New PR S1 BiPAP Auto, dialing in lower AHI, etc.

[cwsanfor]

I just got a new PR S1 BiPAP Auto, and it is much improved over my late Remstar Tank. I'm getting a good AHI, about 0.8 over a week, but there are some events I'd like to minimize. I know that 0.8 AHI is good, and that this may be Sleep Apnea as a Hobby, as SAG/NotMuffy put it, but any constructive comments are welcome.

The image below is typical. My settings are 23/16 EPAP/IPAP, no BiFlex, PS=7. My 90% pressures are about 19-20/16. I've read at viewtopic/t23608/Auto-BiPAP-pressure-su ... g-AHI.html that "the rule of thumb tends to be chase only apnea events with EPAP, and attack everything else with IPAP". My questions are:

1) Since I run at 19 IPAP much of the night, is there a way to have the PR S1 just start at that pressure (to chase hypopneas and snores), rather than 16+2=18?
2) I still have apneic some events I'd like to reduce. Is lowering the PS from 7 a reasonable way to do that, and if so, would PS=4, or PS=3 seem about right?
3) On some charts other than this one I show one or two CA (clear airway apneas) a night. CA's were not detected or charted by my old machine or software. Am I correct in thinking that these are best ignored?
4) I searched for but did not find a guide to all the chart symbol that EncorePro 2.4 makes in the waveform charts, such as four blue or black dots grouped together. Does anyone have a summary? There seem to be some symbols not called out in the legend.

Thanks in advance.

[Pugsy]

3) On some charts other than this one I show one or two CA (clear airway apneas) a night. CA's were not detected or charted by my old machine or software. Am I correct in thinking that these are best ignored?

Yes, occasional CA just ignore.

4) I searched for but did not find a guide to all the chart symbol that EncorePro 2.4 makes in the waveform charts, such as four blue or black dots grouped together. Does anyone have a summary? There seem to be some symbols not called out in the legend.

We don't know what those dots mean. They have been discussed but I haven't seen any explanation as to what they are.

Your other questions best left for Bipap users to offer ideas on.

[GumbyCT]

Is there a reason you aren't happy with things the way they are?

Consider trying a different mask? btw - which mask are you using?

[cwsanfor]

Is there a reason you aren't happy with things the way they are?
Consider trying a different mask? btw - which mask are you using?

Gumby, I'm really happy with my current results, but I am a geek, and like to optimize things. I tend to spend some time fiddling with a new gadget, get it as optimal as I can, then let it run. Same with computers, bikes, ammunition, and xPAP devices. It also seems that I can detect the difference between say, 1.8 and 0.6 AHI by how I feel the next day, so this is not entirely an idle activity.

I use the Quattro, but have maybe a dozen other types from back when my insurance did not limit mask purchases. I've tried many nasal, hybrid, FFM, etc. I also like the Activa, since it works well at these pressures, and may revisit it soon. Don't care much for things inserted into my nose.

[GumbyCT]

It also seems that I can detect the difference between say, 1.8 and 0.6 AHI by how I feel the next day, so this is not entirely an idle activity.

Thats what I was wondering....I can tell if my AHI including FL's is approaching 1. I keep my PS at 3.

Don't care much for things inserted into my nose.

You may get better treatment if you did insert things. Esp when it comes to snores

But hey, to each his own.

[rested gal]

I'm getting a good AHI, about 0.8 over a week

That's not just good. That's excellent! As good as "zero" in my opinion.

but there are some events I'd like to minimize.

Well, I personally wouldn't give those leftover crumbs a second thought.

I know that 0.8 AHI is good, and that this may be Sleep Apnea as a Hobby, as SAG/NotMuffy put it

Yes, I think that's what it would be. You're already getting a much lower AHI than probably most "normal" people have -- people who have a sleep study and are told they don't have OSA. "Normal" being AHI under 5.0

2) I still have apneic some events I'd like to reduce.

If you want to try that just out of curiosity, I understand. If you want to do some hobby tweaking just to see what the data reports, ok.

However, if you're trying to improve how you feel, I don't think trying to eliminate those few random "events" is worth pursuing at all.

3) On some charts other than this one I show one or two CA (clear airway apneas) a night.
---
Am I correct in thinking that these are best ignored?

Yes.

_______________________

I'm really happy with my current results, but I am a geek, and like to optimize things. I tend to spend some time fiddling with a new gadget, get it as optimal as I can, then let it run.

I understand that. So, yeah, have fun fiddling with it.

It also seems that I can detect the difference between say, 1.8 and 0.6 AHI by how I feel the next day, so this is not entirely an idle activity.

In that case, before I started ANY tweaking-settings experiments at all, I'd try this little experiment first to see if there really was a possible correlation:

I would not look at ANY machine data at all until the day was finished and bedtime was nigh. I'd make a note of how I felt that day. THEN (and only then) I'd look at the data. I'd keep doing that for a solid month -- without changing any settings. Never, ever looking at the data until after I had noted how I felt at the end of the day.

Better yet, I'd do more than make a note just about "how I felt." In the interests of finding out if there might be OTHER things affecting how I had felt that day, I'd note what I ate and drank, and what time I consumed it. More nasal stuffiness than usual? More exercise than usual? Unusual stress in job or family? Acid reflux acting up? Change in meds or the time they were taken? Went to bed (or got up) later or earlier than usual? Sleep environment warmer or colder or noisier than usual? More or fewer wake ups in general the night before? Wake-ups due to noticeable mask leaks? Wake-ups from noticeable pain issues?

If there are things other than machine settings that could account for a difference in how a person feels day-to-day, there wouldn't be much point in trying to zero in just on "settings" that are already doing their part of the job great.

[cwsanfor]

Thanks, all, for your replies.

[cwsanfor]

I took tips from both Gumby and RestedGal, lowered my PS to 3, ran it two nights without looking at the data, noted that I felt much more energetic, and then found my AHI reduced from 0.8 to 0.3 (!). I'm done here with the xPAP Olympics/Apnea as a Hobby. Thanks all.