Can someone interpret these results?

[Firehope]

Are you basing this on the daily events numbers graph at the bottom of the report?

I would reduce the minimum to 11..see how the obstructive component does.

Also once we get these pressures to where we like them I would suggest trying straight cpap. APAP pressure swings upwards may not be the best thing with pressure induced centrals..

Oh, I was basing it on lowest OA and CA combined, as well as that "90%" thing =P.

I completely forgot to factor in the amount of time it spent on 12. Since it spent time on 12 ~6x as much vs. 13, it makes sense the numbers there would be more accurate.

As for the OA, what is a "safe" number? I naturally assumed 0 >.>. Guess with these results (1.1 being low), I can go down 1 or 2 notches. And it really does seem like APAP is a bad idea, as you said, since it's increasing to 14, 15, 16 "for no reason", and occurring CA.

Thanks again =D

[Pugsy]

Forget CA index for the moment.

We like to see AHI less than 5. Less is even better. If you subtract your CA index from your AHI....you have minimal obstructive component. It would be wonderful if you could keep that AHI but the CA is just too much...not as bad but since your obstructive is well below 5....you have some wiggle room.

Of course this is one night and we have variations from night to night anyway. Reducing the minimum may not severely impact the obstructive component yet. We don't know where that line is yet.

And yeah APAP may not be the best option. In theory the machine will not increase the pressure unless it senses the proper obstructive precursors. It won't respond at all to centrals. It will increase pressure in response to a good leak and that it turn could trigger CAs. If APAP is used.. I would use a tight range just as precaution.. Since I don't like to make multiple variables in an experiment and since you aren't spending a huge amount of time at the higher pressures it is hard to say to reduce the maximum right now. You are going to need to at some time either tighten the range pretty tight or go to CPAP though.

[Firehope]

Of course this is one night and we have variations from night to night anyway. Reducing the minimum may not severely impact the obstructive component yet. We don't know where that line is yet.

Reduced to 11, and the results are better than ever, it looks like:
http://i55.tinypic.com/1g38nk.png

Everything went down, except for VS (vibratory snore), which I can't really understand (why would I snore more, if there's less obstruction...? >.>).

Now, should I try going down to 10, or stay at min 11, 'till there's a problem?

This seems to counter the sleep study, where 11 resulted in 10 OA in a grand total of 9 minutes heh =P. But I do remember significant air leakage during that sleep study (and I mentioned this to my doctor, as well as the tech).

[Pugsy]

Well done. This last report is quite acceptable. The snores (VS) not enough to worry about. Small flow limitations and unless they come in huge numbers.. ignore. Especially if the machine didn't increase the pressure in response to it.
Up to you if you want to try 10. I probably would just to see how far could push things but this is quite acceptable.
I had a much worse report this this myself just a couple of nights ago.

Amazing how going down works better than going up. You might want to let your doctor know that you seemed to be prone to pressure induced centrals and with a bit of work you found that the 11 (or 10 minimum if you go there and it works) seems to take care of the obstructive and not produce a boatload of centrals.

Might want to cap the max to maybe 12 or 13 or use straight cpap...just in case you get a bad enough leak the machine tries to fix it and increases the pressure enough to trigger the centrals.

We have been making some rather rapid changes so whichever you decide on...10 or 11 minimum...give it a few days good trial now. From your titration pressures 9 would probably not take care of the obstructives well.
There isn't a whole lot of difference between 10 and 11 but sometimes a person can be surprised. My minimum is 10. When I drop to 9.5 my AHI doubles. While a 1.5 AHI double to 3 is not huge... it is still higher than I normally see. Now don't get discouraged if you have a bad night..we all have them from time to time even those of us that have been at this a long time.

Again, good job.

[Firehope]

My minimum is 10. When I drop to 9.5 my AHI doubles. While a 1.5 AHI double to 3 is not huge... it is still higher than I normally see.

While the number may not be big, the percentage of increase is huge, right? Might as well use 10 =P

Thank you for helping me throughout this ordeal =).

[Pugsy]

While the number may not be big, the percentage of increase is huge, right? Might as well use 10 =P

True. Percentage is great BUT bear in mind when I was doing these experiments I didn't do one night at 9.5 minimum
and see that happen and quit. My AHI can vary from 0.5 to 3.0 even now on 10 cm minimum too. This is why we don't usually advise making changes based on one night's results. I did about a week on each setting..9.0..9.5...10.0..10.5 all the way up to 12 just to see where I seemed to do the best. 10 was my best minimum. Even up to 12 min the AHI didn't really improve so no sense in using it.

Made an exception to the usual rule for you. It was pretty evident change was needed especially after I saw that titration graph.
Now you have a good starting point.. just give it some time to settle in with whichever seems to suit you the best.
If no real change in results at 10..use whichever feels best for you. I just imagine you have a good feel now what to look for.

And don't feel bad if you have an ugly night...Take a look at one of my recent disasters.. Yep, I was experimenting again. Ugly, ugly night.
viewtopic.php?f=1&t=67883&p=631354&hili ... mb#p631354

[Firehope]

And don't feel bad if you have an ugly night...Take a look at one of my recent disasters.. Yep, I was experimenting again. Ugly, ugly night.
viewtopic.php?f=1&t=67883&p=631354&hili ... mb#p631354

Oh god, that 8/25 one where it's just going up capping, and staying, at 20... x.x

[Pugsy]

Oh god, that 8/25 one where it's just going up capping, and staying, at 20... x.x

That was probably the worse night I have ever had. I slept horribly and was blown up like a puffer fish the next day. I won't be trying to duplicate those results. Once was enough.

I have had some less ugly nights though for some unknown reason. I don't dwell on them. They aren't my norm and I can't expect to be textbook perfect. I don't put my reports under a microscope anymore. I have had one night with an AHI of 0.0 in over 2 years of treatment. I didn't feel any different with it than any other normal report night.
I have found if I keep AHI under 3 it works. Over 3 and I start having a few clusters which I think does impact how I feel a bit.

I think that on the 25th night that I was so uncomfortable with no AFlex that I tossed and turned much more than usual. I know I woke up multiple times. And with the tossing and turning the mask leaked causing the machine to ramp up the pressure to fix the leak....which cause me to leak more....so the machine tried more pressure...till it couldn't give any more. Nasty little circle.

I do see 18 and 19 cm sometimes and no leak and never wake up or have any idea what happened. I do know that I am worse in REM sleep and when I see the high pressures it always in the wee hours of the morning when I am apt to be having more REM. I just shrug it off as events on steroids, hard to kill and just need more pressure.
It is why I do use APAP 10 to 20...just to try to catch those events on steroids. It suits my needs and it doesn't give me any pressure induced centrals. I have a rare occasional central and don't worry about it.