NEED A HIGHER CPAP PRESSURE???

[jimbud]

To get your treatment where you want it is going to take time.
Everyone is different. Some get lined out quickly others more or less.
Your large leaks are 0.0. Very good.
You can try a chin strap to keep your mouth closed, but many people do not tolerate it well. You might?
You are probably going to have to raise your pressures more. First get the APNEAS under control. (OA & HA)
I would not buy other equipment until you use up all options with this one. You haven't even come close to that.
I do not feel that I have enough knowledge to recommend settings for you.

Others on here do. They will show up and help you out with that.

JPB

Fill out your equipment list ; machine, mask, ect.
This is needed.
Saves time for everyone.

[bsgontijo]

Hello Pugsy!

Could you give me a sugestion?

Tks

[Pugsy]

Assuming that the bulk of what we saw on the last report was real asleep flagged events and not awake events....
I would suggest trying 10 minimum with 20 max and see what happens.

Also, when you report your results....always include how you slept and how you feel.
Numbers aren't the whole picture.

[bsgontijo]

Hey Pugsy!

I had not leaden your post, so I decided to put my pressure in 12 cm last night..
Do you still thinking I should use min 10cm and max 20cm? I read the Philips algorithm is not so good, it demand time to increase the pressure and than decreases very fast.. Do you agree?
I'm feeling better than last nights but still tired and dizzy....

Tks!!

[Pugsy]

Yes, Respironics machines do seem to respond slower (both in increasing and decreasing though) but that's no reason to not at least let the machine try to deal with the apnea events you are having. The trick with the Respironics apap machines (and other brands) is to give the machine a good enough head start with a good minimum pressure.

You can either continue with increasing the fixed cpap pressure and using higher all night (even when not needed) or change to auto mode and let the machine at least try to prevent those apneas you see flagged at 12 cm.

Your choice.

[bsgontijo]

Tks Pugsy!
Next night I’ll try min 12 cm to max 20cm.. do you think it’s the best alternative?

[Pugsy]

I think it is at least worth trying. This is the tweaking stage of things where we try different things and different settings to see if we can get the best results with something.

The machine won't try to increase the pressure without a good reason...and snores, Flow Limitations, OAs and hyponeas are considered good reasons. Right now we don't even know the status of the FLs because FL flagging is turned off in cpap mode.
If you end up doing better with a single fixed pressure I would still do it in apap mode so that I would know if I was having FLs or not.
They are really important and a driving factor in the auto algorithm....might be nice to know if you are having any or not.
There's a way to make the machine function in auto/apap mode like it functions in cpap fixed mode but you get the FL flagging turned on.
Easy to do...minimum pressure equals maximum pressure and the machine won't roam around.

Again...when you report your results and share your detailed images....please include how you slept and how you feel.
Very important to know that also. Numbers mean nothing all by themselves.

[bsgontijo]

Hello Pugsy!!

I did like you suggested: mon 12cm max 20cm.. I really feel worst than the last days.. And the numbers did not get better.. I'm really depressed and don't know what to do.
Do you have any other suggestion?

[ajack]

check for chin tucking positional stuff, it may account for the pressure swings. I would suggest you follow the cpap titration protocol. Raise min pressure 1cm at a time to clear obstructive events.
http://c398534.r34.cf1.rackcdn.com/DOCU ... Canada.pdf

[Pugsy]

So how do you feel worse?
Was your sleep quality worse? Wake often or sleep soundly?
Daytime fatigue worse? What is worse?

How long did it take you to go to sleep?
What sleeping position do you use?
At the beginning of the night when all those RERAs got flagged....were you asleep?

[bsgontijo]

Hi Pugsy!! Yes, the quality of my sleep was worse.. And also the daytime fatigue is worse..
I think I took 10 to 15 minutes to sleep.. No more than this. Generally I sleep on my back and on my left position. I think I was asleep during the time these RERAs occurred..
I think I will try to rent a RESMED S10.. Don't you think it could help me?

Tks very much!!

[Pugsy]

When our sleep quality is in the toilet we are going to feel like crap the next day.
Why was the sleep quality in the toilet? Anything special bug you or cause wake ups or difficulty getting back to sleep?

Would a ResMed AIrSense 10 AutoSet make a difference? It might. Worth trying for sure if you can.