CPAPtalk.com

Hang Fire wrote:

Julie wrote:Den - sometimes you can't win for trying!

Unfortunately, Den thinks this is about winning.

It is not. It's about helping the OP optimize his therapy.

Precisely!!! And that's something some of you can't figure out. Including SLEEP QUALITY.


Den

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Wulfman... wrote:

palerider wrote:

Wulfman... wrote:Considering the OP's breathing patterns, using a range of pressures will be a disaster.

if, as you *ASSUME* the OP will be bothered by the machine behaving as it's designed, and modifying the pressure to suit the situation.
not everybody is bothered by that. possibly not even a majority.
the OP certainly didn't complain about it.

But, obviously he was concerned about what he saw in his report. SOME things are just obvious and need to be pointed out.

and, what was it that he was concerned about? not bad sleep, but excessive flow limitations and the machine being unable to treat them.

palerider wrote:

Wulfman... wrote:Edit: The thing that jumps out at me are the Flow Limitations. Increasing the upper pressure may be problematic with them.

yes, it might make them go away and give the OP better sleep.

Or it might cause the machine to chase flow limitations that are not caused by a partially collapsed airway. In other words, additional pressure does not always fix flow limitations. And sometimes the additional pressure needed to smooth out the flow limitations creates additional problems such as aerophagia.

When it looks like more pressure is needed (and it does in this case), I'm hesitant to tell people to raise the cap all the way to 20. I'd rather go slowly and raise the cap by only 1-2 cm at a time.

In this particular case, the first thing that I'd recommend is an increase in the minimum pressure first. And then after 3-4 days with a higher minimum pressure, I'd reevaluate the data. If there are still clusters like this one when the pressure is maxed out, I'd raise the max pressure by 1-2 cm, but no more, for another 3-4 days and then reevaluate the data.

zzrrrp wrote:Hi there, I'm 9 nights into my CPAP therapy and having a great time. Typical nights have been 1-2 AHI, but last night I had an hour-long (515-615am) cluster of hypopneas even though my machine maxed out my prescribed pressure (5-10 cm H2O). Is that an indication that I should start tinkering with the allowed pressure range, or should I stay the course? Please advise if other data are pertinent.

Just to rercap...The OP said his typical night has been 1-2 AHI...ONE NIGHT the AHI jumped up. I still don't see any reason to mess with the pressure unless this trend continues. He should stay the course for a few days.

LSAT wrote:I still don't see any reason to mess with the pressure

A min of 5 is too low.

So the last two nights I've been running APAP with 5-12 cm H2O. AHIs were 1.5 and 0.8. The machine actually spends about 75% of the time at 6 cm H2O or below, so I'm hesitant to raise the minimum pressure. The only other reason to raise it would be to minimize sleep disruptions due to big pressure swings, right?

No event clusters. Max pressure was 11.2 cm H2O last night.

zzrrrp wrote:So the last two nights I've been running APAP with 5-12 cm H2O. AHIs were 1.5 and 0.8. The machine actually spends about 75% of the time at 6 cm H2O or below, so I'm hesitant to raise the minimum pressure. The only other reason to raise it would be to minimize sleep disruptions due to big pressure swings, right?

Given the fact that your AHIs are consistently below 2.5 and are almost always below 1.5, you really are at the stage of worrying primarily about your comfort and the quality of your sleep.

If you are sleeping fine at 5-12 and have no desire to change the pressures, stick with your instincts.

If, on the other hand, you are not sleeping as well as you would like to---in terms of fragmented sleep, then you do need to be thinking in terms of what's waking you up. If pressure swings seem to bother you, then bumping up that min pressure may help.

zzrrrp wrote: The machine actually spends about 75% of the time at 6 cm H2O or below, so I'm hesitant to raise the minimum pressure.

During the "bad" night, it was above 6 about 95% of the night.

But hey, you do what you want.