New chart for review

JBarizona · Post by **JBarizona** » Tue Oct 30, 2018 10:36 am

New chart for any advice you may have...changed settings from 8/15 to 10/18...OA's went down, Centrals and Hypopnea stayed roughly the same...any advice is welcome.

palerider · Post by **palerider** » Tue Oct 30, 2018 12:03 pm

STOP POSTING NEW THREADS.

Post *EVERYTHING* in one thread.

READ THIS: viewtopic/t172378/Sticky--Newbies-PLEAS ... STING.html

Raise your pressure to min 12, max 20.

JBarizona · Post by **JBarizona** » Tue Oct 30, 2018 12:24 pm

palerider wrote: ↑
Tue Oct 30, 2018 12:03 pm
STOP POSTING NEW THREADS.

Post *EVERYTHING* in one thread.

READ THIS: viewtopic/t172378/Sticky--Newbies-PLEAS ... STING.html

Raise your pressure to min 12, max 20.

Ok bro

JBarizona · Post by **JBarizona** » Tue Oct 30, 2018 9:25 pm

What's the logic behind raising the bottom pressure? If the bottom pressure is 12 and even a top pressure 15 isn't stopping the apneas why will the bottom pressure of 12 help me?

Snoregone Conclusion · Post by **Snoregone Conclusion** » Tue Oct 30, 2018 10:04 pm

If a low pressure is high enough to keep a blockage from happening, the highest pressure won't be reached because the machine won't ever need to raise the pressure higher.

It's useful to note that the machine doesn't raise the pressure as a blockage occurs, but in reaction to it, to try to keep the next one from happening. If it raises it enough, there won't be a next one. If the lowest pressure is high enough, there won't be a first one. If you find a lowest pressure that's high enough to never allow one to happen, having both highest and lowest pressures the same will be effective, but you may not find it the most comfortable.

zoocrewphoto · Post by **zoocrewphoto** » Wed Oct 31, 2018 1:07 am

JBarizona wrote: ↑
Tue Oct 30, 2018 9:25 pm
What's the logic behind raising the bottom pressure? If the bottom pressure is 12 and even a top pressure 15 isn't stopping the apneas why will the bottom pressure of 12 help me?

As explained in a different thread, after the events stop, the machine goes back DOWN. Then it takes TIME (several minuted) to get back UP to where it needs to be. Look at the graph you posted. See the huge ups and downs. That isn't helping you. Most of your events are during the time that the machine is going from the low to the high. If it had already been where it needed to be, those events would not have happened.

Clearly, the machine at 10 is not helping you. So, why let it be at 10 for any length of time?

djams · Post by **djams** » Wed Oct 31, 2018 10:32 am

JBarizona wrote: Stuff in a bunch of different threads...

In one of your threads, someone inquired if you sleep on your back. Do you? It's an important question.

The reason it's being requested that you stick to a single thread is that it's simply too much work/time to find them all. Please pick one thread and use it. Think of it as your personal therapy thread. You can edit the post title if you like.

I am a natural back sleeper, and there are two major aspects to optimizing my therapy.
1) min pressure increase (straight forward)
2) sleep on my side. (approaches impossible..., many different paths to semi-success)

From the look of your charts(which are similar to mine), I suspect you are on your back during your clusters of events.

zewcrewphototo's explanation of the need to raise min pressure is perfect. But if that isn't enough to convince you, here are a couple of my charts. One from when I initially came here seeking help, and last night's. Since I reached 12min/20max pressure, my average AHI is 0.5, and my range is 0 - 1. Prior to getting advice here, MyAir was regularly reporting AHI in the 6-10 range. When my min pressure was set too low, my obstructive apneas would frequently last up to 120 seconds. My "personal best" was 154 seconds long. At 12 min the quantity of my OA's is greatly reduced, and I rarely see one that lasts over 30 seconds.

I did not grasp the importance of min pressure initially either. Honestly, best advice I can give you is: don't try to reason through this stuff on your own. Ask questions and take the advice given by the experts. I had drawn all sorts of incorrect conclusions over the 6 weeks time before I joined here.

Here's my before / after examples.

JBarizona · Post by **JBarizona** » Wed Oct 31, 2018 11:14 am

Ok, I'll keep all my posts in this thread and will attempt to delete the others. I sleep both on my back and my side....new chart from last night...pressure upped to 12/20....most interestingly to me, pressure goes to highest levels early in the night as usual, but this time, it was only to deal with a small amount of hypopnea/rera and zero OA's....Up until this I have consistently had cluster OA early in the night resulting in pressures reaching highest levels of the night...and when cluster of OA did appear later in the evening, pressure barely went above 16 instead of maxing out...would love experts thoughts on this...also, CA and Hypop numbers seem to be elevating as pressure increases and OA's beginning to trickle downwards....AHI was 6.5...what should I do about the current pressure settings of 12/20? Fyi EPR is set to 3 (highest level)

JBarizona · Post by **JBarizona** » Wed Oct 31, 2018 11:25 am

palerider wrote: ↑
Tue Oct 30, 2018 12:03 pm
STOP POSTING NEW THREADS.

Post *EVERYTHING* in one thread.

READ THIS: viewtopic/t172378/Sticky--Newbies-PLEAS ... STING.html

Raise your pressure to min 12, max 20.

only posting in this thread from now on

palerider · Post by **palerider** » Wed Oct 31, 2018 11:34 am

JBarizona wrote: ↑
Wed Oct 31, 2018 11:14 am
...also, CA and Hypop numbers seem to be elevating as pressure increases and OA's beginning to trickle downwards..

What were full apneas are now incomplete apneas, or ... hypopneas. so as you get closer to the pressures you need, you go through a period where you have less apneas and more hypopneas.

Try a min 14, or min 13, EPR 2. Leave max at 20.

djams · Post by **djams** » Wed Oct 31, 2018 12:40 pm

JBarizona wrote: ↑
Wed Oct 31, 2018 11:14 am
Up until this I have consistently had cluster OA early in the night resulting in pressures reaching highest levels of the night...and when cluster of OA did appear later in the evening, pressure barely went above 16 instead of maxing out...

Don't expect anything to be the same from night to night. Just doesn't work that way.

The amount of pressure increase for me is typically based on severity of flow limitation. This is shown in the SH Flow Limitation chart, which you're not displaying in your screenshots, despite requests to read this: viewtopic/t172378/Sticky--Newbies-PLEAS ... STING.html. (hint: number 4 is about screenshots)

JBarizona · Post by **JBarizona** » Wed Oct 31, 2018 3:00 pm

What is it that I should be looking for on the flow limitation chart? Meaning, what's good and what's bad? What indicates an adjustment is needed either up or down? Anything you can tell me about how I should read the flow limitation chart would be helpful. Yes I can post it and get your feedback but I'd also like to get a little info from you to learn to do it myself

palerider · Post by **palerider** » Wed Oct 31, 2018 3:32 pm

JBarizona wrote: ↑
Wed Oct 31, 2018 3:00 pm
What is it that I should be looking for on the flow limitation chart? Meaning, what's good and what's bad? What indicates an adjustment is needed either up or down? Anything you can tell me about how I should read the flow limitation chart would be helpful. Yes I can post it and get your feedback but I'd also like to get a little info from you to learn to do it myself

Spikes

Julie · Post by **Julie** » Wed Oct 31, 2018 3:34 pm

The higher the number (flow chart) the worse air flow is... meaning something is obstructing it. Some people have trouble with e.g. uvulas, some with tonsils (tho' removal is not necessarily recommended), etc. etc. but often the simplest thing might be that when they sleep, their head falls forward and down, blocking the airway to an extent, which is why a soft cervical collar is often recommended to keep the head up (more so) and jaw - if not lips - more closed, avoiding mouth leaks. Don't know if it applies to you, but another thing to think about.

I've seen worse FR's than yours and worse leak rates, so ... might not be factors for you.

palerider · Post by **palerider** » Wed Oct 31, 2018 8:45 pm

Julie wrote: ↑
Wed Oct 31, 2018 3:34 pm
The higher the number (flow limitation chart) the worse air flow is...

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Machine

Additional Comments: 3B Elara FFM