New to CPAP, need help choosing right pressure.

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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zonker
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Re: New to CPAP, need help choosing right pressure.

Post by zonker » Tue Jul 19, 2022 12:52 pm

kidchameleon wrote:
Tue Jul 19, 2022 12:25 pm
Alright, after a good while I decided to post what I have.
kudos, kid! to follow up on dogslobbers excellent advice, what you are dealing with, in this one chart, is obstructive apnea events. generally speaking, this is easily dealt with by increasing the minimum pressure which is why ds suggested it.

i also concur with his advice to up the minimum in increments, should a full implement be too much. i know it was for me when i first started. i ended up with aerophagia and my belly felt like a basketball. so i ended up increasing my minimum by .2 at a time.

continued good luck!
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kidchameleon
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Re: New to CPAP, need help choosing right pressure.

Post by kidchameleon » Wed Jul 20, 2022 5:16 pm

Cool, thanks!
I tried 15cm last night and woke up to an AHI of 1.0! I'm so glad to see some progress now. I felt fine this morning so I'll keep it at 15.
Hopefully the trend continues. I'll post my results the week after next, thanks for all the help!

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zonker
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Re: New to CPAP, need help choosing right pressure.

Post by zonker » Wed Jul 20, 2022 5:20 pm

kidchameleon wrote:
Wed Jul 20, 2022 5:16 pm
Cool, thanks!
I tried 15cm last night and woke up to an AHI of 1.0! I'm so glad to see some progress now. I felt fine this morning so I'll keep it at 15.
Hopefully the trend continues. I'll post my results the week after next, thanks for all the help!
yay! after seeing all the trolls spew forth lately, it's good to see you and billy doing so well on your therapy.
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Dog Slobber
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Re: New to CPAP, need help choosing right pressure.

Post by Dog Slobber » Wed Jul 20, 2022 6:21 pm

zonker wrote:
Wed Jul 20, 2022 5:20 pm
yay! after seeing all the trolls spew forth lately, it's good to see you and billy doing so well on your therapy.
And did you notice that said trolls *never* help, advise or even encourage novices. They have an awful lot to say and claim expertise. But where are they when somebody actually asks for guidance.
kidchameleon wrote:
Wed Jul 20, 2022 5:16 pm
I tried 15cm last night and woke up to an AHI of 1.0! I'm so glad to see some progress now. I felt fine this morning so I'll keep it at 15.
Damn right you're going to keep it at 15 for a bit. :)

I've been drumming into your head that one night, does not a trend make

Not only do we want to see a lower AHI, but we also want to see some of the other positives of our minimum being closer to optimum. We also want a little more statistical significance.

Keep it up.

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zonker
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Re: New to CPAP, need help choosing right pressure.

Post by zonker » Wed Jul 20, 2022 7:04 pm

Dog Slobber wrote:
Wed Jul 20, 2022 6:21 pm
zonker wrote:
Wed Jul 20, 2022 5:20 pm
yay! after seeing all the trolls spew forth lately, it's good to see you and billy doing so well on your therapy.
And did you notice that said trolls *never* help, advise or even encourage novices. They have an awful lot to say and claim expertise. But where are they when somebody actually asks for guidance.
you're trying to get me in trouble with pugsy re: sabotaging threads! :lol:

so before she yells...nothing really changes in that regard. so many will complain that the regulars on the forum will say something THEY think we shouldn't say. but where are they when the new user comes in for help? nowhere to be found.
¯\_(ツ)_/¯
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kidchameleon
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Re: New to CPAP, need help choosing right pressure.

Post by kidchameleon » Mon Aug 01, 2022 7:02 pm

Alright, I'm back. I've been on 15cm and after about 2 weeks I don't really feel any difference yet, which is no surprise. I feel like my AHI has been more or less the same as when I was on 14cm, but I didn't get any 0s this time around. I'm still glad to see my AHI being consistently around 1-2cm, though I had some bad nights on the 25th and 26th. On the 25th I fell asleep without my CPAP by accident and I woke up around 5am and put it on. I was expecting to sleep more but I was called in to work thinking I had a day off. The 26th had me accidentally falling asleep by accident again. I'll do my best not to do that again, it's really annoying and a waste of a good night's sleep.
Anyway, here are my results. I also included my statistics just in case.
https://imgur.com/a/MnIi6gu
Should I now increase my pressure or decrease?

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zonker
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Re: New to CPAP, need help choosing right pressure.

Post by zonker » Tue Aug 02, 2022 10:44 am

kidchameleon wrote:
Mon Aug 01, 2022 7:02 pm

Should I now increase my pressure or decrease?
i would increase just to see where to goes. up a full point from where you are and see if it makes any difference.

i'm too lazy to go back over the thread, so i'll ask instead. what is it you want to accomplish? better sleep? longer sleep? you sai in the post i'm replying to that you didn't feel any different.
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kidchameleon
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Re: New to CPAP, need help choosing right pressure.

Post by kidchameleon » Tue Aug 02, 2022 2:01 pm

I was actually surprised to wake up with a 0.3 AHI this morning. Although looking at it now on OSCAR it seems I had a large leak and I turned off the machine for some period of time. I really don't remember what happened there unfortunately.
https://imgur.com/a/KfIxmB8
Anyway, I have the usual sleep apnea symptoms and I never feel refreshed after sleeping. I really wish I could wake up feeling great like those stories on Reddit I read, but I know everyone is different. At least I feel like I'm making a little progress just by how consistent my AHI has been recently.

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Re: New to CPAP, need help choosing right pressure.

Post by Pugsy » Tue Aug 02, 2022 2:13 pm

Why did you deviate from the standard basic graphs and include useless graphs this time?

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kidchameleon
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Re: New to CPAP, need help choosing right pressure.

Post by kidchameleon » Tue Aug 02, 2022 3:30 pm

Oh! I didn't notice. Sorry about that, I scrolled down and forgot to scroll back up for the screenshot. Here's another link.
https://imgur.com/a/Fs4zOkf

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zonker
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Re: New to CPAP, need help choosing right pressure.

Post by zonker » Tue Aug 02, 2022 5:56 pm

kidchameleon wrote:
Tue Aug 02, 2022 2:01 pm
I was actually surprised to wake up with a 0.3 AHI this morning. Although looking at it now on OSCAR it seems I had a large leak and I turned off the machine for some period of time. I really don't remember what happened there unfortunately.
https://imgur.com/a/KfIxmB8
Anyway, I have the usual sleep apnea symptoms and I never feel refreshed after sleeping. I really wish I could wake up feeling great like those stories on Reddit I read, but I know everyone is different. At least I feel like I'm making a little progress just by how consistent my AHI has been recently.
you might want to keep a journal of how you feel each morning. do it BEFORE looking at your ahi. i know for me, the changes came gradually. over months of use, when i first began. by keeping a record, you may be surprised at what is going on.

if you haven't already, you may want to google "sleep hygiene". it's a stupid phrase but it will give some tips on how to get a better night of sleep.
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Re: New to CPAP, need help choosing right pressure.

Post by Dog Slobber » Wed Aug 03, 2022 7:01 am

Great job on the discipline of setting the machine and then leaving it alone.

There is no information to be gleaned in that string of single day.

You now have two pretty good data points:
11 days at 14-20 AHI of 2.22
13 days at 15-20 AHI of 2.23

You *could* move your minimum to 16, but I think you're at the point of diminishing returns.

Would moving to 16 reduce your AHI by any significant amount? Even better, did moving from 14 to 15 change anything for the better, and it didn't. In fact, one might argue that your leaks maybe worse.

Looking at the frequency of the pressure increases, a consideration is your apnea is a lot worse in REM. Is it worth having to deal with more pressure (unnecessarily) during non-REM to better deal with REM?

By all means continue to experiment, but do so as we have for the last 24 day. Make one change than stick with it.

Personally, I can't help but believe you are to hung up on chasing numbers and hitting 0.0. You seem to think that there is some machine setting, where everything is going to change and you'll sleep through the night and your day will be energetic and fulfilling. That's not going to happen by changing your pressure.

Just keep putting in the time. There isn't going to be a single significant day, but a series of small imperceptible changes.

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kidchameleon
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Re: New to CPAP, need help choosing right pressure.

Post by kidchameleon » Wed Aug 03, 2022 1:38 pm

It used to be tempting to want to change it, but I got used to it pretty quickly. Since my results are similar, would going to 14cm or even 14.6cm be a good idea? I'm sure the leaks will decrease if I lower it.
The reason why I wanted to aim for around 0 is because I thought that was the ideal goal for anyone with sleep apnea, although I'm just assuming here. I know AHI doesn't matter, but I wanted to see for myself. If everything looks fine with my charts then I'd be satisfied with where I am. I'm sure I'll see some progress as time passes by.

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Re: New to CPAP, need help choosing right pressure.

Post by Pugsy » Wed Aug 03, 2022 2:26 pm

Let me share a little story about myself.

Many years ago (like the 1st year of my being on cpap and it's been over 13 years now) I did an experiment to see if I could get the AHI any lower or change how I felt or anything..
I had already figured out that a setting of 10 cm minimum with the range going to 20 (my OSA is documented 5 times worse in REM so in REM I see much higher pressures in the mid to upper teens). My AHI was running somewhere along the lines that yours is running...sometimes a little lower and sometimes a little higher. Usually running between 1.0 and 2.0 though.

I decided to start increasing the minimum 0.5 cm at a time and give each change one week to see if anything changed.
So devoted 6 weeks to that experiment.

At the end of the 6 weeks, and after spending a week at the minimum of 13, I reviewed the past 6 weeks results.
Nothing changed at all. Same amount of sleep....pretty much still had the same AHI...same energy levels...nothing changed at all beyond very minor small changes that happen from night to night anyway.
So I decided to abandon any further experimenting with higher pressures.

I had 2 main symptoms of OSA go away pretty much immediately and those were nocturia and killer morning headaches but the overall energy levels I wished would improve to reflect the AHI I was seeing but they just didn't change as much as I wanted them to change.
As I reflect on the experiment now I realized that I was having unrealistic expectations as to what a lower AHI would or could do. The therapy itself was working and working quite well. No more getting up to pee ever hour on the hour with a painfully full bladder and no more killer morning headaches from the low oxygen levels during the night.
The energy thing...well there were other potential reasons from pain to BP meds to just not getting enough sleep and some days are good days and some days are bad days still to this day.

As for what minimum to use...most likely you could do well with anything around 14 or 15 or 16 and I would suggest just pick one and stick with it for longer time frame.

One other thing....you probably should learn to distinguish arousal vs asleep flagged events.
It's very possible that your AHI while asleep is lower than you think because of potential false positives being flagged.
Increasing the pressure doesn't help reduce awake/arousal related flagged events.
You can have false positives in any category of event. Go here and watch the videos and learn how to zoom in and figure out awake vs asleep and while they are talking mainly about central apneas ....it can happen with any event category.
http://freecpapadvice.com/sleepyhead-free-software

I have learned that most nights my AHI will run anywhere from 0.7 to 2.0 or 3.0 and without exception about 75% of whatever the AHI is...will be from false positives and I am not asleep when flagged. The asleep AHI is quite low but some nights I don't sleep so great due to pain or stress or insomnia or whatever. No amount of tweaking the settings is going to let the machine fix my problems with pain or stress or insomnia or whatever.

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kidchameleon
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Re: New to CPAP, need help choosing right pressure.

Post by kidchameleon » Wed Aug 03, 2022 7:19 pm

I guess where i am at now is good enough, I don't think raising the pressure more than what I have now would be good. Especially since I'm seeing more leaks. I'm just glad to see similar results at what are considered normal AHI levels. I'll probably start seeing some physical results sometime in the future, but we'll see about that.
I think I'll change my pressure to 14 since I felt like I got the best results from that than with 15, even if there wasn't much of a difference. It's great that I can go from 2 to 1 to even 0 a few times. The only times I'd get anything above 3 would be bad nights where I accidentally fall asleep. I'm sure even people without sleep apnea would get numbers like that if they checked. I'm sure all these years of bad sleep will take awhile to make up for so I'll stick to 14cm and see where that goes in the future.

I'll be sure to watch those videos, thanks a lot!