When/if to repeat a sleep test

[zonker]

Raise your max pressure to at least 15 (or 20) for a few nights - it wants to go higher but is being blocked.

look again. there is only one night where it wants to go past 11.

[zonker]

Here are the last 4 days putting machine on auto.

lilly, look closely at these charts in apap as compared to cpap. in cpap (straight pressure) you start and stay at 11.5.

on apap, you have min set at 8 and MAXIMUM set at eleven.

ima offer you different advice from julie. stay on apap and set your minimum at 11.5 and the max at 20. this will allow the machine to keep up with your events and vanquish them.

good luck!

[Julie]

Ummm I suggested going even to 20 for the max, what are you looking at?

[zonker]

Ummm I suggested going even to 20 for the max, what are you looking at?

the charts she posted today. she only has one that wants to go higher than 11 and that's on 3/12.

the last chart she posted she has set at min 7 and max 20.

she shows on her fixed pressure charts that she can tolerate 11.5 and the fixed charts show lower ahi than her apap does.

just thinkin' it would work, is all.

[Pugsy]

Julie.....she only once very briefly hit the 11 cm max when she was using a restricted maximum in auto mode.
March 11, 2021 report and between 5:45 and 6:00....all the other auto mode reports she never really hit 11....increasing the max to 20 is unlikely going to do much. Just because it can go higher doesn't mean it will and most likely it won't.
For better results in this situation an increase in the minimum would be the most likely more effective way to go. It wouldn't hurt to increase the max but it won't help either.

This is why I don't always tell people to increase the max....if the machine isn't going up there now it won't even if we let it go up with a wider range.

So she ended up trying fixed cpap at 11.5 and got fairly decent numbers with it...and it doesn't surprise me.
Unfortunately in fixed mode her machine doesn't flag flow limitations...so we don't know if she just didn't have very many or the machine didn't flag them.
If she feels like she sleeps better in fixed mode then maybe setting the minimum to equal maximum in auto mode is the way to go so that we can at least see if any flow limitations are happening.

Obviously she needs more minimum for sure than the 7 or 8 she tried in auto mode. Quite common for the Respironics machines unfortunately. It just doesn't respond fast enough. More minimum is the likely way to go here....I don't see increasing the max doing anything at all because the machine most likely won't be going up there anyway.

[Tigerlily]

Julie.....she only once very briefly hit the 11 cm max when she was using a restricted maximum in auto mode.
March 11, 2021 report and between 5:45 and 6:00....all the other auto mode reports she never really hit 11....increasing the max to 20 is unlikely going to do much. Just because it can go higher doesn't mean it will and most likely it won't.
For better results in this situation an increase in the minimum would be the most likely more effective way to go. It wouldn't hurt to increase the max but it won't help either.

This is why I don't always tell people to increase the max....if the machine isn't going up there now it won't even if we let it go up with a wider range.

So she ended up trying fixed cpap at 11.5 and got fairly decent numbers with it...and it doesn't surprise me.
Unfortunately in fixed mode her machine doesn't flag flow limitations...so we don't know if she just didn't have very many or the machine didn't flag them.
If she feels like she sleeps better in fixed mode then maybe setting the minimum to equal maximum in auto mode is the way to go so that we can at least see if any flow limitations are happening.

Obviously she needs more minimum for sure than the 7 or 8 she tried in auto mode. Quite common for the Respironics machines unfortunately. It just doesn't respond fast enough. More minimum is the likely way to go here....I don't see increasing the max doing anything at all because the machine most likely won't be going up there anyway.

Hi Pugsy! Thank you for the reply. Ok, so tonight I will increase minimum to 11.5 and see if that helps. I don't know if my machine does flow limitations? I will double check. Also, I really don't know what that means. Can you explain?

Also, what I don't understand is why when I had it on cpap that I had pressure set at 11.5, it never went up that high?

The red line (pressure set) is what pressure I set cpap at. The green line (Epap) is what pressure is coming out, right? What does epap mean? If it was usually down at the 9.5 setting, wouldn't that mean I don't need higher pressure? But, when I lowered pressure in past, it didn't help me. Sorry I'm confused by my charts. I also don't know how to interpret the flow rate chart.

[Tigerlily]

What about the percentage of CA's I'm having? Does that mean I may have mixed sleep apnea?

Here are the latest 2 nights, still 7 to 20, since I just read these posts, I will adjust it to 11.5 to....20? Or maybe I will lower the max number to say...17?

[Pugsy]

No, you don't have mixed apnea. A few centrals here and there is normal to see.

Your machine will flag flow limitations but only in auto mode......and only if you have the.

IPAP...inhale pressure
EPAP...exhale pressure
you see 2 lines on the pressure graph when Flex is used because Flex drops the pressure a little bit during exhale.

Flow limitations are early warning signs the airway is trying to collapse but not part of the official AHI

[tisket]

Only sleep study I had was an at-home one to get the prescription. Skipped the insurance/DME because the whole cost for the equipment would have come out of my deductible anyway and I would have to do the compliance nonsense as well as have no control over the machine.

I would be tempted to do one if I thought it would help with these large leak problems (24% again last night) but I doubt it would. In fact I doubt I could even sleep in a lab, I had a hard time sleeping even during the at-home study. My girlfriend had to do a sleep study twice ($$$) because she couldn't sleep the first time.

[Tigerlily]

Changed minimum to 11.5 and max at 17 - thoughts? Tips? Anything else I need to tweak?

[Tigerlily]

Anyone?

I was hoping to get help here figuring it out since I can't get another sleep test.

[Tigerlily]

Guess not.....

[tisket]

Figure what out? I would kill to have numbers like yours.

[zonker]

Changed minimum to 11.5 and max at 17 - thoughts? Tips? Anything else I need to tweak?

lilly, every chart you've posted prior to this comes up with this instead of the chart-















looks like you've deleted them. kind of hard to see what progress you've made if there is nothing to compare it to.

as to current, you don't mention how you've slept or how you feel. that's as important or even more so than the numbers.

[Tigerlily]

Oh bummer. Yep, I deleted them because the site wouldn't keep them in the order I wanted and it was annoying me, lol. Sorry, I'm used to sharing things on social media and not having to store the image. This is an old school way to share images. I won't delete any future images I put up. In regards to how I feel now with auto 11.5 -17 vs cpap 11.5 - same. I feel the same. I still am tired when I wake up and have the same amount of energy during the day, not enough.

I will upload more images soon and maybe I need to make different adjustments?