First post, trying to tune the machine

[jbsims]

Hi,

New user here, been using CPAP for about 3 years now. I didn't start adjusting the settings until recently (past few weeks). It came with low setting of 5, and in the morning it would say I had some events and it went up to 6. So I changed the minimum to 6 and it would go up to 7. So I changed it to 7 and it would go up to 8. I have it on 8 now and it is going up to 9. I am wondering how far I should go with this, or what else to try. I am sleeping better and dreaming more, though I think I have more mask leaks.

[babydinosnoreless]

I am not one of the experts, hopefully they will be along soon to advise.

Just me personally as long as you are sleeping well and tolerating the pressure, I would keep raising my minimum pressure slowly until the ahi is regularly under 1. When you are fine tuning, I have been told you don't want to make changes fast but give it 7 days before you make another adjustment.

[LSAT]

What are you looking at that keeps going up? Minimum? Med? 95%? Set your Minimum pressure at 8.5 and leave it alone for a few days.

[palerider]

I am wondering how far I should go with this, or what else to try.]

Until your ahi is under 2.

[Pugsy]

Welcome to the forum.

As long as the bulk of your AHI is obstructive in nature (OAs and hyponeas) then more minimum pressure is usually what is advised to get the AHI reduced.

Now if your AHI flip flops and it's primarily central in nature (those Clear Airway events/ Central apneas) then more pressure wouldn't be the answer with this type of machine.

If that was my report I was seeing...primarily obstructive in nature...I would continue increasing the minimum pressure a little at a time until the AHI was below 2...then I would give it even more time to see what happens long term.
Some years ago I did a test where I used the same settings for 6 weeks and didn't change anything....the AHI was reduced by 50% at the end of the 6 weeks without my changing anything.
Get yourself close...so that you are also sleeping decently and then give it a bit more time to settle in.

[jbsims]

OK, thanks for all the feedback folks. It is the minimum I am raising. Started out at 5, now at 8. My AHI is usually between 2 and 4 when I get out of bed in the morning, but if I look at the data it will have risen to 6 overnight. The minimum has been on 8 for a couple weeks now. I will try 9 for the next several nights and see how that goes.

I am certain my apnea is obstructive in nature. I have a very restricted airway due to cervical pull headgear as an adolescent which prohibited the natural maturation of my maxilla and mandible. I am thin, not overweight, but I have a "double chin" because my tongue doesn't fit in between my jaws and is jammed down into my throat.

[jbsims]

It's 4 AM and am I up, bright eyed and bushy tailed. Machine says it was on for six and a half hours. This happens whenever I get anything approaching restorative sleep. Usually I can't get out of bed after 9 or 10 hours of sleep. I think my body has adapted to getting by on such poor quality sleep that if I get any good quality sleep at all I don't need much of it. Let's hope this lasts.

[palerider]

It's 4 AM and am I up, bright eyed and bushy tailed. Machine says it was on for six and a half hours. This happens whenever I get anything approaching restorative sleep. Usually I can't get out of bed after 9 or 10 hours of sleep. I think my body has adapted to getting by on such poor quality sleep that if I get any good quality sleep at all I don't need much of it.

Something like that.

Let's hope this lasts.

You'll probably move to a more normal 7-8ish hours after you get used to it.

[ChicagoGranny]

I am certain my apnea is obstructive in nature. I have a very restricted airway due to cervical pull headgear as an adolescent which prohibited the natural maturation of my maxilla and mandible. I am thin, not overweight, but I have a "double chin" because my tongue doesn't fit in between my jaws and is jammed down into my throat.

You have a good understanding of the root cause of your OSA. So many start here without a clue, or worse a wrong understanding, of what caused their apnea. Their doctors are uncommunicative or give out wrong information.

If you don't mind saying, how did you come to your understanding of the problem?

[jbsims]

When I was 12 years old my parents took me to see an orthodontist. He explained that my upper teeth had grown ahead of my lower teeth, and cervical pull headgear would hold my upper teeth back and allow my lower teeth to catch up. I wore the headgear for five years, from age 12 to age 17. I hated it. I wore it mostly at night, and it prevented me from sleeping well. I started a lifelong pattern of not being able to fall asleep at night and not being able to get out of bed in the morning. It also caused my head to hurt during the day. By the time I was 18 my thoracic spine had started to hurt as well. In college I was constantly sleeping in and late for class, but couldn’t fall asleep at night. By the time I was 25 my spine was hurting constantly. My posture got worse and worse. I hated seeing myself in the mirror or in a security camera. I didn’t understand why I was growing so poorly. I started chiropractic and yoga at age 28 in an effort to relieve the constant pain in my neck and back. I started acupuncture around age 30. I kept up a regular regimen of physical therapy, chiropractic, yoga, massage and acupuncture just to try to feel normal and get through life without constant pain. Everyone trying to help me constantly coached me to stand up straighter, to try and tuck my chin and open my chest. Nevermind that if I tuck my chin I can’t breathe. Around age 36 I started trying to address my problem as a TMJ/TMD issue. I got a “brux guard”, an acrylic night-time occlusal splint. I got an acrylic bite splint to wear during the day. I started seeing an osteopath. I got orthodontia a second time. I had equilibration to try and fix my bite. I started using a CPAP around age 44. I woke up after the first night with the CPAP feeling more rested than I could remember. At 45 the pain was so constant and so aggravating I felt I couldn’t work anymore. I tried methocarbamol, cyclobenzaprine, all the NSAIDs. Opoids work for a day but I can't stand taking them. I left my career on the west coast as a computer programmer and moved my family to rural Kentucky, hoping we could survive on our savings.

[jbsims]

Since I increased my minimum to 9 I have had mixed results. About one good night's sleep for every poor one. This is purely qualitative analysis, just based on how I feel in the morning. Do I feel rested and energized or exhausted? Today I feel exhausted, I just want to crawl back in bed, even though I slept for 9 hours according to the data. Any idea what is going on here? I don't know if I should keep jacking up the minimum pressure or tighten my mask or try a different mask.

[Pugsy]

Approx how many time do you remember waking up last night?

[Janknitz]

I am certain my apnea is obstructive in nature. I have a very restricted airway due to cervical pull headgear as an adolescent which prohibited the natural maturation of my maxilla and mandible. I am thin, not overweight, but I have a "double chin" because my tongue doesn't fit in between my jaws and is jammed down into my throat.

Me too, they really screwed us with retraction orthodontia, and I had four teeth removed, too so my jaw is also very receded and the airway is extremely narrow. But it was all they knew in those days, they thought they were helping.

My daughter had the same issues and she has had palate widening and an appliance called the Herbst Appliance to bring her lower jaw forward. She has all her teeth. The results appear to be really great, she's got a nice, patent airway and a broad, beautiful smile. I hope she doesn't curse this some day 40 years from now, too, for what we don't know about the long term effects.

[jnk...]

. . . rural Kentucky . . .

Them's my people. Say hey fer me.

[jbsims]

I toss and turn so much, I couldn't even begin to count how many times I wake up.