Last night's readings

I just want to show this screen shot to ask for a couple of clarifications on what I think I understand
(I use Photobucket and the thumbnail at first, but upon preview and clicking through, it did not seem
big enough, so I put in the image instead)
I did look at some info from a link to changing the pressures myself, but I didn't quite understand it. I know it should be
easy, but I get confused more easily! lol
Thank you for your time and insights

1. the top left date and time. 12:23 is when I started the machine, so 0-8 are the hours I used the machine?
2. if 0-8 are the hours, then I had most activity between 3-5 hours
3. it appears that I spent 90% of those hours at 7 (which is the upper limit I am set at for now)
4. the bottom graph confuses me. I realize those are the pressures, but why does it say I spent 90% of the night
at 7, when I spent more minutes at 5 and 6?

These readings look a lot better. The timing or your events could be during REM sleep. The 90% pressure reading just means that you were at OR BELOW 7. So it is including the 5 and 6 pressures. On your last post you stated you have been on a pressure of 14 and couldn't use it. Could you tell us when, was it straight CPAP, and what were your problems.
As far as changing pressures, have you downloaded your machines clinical manual? You can get it at http://www.apneaboard.com/adjust-cpap-p ... tup-manual If you have any questions about changing settings many here can help you.

If you look at the statistics summary graph at the bottom, it is telling you the frequency of events at different pressures. Note that your AHI goes from 2.2 at 5.0, 2.6 at 6.0, and drops to 0.7 at 7.0 cm pressure. What this is telling you is that you are experiencing nearly all of your events at 5-6 cmH2O. You still have some events at 7.0, but significantly less than at low pressure.

You currently achieve the best therapy at 7.0 cmH2O, and the machine is automatically titrating to this pressure more than 90% of the time to keep you out of apnea. Logically, you should eliminate the lower pressures from your therapy, and increase the upper range to see if the events disappear entirely at a slightly higher pressure. You are still showing flow limitations, snores and hypopneas at 7.0. If this was my chart, I'd raise my minimum pressure to 6 or 7 and allow a maximum pressure of 11.0, but it's your chart, so your decision.

OkyDoky wrote:These readings look a lot better. The timing or your events could be during REM sleep. The 90% pressure reading just means that you were at OR BELOW 7. So it is including the 5 and 6 pressures. On your last post you stated you have been on a pressure of 14 and couldn't use it. Could you tell us when, was it straight CPAP, and what were your problems.
As far as changing pressures, have you downloaded your machines clinical manual? You can get it at http://www.apneaboard.com/adjust-cpap-p ... tup-manual If you have any questions about changing settings many here can help you.

thank you OkyDoky, the pressure at 14 was back in 2008 on a continuous pressure CPAP. I must admit,
I didn't like it and could not seem to get any help from the DME at the time, so I gave up. It was just
too much air going in (I also had nasal pillows at the time) and felt like I was not able to breathe out.
This Auto Pap is so much nicer, I actually look forward (somewhat) to using it.

I could not find the Clinician setup manual for my machine in the list given on the site, but I found
the video to be informative. I will look again. Will changing the setting erase all my reports that
I have on the chip now? Or do something to them that the Sleep Therapist is going to notice when
I do go back in 5 weeks?

Sleeprider wrote:If you look at the statistics summary graph at the bottom, it is telling you the frequency of events at different pressures. Note that your AHI goes from 2.2 at 5.0, 2.6 at 6.0, and drops to 0.7 at 7.0 cm pressure. What this is telling you is that you are experiencing nearly all of your events at 5-6 cmH2O. You still have some events at 7.0, but significantly less than at low pressure.

You currently achieve the best therapy at 7.0 cmH2O, and the machine is automatically titrating to this pressure more than 90% of the time to keep you out of apnea. Logically, you should eliminate the lower pressures from your therapy, and increase the upper range to see if the events disappear entirely at a slightly higher pressure. You are still showing flow limitations, snores and hypopneas at 7.0. If this was my chart, I'd raise my minimum pressure to 6 or 7 and allow a maximum pressure of 11.0, but it's your chart, so your decision.

thank you Sleeprider, that's very helpful to know. You mentioned yesterday that you would recommend 8-11....I'm still thinking about it. I'm just a little fearful, at this stage, to take matters into my own hands.

I can understand difficulty with straight pressure of 14 and no help when you need it. Sorry you had to wait so long to be treated. My pressures are 15/11 because I had difficulty exhaling at the higher pressure. Looks like you are on the right track now.
If you will take out the water from your humidifer and turn your machine over and read the REF# we might be able to direct you yo the right manual.
I do believe the changes will be recorded on the SD card because I see them on Sleepyhead Data reports. But that doesn't mean you shouldn't do it. If you would feel better maybe fax or email them an Encore report and ask if you can increase?

RuthArt wrote:

Sleeprider wrote:If you look at the statistics summary graph at the bottom, it is telling you the frequency of events at different pressures. Note that your AHI goes from 2.2 at 5.0, 2.6 at 6.0, and drops to 0.7 at 7.0 cm pressure. What this is telling you is that you are experiencing nearly all of your events at 5-6 cmH2O. You still have some events at 7.0, but significantly less than at low pressure.

You currently achieve the best therapy at 7.0 cmH2O, and the machine is automatically titrating to this pressure more than 90% of the time to keep you out of apnea. Logically, you should eliminate the lower pressures from your therapy, and increase the upper range to see if the events disappear entirely at a slightly higher pressure. You are still showing flow limitations, snores and hypopneas at 7.0. If this was my chart, I'd raise my minimum pressure to 6 or 7 and allow a maximum pressure of 11.0, but it's your chart, so your decision.

thank you Sleeprider, that's very helpful to know. You mentioned yesterday that you would recommend 8-11....I'm still thinking about it. I'm just a little fearful, at this stage, to take matters into my own hands.

Understandable. I'll just offer that you are already spending most of the night at 7.0, so even if you don't change the maximum pressure, but raise the minimum pressure to 7.0, you will lose 87% of the apnea events (based on the last dataset) and be running the machine in a CPAP mode. Pretty conservative, but might be helpful.

it appears that I spent 90% of those hours at 7 (which is the upper limit I am set at for now)

why does it say I spent 90% of the night at 7, when I spent more minutes at 5 and 6

The 90 percent pressure is the pressure the machine was at or below 90% of the time. The chart shows you were at 7.0 almost 20% of the time. Since the machine was limited at 7.0 and you spent so much time there, we don't know what your real 90% pressure would be if the machine were not limited by the max pressure setting. Your AVERAGE pressure was 5.6.

OkyDoky, my Ref# is 560P, I'll put that in my note area

Ok, if you take that link I gave you for the Manual and scroll down to section three under Phillips Respironics Manuals the second one is yours.
Respironics PR System One 60 Series REMstar Auto with A-flex
Follow their instructions under How to ask for a manual by email and they will email it to you. They want the exact name so I just copy and paste it.

One thing that you could try is an even narrower range, but still not constant pressure -- for example 6-7, or 6.5-7.5. This still gives you a feel for what the machine wants to do, even if you are not giving it free range. You might just find that the machine wants to be higher than 5 & 6, but still quite happy well below 14. Given that your AHI is noticeably better at 7 than it is at 5 or 6, it's not crazy to hope that your "sweet spot" pressure is down around 7ish.

When higher pressures cause problems, you sometimes have to compromise and let some events through to get good sleep. But there is still a lot of room to play between 7 and 14, so you might not have to compromise very much.

oh, if I set the ramp to off, would the machine go to 7 right away? Not sure how that works

Yes it'll go to wherever you've set it - exactly how it works.

If the ramp is on I would definitely turn it off at these low pressures and try it.

RuthArt wrote:OkyDoky, my Ref# is 560P, I'll put that in my note area
Machine: PR System One REMstar Auto CPAP Machine with A-Flex
Mask: EasyLife Nasal CPAP Mask with Headgear
Humidifier: PR System One Heated Humidifier
Additional Comments: 560 P, Sleepmapper, Encore Basic, Amara Full Face Mask (just in case), dental device

you have the wrong machine and humidifier selected in your equipment list.

you need to pick
PR System One REMStar 60 Series Auto CPAP Machine
and the humidifier that says '60 series' also.