AHI goal.

[Pugsy]

I would use these settings for 3 or 4 more nights and then if the AHI is still running around 2 to 3 and it's still primarily composed of OAs and hyponeas...I would add another 1 cm to that minimum pressure and see what happens.

[Jcastellaw]

Does EPAP have any effect on any or this? I’m at 1 as I mentioned earlier and it’s comfortable. Love my nasal pillows.

[Jcastellaw]

I actually have several pressures that I tried during the weeks I could post if that might help. Let me know and thanks for all your help!!!!

[Pugsy]

EPAP or using EPR and the drop during exhale can sometimes let the airway try to close off a bit during exhale.
This isn't always going to happen but it's possible when someone's Inhale pressure is really close to where the airway might close off.

If this happens people can either reduce EPR (which effectively increases that overall baseline pressure a little) or increase the minimum pressure a little to offset that drop and let the baseline minimum do a little better job since the person is so close to the line where the airway tries to collapse.

When people like using EPR and they have room to increase the minimum a little I usually suggest keeping EPR and just increase the minimum to offset that little drop.
You don't urgently need more minimum and I don't like making changes based on just one report...which is why I said give it 2 or 3 more nights. This might be a fluke bad night...and tonight might be a 1.0 AHI night...or it might be a fluke good night.

Your flow limitation graph is a bit "active" and we can't blame it on nasal congestion...so the airway is still trying to collapse a little...so that means more minimum pressure.
The flow limitations themselves aren't horrible but when combined with the AHI (which isn't horrible but I think could be reduced a little) it sort of points to needing just a little more pressure to hold the airway open better.
The machine just needs a little bit better head start so it can do a better job....assuming these results are a pattern.

You are in the fine tuning part of things now and have to take the time to watch for patterns and trends and not go basing changes on one or two nights results. We don't sleep the same each night so there will be variances in results.

[Jcastellaw]

Awesome! Thanks!

[Jcastellaw]

Just to reinforce what djams said... when you're 'fine tuning', you have to work with *averages*, since sleep varies from night to night... don't diddle with the settings just because you had an off night... now, if you're having a string of off nights, then it warrants investigation.

This will be obvious to p.r. and most experienced SleepyHead users, but many novices might benefit. I'm quoting his post for context.

SleepyHead has a good mechanism for comparing prescription changes. At the bottom of the Statistics Tab, SleepyHead will display a list include AHI with a demarc for every prescription change. Using this tool, you can easily see the Average AHI and days for every unique prescription.

SH_stats.png


Dark Red - Worse AHI
Light Red - 2nd worse AHI
Dark Green - Best AHI
Light Green - 2nd best AHI

You can also use it to create an artificial demarcation if you want to see if there is another change that might impact your AHI.

For example let say you are changing some medication and you want to see if it affects your AHI. Say your pressure is 12-20cm. Change your pressure to 12-19.8cm, this won't change your therapy, but it will create a demarc point on the SleepyHead chart where you started the new medication.

Now you can easily compare your AHI pre and post medication change. Of course, you need to give your averages some time to settle.

Last night I started some CBTi Therapy to help with night awakenings. I changed my max to create a demarcation point. Now I'll be able easily see if it impacts my AHI.

That has been truly helpful! Thanks buddy!

[Jcastellaw]

02-21-19.png (99.33 KiB) Viewed 3264 times

I’m getting so close. I can tell a difference if I’m under 1AHI. Any fine tuning that y’all can thank of and I do appreciate all of your help!!!!

[zonker]

02-21-19.png


I’m getting so close. I can tell a difference if I’m under 1AHI. Any fine tuning that y’all can thank of and I do appreciate all of your help!!!!

some of us CAN feel the difference. and some don't.

if you want, you can increase the minimum and see if that brings the ahi down.

in any event, i'm so glad to read another success story!!

[billbolton]

I’m getting so close. I can tell a difference if I’m under 1AHI.

I'm sure you have convinced yourself you can feel a difference, but playing AHI number olympics is a pretty pointless exercise in clinical terms.

Any AHI under 5 IS a gold medal winner, and xPAP is not the only factor that impacts your sleep quality (one way or the other)

[zonker]

I’m getting so close. I can tell a difference if I’m under 1AHI.

I'm sure you have convinced yourself you can feel a difference, but playing AHI number olympics is a pretty pointless exercise in clinical terms.

Anything AHI under IS a gold medal winner, and xPAP is not the only factor that impacts your sleep quality (one way or the other)

erm, there seems to be a number missing from that statement. under how much?

[palerider]

I’m getting so close. I can tell a difference if I’m under 1AHI.

I'm sure you have convinced yourself you can feel a difference, but playing AHI number olympics is a pretty pointless exercise in clinical terms.

Anything AHI under IS a gold medal winner, and xPAP is not the only factor that impacts your sleep quality (one way or the other)

erm, there seems to be a number missing from that statement. under how much?

Should be "one".

[Jcastellaw]

Well, I’m not as close as I thought. Clear nasal passage. Feel fair but have felt better

[Jcastellaw]

Here’s the stats.

[Jcastellaw]

Any ideas

[Pugsy]

Any ideas for what?

It's real hard to make a comment from just looking at a report and not having any history to go along with it.
Like how you slept...how you feel.
You have a lot of breaks in therapy. Some are bathroom related if I remember correctly.
Your charts are tiny except for the leak graph and it didn't need to be so big but seeing more pressure graph might have been helpful.

What do you want to improve?