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We can't do much about the maximum but how about we try more minimum and see if more minimum maybe let's you not need as much maximum.

Repeat last night's setup except increase the minimum from 9 to 12 and let's see what happens.
Leave EPR at 3...use the collar...stay off your back...try to make it that the only change is the minimum.

I assume your nose was clear and you weren't having much of a problem with nasal congestion????

I have very good sinus passages. I seldom get a blocked nose.

OK. I will try increasing the minimum pressure.

I have seen it happen where a person is having really high maximum pressures being reached and with the increasing of the minimum pressure the maximum pressure actually drops. I can't guarantee it will happen with you but it's worth trying.
Should also clean up the flow limitations a bit too.

I know one woman who was seeing 18 to 20 all the time and once we got her minimum up better the machine never went above 16...
We thought she might need a bilevel since she was hitting 20 so much but once we got that minimum up she ended up doing well with the apap and no need for the bilevel which of course can go to 25.
And she was okay with the higher minimum and a little exhale relief to help out.

Let me know tomorrow how things went. Try your best to otherwise mimic last night. Keep the variables to a minimum if at all possible.
Later if this happens to work out then maybe add back in the other variables like supine sleeping or going without the collar and see how they impact things.

Thanks - I will do as you suggest and see what happens.

Pugsy wrote: ↑

Mon Feb 25, 2019 5:32 pm

Repeat last night's setup except increase the minimum from 9 to 12 and let's see what happens.

My minimum during the night is already 11. It is only 9 on the ramp. How much should I increase to? 12 is only an increase of 1cm.

I would continue to raise the min pressure till the OA clear.
If you need a lower pressure to get to sleep, use the ramp, otherwise turn it off.

Your settings are showing minimum of 9 and it should show minimum of 11 if that is what the minimum is set at.
That setting should show 11 no matter if ramp is on or not.

Anyway....if the minimum is 11...try 13 minimum...a 2 cm increase in minimum.

OK will do.

I'm gonna guess 14-16 will be needed.

palerider wrote: ↑

Mon Feb 25, 2019 7:50 pm

I'm gonna guess 14-16 will be needed.

As a minimum? Sure. I'll do 13 tonight, but I can go up.

If it were me...I would go up a bit slowly...like the 2 cm more I suggested...see what happens and then move up a little more if needed.
Might get lucky and not need more....might not get lucky but it hurts nothing to go up slowly and take just a little bit of time to adjust to the higher minimums. For me big jumps always seemed to cause a bit of discomfort at the beginning of the night which usually meant I had trouble falling asleep and getting to sleep is the primary goal. If we can't sleep then the rest of this doesn't matter much.
When I suggest something it is usually what I would do if these were my reports. I tend to advise based on my own experiences and how I felt at the higher pressures.....especially when I was playing around with pressures starting in the teens. They weren't much fun for me.

High pressures are distinctly no fun. I seldom wake in the night, but if I do, I often have to turn off the machine and go back to ramp. I have always had problems with leaks too.

katestyles wrote: ↑

Mon Feb 25, 2019 8:18 pm

High pressures are distinctly no fun. I seldom wake in the night, but if I do, I often have to turn off the machine and go back to ramp. I have always had problems with leaks too.

I'm not encouraging you to jump to that higher minimum... I'm just placing a bet, based on the pressure curves, of where you'll probably need to be... Might be wrong, and in fact, I hope I am.

OK. Here is the chart from last night.

I'm guessing I go up another notch.

Sigh....yes...up another notch.

But how are you sleeping and feeling? If you couldn't see the report how would you rate it?