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Re: new APAP is arriving today -- what pressure should I use?

Posted: Tue Jun 13, 2017 6:12 pm
by Pugsy
GoodGuysFinish wrote:Ok with Pugsy's suggestion of 7 thru 15, you'll have inhale 7 and exhale 5 until the machine figures out it needs to increase it. You should not be surprised if it climbs up to around 10 or even more. That doesn't mean your treatment was ineffective with past machine.
That wasn't me.

And with the apap machine unless someone is using the Flex exhale relief...inhale is the same as exhale. There is no reduction to 5 from that 7 example above if Flex is turned off.

And it isn't automatically a 2 cm reduction during exhale on a Respironics...their exhale relief is flow based and how much of a reduction someone gets is based on the air flow...how forcefully they breathe. The most it can offer is 2 cm at the setting of 3 and that's only if the machine feels the air flow warrants that full 2 cm reduction.

So...no reduction unless Flex exhale relief is used on Respironics APAP machines
and then maybe 2 cm reduction if the setting of 3 is chosen and the machine thinks the air flow warrants that much reduction.

Re: new APAP is arriving today -- what pressure should I use?

Posted: Tue Jun 13, 2017 7:21 pm
by sbradley
Got my new Intellipap 2 and also the SoftLink 3 software (couldn't get Sleepyhead to work).
I set the minimum same as the old machine, at 8. The data shows I am staying at 8 much of time. Is this an issue?
AHI is 1.3
I imagine I will try lowering slightly and getting new data. I know that when I tried a really low minimum it was very uncomfortable.

Re: new APAP is arriving today -- what pressure should I use?

Posted: Tue Jun 13, 2017 10:03 pm
by TASmart
sbradley wrote:Got my new Intellipap 2 and also the SoftLink 3 software (couldn't get Sleepyhead to work).
I set the minimum same as the old machine, at 8. The data shows I am staying at 8 much of time. Is this an issue?
AHI is 1.3
I imagine I will try lowering slightly and getting new data. I know that when I tried a really low minimum it was very uncomfortable.
Why do you want to lower the pressure? Do you know the components of the AHI? I would not lower the pressure, and given an AHI of 1.3, I am not sure I would raise the pressure either. 8 CM H2o seems to work well for you.

Re: new APAP is arriving today -- what pressure should I use?

Posted: Wed Jun 14, 2017 9:07 am
by seth
TASmart wrote:
sbradley wrote:Got my new Intellipap 2 and also the SoftLink 3 software (couldn't get Sleepyhead to work).
I set the minimum same as the old machine, at 8. The data shows I am staying at 8 much of time. Is this an issue?
AHI is 1.3
I imagine I will try lowering slightly and getting new data. I know that when I tried a really low minimum it was very uncomfortable.
Why do you want to lower the pressure? Do you know the components of the AHI? I would not lower the pressure, and given an AHI of 1.3, I am not sure I would raise the pressure either. 8 CM H2o seems to work well for you.
AHI is mostly obstructive apnea

Re: new APAP is arriving today -- what pressure should I use?

Posted: Wed Jun 14, 2017 9:12 am
by TASmart
With mostly obstructive apneas I would not lower the pressure. In fact, I may raise it a bit. But and AHI of 1.3 is pretty decent in my view.

Re: new APAP is arriving today -- what pressure should I use?

Posted: Wed Jun 14, 2017 10:00 am
by jamor
GoodGuysFinish wrote:one thing to note is that your prior machine was probably in CPAP mode, which to us means that the inhale pressure and exhale pressure were the same. (and a fixed pressure) 8 inhale 8 exhale.
I use an option called C-Flex with the Phillips machines I have had. I really like it.

Re: new APAP is arriving today -- what pressure should I use?

Posted: Wed Jun 14, 2017 10:03 am
by Julie
So what happened last night - what did you end up doing setting-wise, etc?

Re: new APAP is arriving today -- what pressure should I use?

Posted: Wed Jun 14, 2017 10:06 am
by jamor
I actually didn't have time to do the setup last night so I will be using it tonight. I am going to set it to CPAP mode for a night or two just to get a baseline of how things have been working for me recently, then I am going to adjust it to APAP Friday night so if it impacts my sleep it won't impact work. I am going to do 8-20 and see what happens.

Re: new APAP is arriving today -- what pressure should I use?

Posted: Wed Jun 14, 2017 12:48 pm
by ChicagoGranny
jamor wrote:I am going to do 8-20 and see what happens.
Best wishes for gold and rose dreams.

Misty blue and lilac too.

Re: new APAP is arriving today -- what pressure should I use?

Posted: Thu Jun 15, 2017 10:43 am
by jamor
Quick update -- so using CPAP mode and setting a pressure of 8 last night, and the Dreamstation gave feedback of 17.2 AHI. I didn't anticipate it would be quite so high. I will say I had some nasal congestion last night that may have impacted things, but still significantly worse than I was expecting. So I already configured the machine for APAP 8-20 and am going to give it a shot tonight and see how things go. Seeing that number makes me feel justified in the purchase of this new machine.

Re: new APAP is arriving today -- what pressure should I use?

Posted: Thu Jun 15, 2017 10:51 am
by LSAT
jamor wrote:Quick update -- so using CPAP mode and setting a pressure of 8 last night, and the Dreamstation gave feedback of 17.2 AHI. I didn't anticipate it would be quite so high. I will say I had some nasal congestion last night that may have impacted things, but still significantly worse than I was expecting. So I already configured the machine for APAP 8-20 and am going to give it a shot tonight and see how things go. Seeing that number makes me feel justified in the purchase of this new machine.
If you breathe or leak through your mouth, your leaks will be high and the result will be a higher AHI. Download Sleepyhead software if you want help in adjusting your therapy.

Re: new APAP is arriving today -- what pressure should I use?

Posted: Thu Jun 15, 2017 10:54 am
by D.H.
jamor wrote:Quick update -- so using CPAP mode and setting a pressure of 8 last night, and the Dreamstation gave feedback of 17.2 AHI. I didn't anticipate it would be quite so high. I will say I had some nasal congestion last night that may have impacted things, but still significantly worse than I was expecting. So I already configured the machine for APAP 8-20 and am going to give it a shot tonight and see how things go. Seeing that number makes me feel justified in the purchase of this new machine.

Glad you're being proactive. Remember to blow your nose immediately before putting on the mask. If you take drops of any kind in the nose, use them just after blowing your nose and just before putting on the mask. If you take pills or liquid for congestion, try taking that 30 minutes prior.

Re: new APAP is arriving today -- what pressure should I use?

Posted: Thu Jun 15, 2017 10:58 am
by Pugsy
Get the available software up and running. You are going to need it to evaluate the pressure range results.
https://sleep.tnet.com/equipment

There's so much more to that AHI than what you see on the LCD screen.
AHI is composed of 3 categories
Central/Clear Airway apnea index
Obstructive Apnea index
Hyponea index.

Central/Clear Airway events won't respond to more pressure.
Obstructive Apnea and Hyponea index will respond to more pressure.

Re: new APAP is arriving today -- what pressure should I use?

Posted: Thu Jun 15, 2017 12:29 pm
by jamor
Pugsy wrote:Get the available software up and running. You are going to need it to evaluate the pressure range results.
https://sleep.tnet.com/equipment

There's so much more to that AHI than what you see on the LCD screen.
AHI is composed of 3 categories
Central/Clear Airway apnea index
Obstructive Apnea index
Hyponea index.

Central/Clear Airway events won't respond to more pressure.
Obstructive Apnea and Hyponea index will respond to more pressure.

I have Sleepyhead installed (I tried before realizing it was my previous machine that simply didn't log). I do need to go through the tutorial.

However Philips Dreammapper has the information you mentioned:

Total Clear Airway = 23
Total Obstructive = 2
Total Hypoapneas = 93

Re: new APAP is arriving today -- what pressure should I use?

Posted: Thu Jun 15, 2017 12:48 pm
by Pugsy
Those are total numbers over the entire night. You would need to divide by hours slept to get the hourly index...but in general it's primarily hyponeas which is usually obstructive in nature.

Your machine in auto mode with the ability to go up somewhere will probably increase the pressure somewhat...how much is unknown but usually hyponeas don't take much more to get them under control.

The Clear Airway/Central stuff...maybe some sleep/wake/junk awake breathing getting flagged by mistake...maybe a few real centrals in there also.
Nothing you can do about them anyway with this machine and they may not even need to have anything be done about them.
Just watch them with one eye...1 or 2 per hour average isn't horrible even if they were all the real deal and I am betting some of yours weren't even real.

See how you do in auto mode...the machine will very likely want to increase the pressure but as to how much you won't know until it does its thing.