THANK YOU, PUGSY!

This simple breakdown of:
"Postby Pugsy on Mon Jun 23, 2014 8:03 am

If the AHI is composed of primarily Clear airway events then we just sort of sit back and watch them.
If the AHI is composed of primarily Hyponeas and OAs then normally a little pressure adjustment upwards is all that is needed."

Got me to the next step in my treatment, because now I'm able to better evaluate what combination of factors can justify a bump in pressure. Last night I decided that I would monkey with my pressure a bit, Nurse Cratchett and her Cuckoo Nest be damned. I found the link to tell me how to get into the clinician's menu, then bumped the base pressure from 4cm to 5cm (waiting for the call to tell me I was a bad girl, and they were going to permanently lock me from any more changes ). I even used a 10 minute ramp, not that it's NECESSARY, really...but hey, why not? I also turned the humidifier to 0, I think that makes it a pass over? Whatever, it was humid last night, and I was too lazy to disconnect it.
Results? I slept really well, without the feeling of a slow smother that's been creeping up on me lately. I checked the numbers on SleepyHead this morning, and I had a total of 15 events the entire night, as opposed to 15 events on just one line. Or more. And this didn't happen til after 0430 this morning. Snoring went WAY down. SO...I feel pretty not bad this morning, and I will give it some time to decide if it's a stable trend or if I might want to try 6cm. I think it was also a good time to give it a shot, as I don't have my A/C unit in the window yet, and it was getting pretty muggy.
So long as I either get a doctor who is good with a patient trying to be involved in her therapy OR they all just stay out of my way and let me muddle through with the help from people who actually LIVE with this and know the ins and outs, I think this can work for me.

YAY!

Tatooed Lady wrote:(waiting for the call to tell me I was a bad girl, and they were going to permanently lock me from any more changes ).

Most likely they will never even notice that little increase in the minimum and even if they do and think "OMG she changed the pressure minimum" they can't do anything about it and insurance doesn't really care and DOT doesn't really care. Insurance just wants to know IF you are using the machine per whatever requirements they have and pretty much the same with DOT except next year actual therapy effectiveness is going to need to be proven from what I hear.

There's no way they can "lock" you out of the menu and other than maybe getting your hands slapped...nothing will happen.
I am betting no one notices anyway.
They have the APAP set with the ability to go higher anyway if it needs to. All you are doing is
1...making it more comfortable for you
2...making it so the machine can do its job a little better and a little more quickly
by giving it a little bit of a head start.

Even my titration sleep study started out at 5 cm while awake because it just isn't comfortable (for a lot of people) to deal with that minimal air movement at 4 cm especially with nasal pillow masks that have such a small volume of air in them anyway.

Regarding centrals and anyone reading my "sit back and watch" comment. This is assuming that we aren't seeing centrals in huge numbers. and 2 or 3 per hour isn't a huge number. Some are likely real, some are likely sleep onset transition and some are probably false positive scored by the machine. No matter what the cause...we don't treat them with more pressure using the cpap/apap machine. That's why we just "watch" them for right now. We watch to see if trends and patterns develop and/or are the numbers problematic. If they are..then we discuss options.