New New guy needs some clarification

You can adjust the ramp number up. 5 is terrible to start from, if you need 15 to keep your airway stable. And the duration should be turned down as well if you can tolerate that. No sense struggling to breathe for 15-20 minutes while you’re already asleep. Try increasing the ramp starting pressure to 10 and see if maybe that helps, and don’t start out on your back.

What position do you normally sleep? Especially at that beginning of the night?

How quickly do you usually go to sleep?

Do you think you could manage starting ramp at 6 and set the minimum to 8? Give the machine a little better head start??? I know that these pressures seem high now to you but in time I promise you that you will adjust and they won't seem quite to rough to start at.

Actually you are doing quite well for being so new to cpap and adjusting to all this stuff. You are further along in one week than I was in 2 weeks when I first start so don't beat yourself up too much.

Your clear airway/central events we can't do much with those with increasing the pressure...so set them on the back burner for now.
If we mentally remove them from the evaluation...your obstructive AHI was only 3.0 and that's not too shabby for newbies.

Oh...I saw in your comments that the AirFit F30 wasn't listed in the equipment menu.
It's not up in the "A" section but it is down in the "R" section immediately below the Quest.
For some reason it got listed with ResMed being included in the model name before AirFit so it got stuck down in the R's.

I am normally a side sleeper, especially to fall asleep, then occasionally on my side/stomach. I never choose to sleep on my back, though I am sure I do sometimes during the night.

In looking at the charts, all of my CA's were right at the beginning, when I was falling asleep, so I know that increased pressure won't help those, but I am not overly concerned with those, because they were not during the night. Its my understanding that some CA while drifting off is pretty common/normal.

As far as sleep, I usually fall asleep rather quickly, within the current 15 minute ramp, BUT I have been going to bed later than I should, and only getting 6 hours +/- , I think if I went to bed earlier and shot for 8 hours, I may take a little longer.

I will try your suggestion and up the ramp AND the min pressure, and see what happens tonight. Appreciate both of your help and insights. I am in no way beating myself up, I am just SUPER excited to feel this good so soon, after feeling so terrible for so long!!! As I am sure you are familiar with!! And if I feel this good NOW, how good can I feel once this is all dialed in??? AMAZING!!

Oh and thanks for the info on the mask, I will make that change to my profile.

I think once your machine can get to where it needs to be to hold the airway open at the beginning of the night when you fall asleep and the airway starts to close that the clustering of OAs will reduce.

The airway is closing off sooner or more quickly than the machine can respond with more pressure. Just takes too long to get to where it needs to be to keep the airway open. They can't increase the pressure in the blink of an eye and sometimes the airway closes off faster than the machine can adjust.
Starting the minimum higher gives it a better chance of getting up to where it needs to be in time to prevent the collapse.

That makes perfect sense, if the machine cant respond to the collapse, the collapse happens, and if the machine spends a significant amount of time at a very low pressure, it responds even slower. Sounds logical to me. I will make those changes tonight and see what happens.

Here's the other monkey wrench in things.
When you are actually having some sort of apnea event the machine can't do anything except twiddle its little thumbs.
They can't/won't try to do anything during the actual event. So if you get too many of those collapses close together the machine doesn't have time to do anything which even further slows down the response to the first events.
People tend to think that these apap machine just will try to blow open the collapsed tissues but that's not the way it works at all.
The idea is to prevent the collapse in the first place...because it can't blow through it after it starts to happen.

Ahh thats interesting. So what can be done, if anything, about OSA's that come in clusters? It they keep coming in clusters like that, the machine can never do anything about that, my number can never drop.

Lambo915 wrote: ↑

Fri Mar 08, 2019 10:45 am

Ahh thats interesting. So what can be done, if anything, about OSA's that come in clusters? It they keep coming in clusters like that, the machine can never do anything about that, my number can never drop.

It's easy...you just have the minimum pressure high enough that the clusters don't happen...prevention is the key...not trying to fix things after the fact. Have an optimal baseline minimum pressure and the clusters simply don't ever happen.

I have this problem with my own OSA...it's worse in REM and all I had to do was find a minimum that would prevent the clustering and could respond in time to the random times when I might need a little more pressure.

After a few days or a week most of us HATE the ramp because it feels like you are suffocating. My old machine (without the ramp) used to come on full blast but it takes a few seconds for the ResMed to come to the full starting pressure and I hate that interval. I can't relax until i have the full (minimum) pressure.

Janknitz wrote: ↑

Fri Mar 08, 2019 1:03 pm

My old machine (without the ramp) used to come on full blast but it takes a few seconds for the ResMed to come to the full starting pressure and I hate that interval. I can't relax until i have the full (minimum) pressure.

I, on the other tentacle, like Resmed's soft start, instead of the *thwack* of the respironics.

I dont mind the ramp, I feel fine at 5, probably need to go to 6, but if its not helping the OSA, AND I can handle more pressure while falling asleep, ramp seems useless.

So I took your suggestion Pugsy, and I changed my ramp to 6 and minimum pressure to 8, which comfort wise I tolerated just fine, but it looks like I still had a small cluster at the start of the night. The end of the night LOOKS like I had a ton of OSA but I was awake and moving around trying to get back to sleep so none of those are actually apneas.

So my real volume of apneas was low but still clustered at the start of the night.