Advice on fine tuning my AS 11?

[BobH56]

Hello

Mature, male who has been on CPAP 2 years now. Without a forum like this I would have given up as it seems the industry is primarily to churn
equipment & supply sales vs treatment. That said I have a pressure range that seems to work, I don't use ramp and any time I even try any level of EPR my CA's jump
substantially. All of that took time & trial and error to sort out. My initial sleep study showed no CAs btw.

I am typically at a range of 0.3-1.8 AHI now. I have found a chin strap and an nasal mask seem to work best (N30). I did use an F30 for a number of months but
actually get as good as or better results when using a chin strap and thea N30. Maybe the chin strap helps keep my jaw from falling back and causing OAs. I've also
learned from this forum that I have positional apnea, ie if I sleep on my back my AHI increases dramatically so I side sleep most of the time.
I am not convinced many of the CAs are real as a number of them will show when I know I am all but awake in the morning.

That all said, are there any other adjustments or things I could try to improve my results or is this as good as it gets?

Here are the past few days as shown in SleepHQ which are fairly typical.

https://sleephq.com/public/teams/share_ ... 3dad6c0ddf

THANK YOU for any additional advice/suggestions.

Bob H.

[Miss Emerita]

Just last night's chart showed up. In general, everything is looking good. Do you think you were awake during that little flurry of CAs at the end of the night?

Have you tried lowering your minimum? If you haven't tried that recently, you might want to see what happens. With lower pressures, your flow rate might stabilize a little more. Or not. It would be an experiment. If you want to try this, I'd suggest you drop the minimum slowly, maybe just .4 at a time, waiting for several days at a given setting before making any additional change. If your flow limitations start increasing, go back to a higher minimum.

How do you feel during the day? With numbers as good as yours, that's the real test of how your PAP therapy is working.

[BobH56]

Thank you so much for your feedback. I have in the past dropped pressure and thought the number of events went up, but its been awhile. Actually my prescribed pressure
was much lower and I slowly worked up to my current setting thinking I should prevent an event, vs having one and then the machine having to increase pressure to counteract.

I will admit I was less patient in the past, where I'd make a change and if it adversely impacted my results, I'd quickly change again.
But I will try dropping the pressure 0.4 and leave it for a few days to see what happens.

As for how I feel, I never found it was a day & night difference with or without CPAP. I started with it to eliminate life long snoring. When I did my sleep study it showed
my AHI was 52 all OAs. I "slept" on my back for that study not wanting to move with all of the sensors connected. I realize now that was the worst position possible for me.. When I do get a cluster of CAs I do think I am kind of awake when they occur, at least that last hour before waking up.

In general I feel fine, rested when I wake up though.

Bob H

[BobH56]

PS, you mentioned only last night's chart showed up? You just click on the date arrow at the top of the SleepHQ chart and you can go back additional days.. at least that works for me.

[Pugsy]

When I do get a cluster of CAs I do think I am kind of awake when they occur, at least that last hour before waking up.

If you are awake when those centrals/CAs get flagged all that means is you weren't asleep and if you aren't asleep then anything flagged can be ignored. We can pause our breathing often while awake but the machine can only measure air flow because it has no way to measure sleep status. It's fairly common. I have quite a few awakenings myself so I see a lot of those "false" flags. False in the sense that I wasn't asleep so they don't mean much. Now to the machine.....I paused my breathing so still very real to the machine.

You might also see an occasional OA or hyponea flagged event when not asleep. Might want to take at look at this thread.
I have dozens like it but only this one handy.

viewtopic.php?f=1&t=187767&p=1451526#p1451526

[BobH56]

Thanks Pugsy

I did look at the link or thread you suggested, even recall reviewing it previously when trying to learn more but admit its all less than obvious to me.
I think I'm in pretty good shape, I even have had a couple 0.0 AHI nights but more likely I'll have a week of 0.4 - 0.7 AHI, then the following week of 1.2 - 1.8 AHI, then
back below 1.0 again. Just seems to range like that in a general up & down cycle. The best improvement seems to have been when I started using a chin strap & N30.
The F30 worked well, low leaks but more cumbersome and at times an odd much higher event night than the N30/strap combo.

This site and forum has been an extremely valuable resource to me.
regards

Bob H.

[BobH56]

https://sleephq.com/public/teams/share_ ... e8a5537e18


An update on changing my settings/results. I did try dropping my minimum pressure to 11.4 from 11.8 as was suggested and got slightly worse results (I think?).
This was the period July 16-18 as can be seen in SleepHQ.

Rather than go back to 11.8, I then set it at 12.0 since I often found the 95% high pressure for the the night was 12.5 or so. My novice thinking
is why have an event and then the machine has to catch up when I should just have a pressure that prevents the event from happening to begin with.

So now with the pressure at 12.0 the first night was 1.06 AHI but then well below that thereafter. The dates so far with that pressure are Jul 19 to Jul 21st.
Not a long time I realize but unless there are other suggestions, I'll just continue with that pressure as I am not sure what else I'd change.

regards to all,

Bob H.

[ozij]

How are you sleeping and how are you feeling during the day?

[BobH56]

I sleep just fine and don't otherwise feel tired during the daytime.