palerider wrote: ↑Fri Jul 05, 2019 2:37 pm
Rx's are very often wrong... If they were usually right, and doctors have good results... This (and other) self help forums wouldn't exist. The simple fact of the 4-12 RX means your doctor doesn't know what he's doing.
5 is a bad ahi, even if it is "good enough" for those doctors.
Set max to 20, and keep raising min till your obstructives and hypos come down.
A little context. 4 is the lowest the machine will go -- many patients struggle at 4 as they feel like there is not enough air. My sense is that would be a very unusual patient for whom 4 is the best starting point. Testing in the lab is great -- but sometimes the results are different than when you are at home. It is always possible that your doc saw something in your test results when your max pressure went much higher -- perhaps more centrals or mask leaks. The good news is that you have the tools to be able to measure these changes as well.
As pressures increase, you can see some things happening more. Three come to mind: a) air swallowing; b) mask leaks; and c) centrals. The good news: many patients have none of these things happening. On the good side, most other events (like obstructives) tend to go down with more pressure. Final bit of context: the machine does not always know when you are asleep or awake. So we tend to disregard any events that show up if they happened while you were awake.
So, what is important is getting some data (objective from Oscar and subjective from you) as you change the settings -- how is the current setting working before you up it a bit. Personally, I would change my max settings slowly -- go up by 1 or 2 and try that for a few days. The machine will only go as high as needed (or the max, if that is less). It seems likely that you are hitting the max often. Personally, I would increase mins more slowly than the max -- probably .5 to 1 per day. As I do all of this, I would be looking at the detailed data.
Caveats: There might be some reason why your doctor set the max pressure that low -- in your shoes, I would call them and ask. It is always possible they saw lots of centrals when the tried higher pressures or you have some other medical issues they are working around. My guess is these will not turn out to be the case and many here would not call their doc.
I am not a health care professional -- just a cpap user. Using the advice from here (especially from Pugsy but also Pale Rider), I dropped my AHI to consistently below 1. Subjectively, I feel much better when my AHI has been under about 2 -- I feel like crap at 5. I did keep my doctor in the loop (and he was cool with my plan -- once he understood that I was looking at and using data and not making any big jumps in pressures on any given day). How much you choose to involve your doctor is up to you.
My nose was clear when I went to bed using RC (respiratory care) and majoram Essential Oil. 
