palerider]

Felt like I slept fairly well yesterday. My screenshot shows I had a lot of leaks. I was not aware of the leaks,does it effect my overall ahi since the leak rate was so high?

As leaks get progressively worse, first the machine looses the ability to tell what kind of an apnea you're having, and it'll list UA instead of CA or OA. At some point, it will not be able to detect the breathing that makes up the flow rate, and then at some further point, it won't be able to maintain therapy pressure (which will show up in the mask pressure chart.

So, at the point you're at, the answer is "no, it doesn't affect the AHI".

[mets123]

When do I have to be concerned?
Thanks palerider

[palerider]

When do I have to be concerned?
Thanks palerider

I'd say, when you start seeing UAs flagged... it's seeing apneas, but can't tell what they are... and things get increasingly fuzzy as the leaks get worse.

[mets123]

Thanks palerider,can you give me any advice from the data I posted on Monday?
Really appreciate your taking the time.

[palerider]

Thanks palerider,can you give me any advice from the data I posted on Monday?
Really appreciate your taking the time.

I don't follow everyone's history nearly as well as Pugsy, so if you're having issues with aerophagia... then this advice can be problematic, but for most people, I don't like seeing the max pressure reduced, let the machine do what it can when it needs to.

Basically, getting the min pressure up enough, and the max open for 'exceptions' as they come along is the generic route to success. (if that makes sense).

[mets123]

Yes it does,would you then recommend increasing my min epap and leaving the max ipap alone? If so can you give me what I should set my new settings at? Also should the pressure support stay as is?
Again thanks for your help.

[palerider]

Yes it does,would you then recommend increasing my min epap and leaving the max ipap alone? If so can you give me what I should set my new settings at? Also should the pressure support stay as is?
Again thanks for your help.

Oh, you're hitting the lowered max setting, and thus the machine can't do all it could... I'd go for minepap 11, maxipap 25. (I know, that sounds scary, but it won't go higher than it needs to.)

[mets123]

Thanks again palerider,will attempt at raising Max IPAP slowly to try and not induce aerophagia. Also will increase the min epap as you suggested.

[palerider]

Thanks again palerider,will attempt at raising Max IPAP slowly to try and not induce aerophagia. Also will increase the min epap as you suggested.

Have you had problems with aerophagia? If not, then don't assume you will, most people don't have a problem.

[mets123]

I have had problems with aerophagia in the past on and off. This is the reason why I try to limit the pressure. I was told that since I suffer from flow limitations the pressure will always seem to be hitting the maximum pressure that the machine is set at. So I am concerned if I put the machine settings to maximum ipap pressure of 25 when I have an event that is triggered by flow limitations it will hit the maximum pressure cause leaks and probably wake me up.
Is my thought process correct?
Thanks,any other advice would be greatly appreciated.

[palerider]

I have had problems with aerophagia in the past on and off. This is the reason why I try to limit the pressure. I was told that since I suffer from flow limitations the pressure will always seem to be hitting the maximum pressure that the machine is set at. So I am concerned if I put the machine settings to maximum ipap pressure of 25 when I have an event that is triggered by flow limitations it will hit the maximum pressure cause leaks and probably wake me up.
Is my thought process correct?
Thanks,any other advice would be greatly appreciated.

The pressure will go up till the FLs are tamed... that doesn't mean it'll go up to 25. (even if it has done in the past.).

But, if you have bad aerophagia, that does make the whole "enough pressure to sleep well" vs "stomach pain" a balancing act.

Flow limitations themselves are disruptive to sleep, so getting rid of them helps.

[mets123]

Thanks for your feedback,I will increase both pressures slowly and post again soon.
You and this forum are a great find.