Taking charge of my theropy

[Ticman]

Greetings,
I've been a lurker for quite a while and since my S8 Escape died a few days ago I now have a S8 Autoset. Thanks CPAP.com! Pretty rough few nights without a machine.

I had a few problem getting used to the auto pap. The EPR will take some getting used too. I really like it though. Had the humidfier way to high and got rain out even with a hose snuggy. I have it turned down now and will try agin tonight. I have the software loaded on my PC and a card reader on the way so I'm sure I'll have more questions once the reader comes in.

I did get the readings from the LCD screen: AHI 16.4 AI 2.2 Leak 0.02 and here's the question? Pressure was 10. (I set the pressure range from 6 to 10) My titration study had me at a 6. With my old CPAP I couldn't breathe at that low pressure. Felt like the C02 wasn't washing out. I played around with the pressure my self since my sleep doc moved 2000 miles away and found I felt/slept better at 7.6. Been that for over 5 years now.

I knew my AHI would be high since I had all the problems but the pressure being 10 really suprized me. Should I set it to 12 or try it as is for a few more nights? Thanks in advance..

[bdp522]

An AHI of 16.4 is not good at all. What was the AHI with the old machine? Unless you have trouble with runaway pressure or the pressure change disrupts your sleep, there is no reason to limit the upper pressure. The machine should only go as high as you need it to go to keep the airway open. I would have the starting pressure at 7 and not limit the top pressure for a few nights to see where the machine goes. What is the EPR set on? EPR setting seems to have an effect on the AHI.

Brenda

[Janknitz]

The OP has no idea what the AHI was before because there's no way to tell on the Escape. The scary part is that it's possible you (the OP) have had a lousy AHI for years!

Or not. Who knows??? This is the problem with a data-less machine.

You might try setting your machine in CPAP mode at 7.6 and then check your AHI. It might help you know what it's likely to have been. Some people do better in CPAP mode and it seems like you felt OK at that setting.

Meanwhile, you can turn off EPR entirely if you want. It's a comfort feature, and you may do fine without it.

If you are still having a high AHI at 7.6 cm in CPAP mode, then you need to retitrate yourself. I'd start at a pressure of 7 and go to 10 or 11. i do not agree that a wide open pressure setting is a good thing--too much "play" requires the machine to "chase" your AHI's and you won't get an accurate picture of what's going on. Instead, run 7 to 11 cm for several days and then look closely at the rescan data to see what's going on. Based on that info you can decide if you want to change the pressures or not.

[cowlypso]

Yup... 16.4 is way too high. My AHI on my initial sleep study was only 15.5, and that was enough for them to prescribe CPAP for me.

[HoseCrusher]

Let's not forget that the S8 scored hypopneas much more aggressive than other units. I think you need to ponder the AHI value, and look at the AI value for a better idea of how things are going. I regularly see an AHI in the 10 - 12 range while the AI component is usually under 1.

[LSAT]

Greetings,
I've been a lurker for quite a while and since my S8 Escape died a few days ago I now have a S8 Autoset. Thanks CPAP.com! Pretty rough few nights without a machine.

I had a few problem getting used to the auto pap. The EPR will take some getting used too. I really like it though. Had the humidfier way to high and got rain out even with a hose snuggy. I have it turned down now and will try agin tonight. I have the software loaded on my PC and a card reader on the way so I'm sure I'll have more questions once the reader comes in.

I did get the readings from the LCD screen: AHI 16.4 AI 2.2 Leak 0.02 and here's the question? Pressure was 10. (I set the pressure range from 6 to 10) My titration study had me at a 6. With my old CPAP I couldn't breathe at that low pressure. Felt like the C02 wasn't washing out. I played around with the pressure my self since my sleep doc moved 2000 miles away and found I felt/slept better at 7.6. Been that for over 5 years now.

I knew my AHI would be high since I had all the problems but the pressure being 10 really suprized me. Should I set it to 12 or try it as is for a few more nights? Thanks in advance..

Where did you find the card reader

[Perrybucsdad]

I did get the readings from the LCD screen: AHI 16.4 AI 2.2 Leak 0.02 and here's the question? Pressure was 10. (I set the pressure range from 6 to 10)

I'm a little confused... you say pressure was 10, but then you say the range was 6 - 10. Are you saying the average pressure was 10? If that's the case, I think I would set the min to 10 and the max to 20 and see what the software tells you after a few days.

[Ticman]

Where did you find the card reader

Found them on EBAY.

[Ticman]

I'm a little confused... you say pressure was 10, but then you say the range was 6 - 10. Are you saying the average pressure was 10? If that's the case, I think I would set the min to 10 and the max to 20 and see what the software tells you after a few days.

Yes, the pressure reading on the LCD was 10. I moved it to 12 last night was it was 11.4 see above post. I don't have the card reader yet so I can't down load the real data.

[Ticman]

Well my post this morning is gone now. Hmm.. trying again.

Last nights numbers:
Pressure: 11.4
AHI: 9.6
AI: 1
Leak: 0.02
HI: 8

I moved the high up to 12 last night. I left everything else as is. I'm going to move the low up to 8 tonight and see how that works.

Thanks for the help/replies
Ticman

[Lizistired]

That's a pretty dramatic decrease in AHI! Mininum 8 may very well clean up your hypopneas since you were at 7.6 before. Then I would try to stay with that setting for a few days.

[robysue]

Asking some questions for clarification:

Old (now dead) machine was an S8 Escape set to 7cm. And you either did not have or did not use EPR. Is that correct?

New machine is an S8 Auto and you are using both the Auto feature and EPR. Is that correct?

Auto range was 6--10cm and the 95% pressure reading from the LCD was 10cm.
Last night the Auto range was something like 6--12 cm and the 95% presssure reading from the LCD was 11.4.
It that correct?

And you are using EPR turned on? To what setting? Remember that EPR reduces the pressure by a fixed amount on each and every exhale: EPR = 3 gives a 3cm drop in pressure. While this drop in pressure is not supposed affect the quality of therapy, for a few people it does seem to matter. You might be one of them. There are posters here who have found that they need to bump the pressure up in order to use EPR without increasing their AHI. You may be one of them. That could explain the higher than expected 95% pressure reading.

Your idea of increasing the min pressure to 8 is reasonable. But you also may want to give your body the time to settle into an 8--12 range by using it for 3--4 days (or even a week) to see what happens to that AHI over a bit of time. It's hard to see a trend in the data if you are changing the settings every night.

That said, I do think you need to work on tweaking the pressure setting some since the AHI remains high even if you "cut the HI in half because the S8 Auto tends to overscore H's" before recalculating an AHI number.

So if

[Ticman]

Asking some questions for clarification:

Old (now dead) machine was an S8 Escape set to 7cm. And you either did not have or did not use EPR. Is that correct? Yes
New machine is an S8 Auto and you are using both the Auto feature and EPR. Is that correct? YES
Auto range was 6--10cm and the 95% pressure reading from the LCD was 10cm.
Last night the Auto range was something like 6--12 cm and the 95% presssure reading from the LCD was 11.4.
It that correct? YES

And you are using EPR turned on? To what setting? Remember that EPR reduces the pressure by a fixed amount on each and every exhale: EPR = 3 gives a 3cm drop in pressure. While this drop in pressure is not supposed affect the quality of therapy, for a few people it does seem to matter. You might be one of them. There are posters here who have found that they need to bump the pressure up in order to use EPR without increasing their AHI. You may be one of them. That could explain the higher than expected 95% pressure reading. Yes, my EPR is set to 3

Your idea of increasing the min pressure to 8 is reasonable. But you also may want to give your body the time to settle into an 8--12 range by using it for 3--4 days (or even a week) to see what happens to that AHI over a bit of time. It's hard to see a trend in the data if you are changing the settings every night.

That said, I do think you need to work on tweaking the pressure setting some since the AHI remains high even if you "cut the HI in half because the S8 Auto tends to overscore H's" before recalculating an AHI number.

I answered your questions in the above quote. I'm going to try the low setting at 8 tonight and if I keep going in the right direction I might drop the EPR next.
Thanks for the reply.

[Pugsy]

Until you get your card reader to use the software be sure to check your nightly data before noon.
The machine starts a new day at noon and resets to zero for single nightly data.
There is a way to go further into the menu to see other overall averages though.

The minimum pressure setting is your most critical pressure setting unless you see the maximum being reached most of the time. The minimum needs to be able to raise to the pressure needed to deal with the events in a timely manner.
When it is too low it can't respond quickly enough because it raises the pressure in stages. The events come and go before the machine can prevent them. Giving the machine a head start with a higher minimum will help.

Raising the minimum to 8 will help. It remains to be seen if it will help enough but it is a good place to start.
And yes, some people have found that the use of EPR does impact the AHI so modifying it is also an option.

[Uncle_Bob]

Where did you find the card reader

They are on ebay, some expensive at $70+ buy it now prices
But i just sold mine a couple of weeks ago and it went on auction for $25