New to CPAP, need help choosing right pressure.

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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palerider
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Re: New to CPAP, need help choosing right pressure.

Post by palerider » Sun Jun 26, 2022 5:47 pm

kidchameleon wrote:
Sun Jun 26, 2022 4:58 pm
So 11 is fine based on my charts? And maximum stays the same, right? I need to be sure so I don't overthink things like I usually do and make changes.
If you're not getting aerophagia there is *ZERO* reason to lower the max from 20, all you're doing by setting a lower max is preventing the machine from responding to your changing needs if you have a night where you need more pressure.
kidchameleon wrote:
Sun Jun 26, 2022 4:58 pm
Also, I'm pretty sure the charts I just posted had the EPR off. Did you mean June 25 and 26 or one I previously posted before that? I don't mind, I just wanted to be absolutely sure I do everything right.
Not all of them, it's easy to see when it's on and off, if off, you get one pressure line, if on, you get two.

Also, don't waste time posting long strings of numbers, just post the charts.

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kidchameleon
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Re: New to CPAP, need help choosing right pressure.

Post by kidchameleon » Sun Jun 26, 2022 7:09 pm

Okay, I've read different opinions on what the maximum should be, but I trust this site so I'll raise it to 20.
And I'll be sure to set the EPR to 2 then.
I'll post my results in a few days and see how things go. And I'll post charts this time for sure.

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Re: New to CPAP, need help choosing right pressure.

Post by palerider » Mon Jun 27, 2022 2:24 pm

kidchameleon wrote:
Sun Jun 26, 2022 7:09 pm
Okay, I've read different opinions on what the maximum should be, but I trust this site so I'll raise it to 20.
And I'll be sure to set the EPR to 2 then.
I'll post my results in a few days and see how things go. And I'll post charts this time for sure.
There's a prevailing ignorance that conflates the proper "raise the minimum pressure to where it prevents most apneas outright" with "a tighter range" (and technically if you raise your minimum from 4 to 10, that has changed the 'range' from 16 to 10, and those ignorant people think that what's important is the 'range of 10' (it's not) and so "think" they're doing just as much good by creating a 'range' of 10 by setting the max pressure to 14, and leaving the min at an ineffective 4).

The max setting on a machine is like the speed limit (theoretically observed) on a roadway. If you're in a golf cart, then it doesn't matter if the speed limit is 30, 50, or 80, you'll never get to that speed, but if you get in a fast car, then that 30mph speed limit is going to slow you down quite a bit compared to a speed limit of 80.

You may not need a higher limit today, but sleep varies, and all you do by lower the max pressure is preventing the machine from being able to respond to any needs you might have tomorrow, or next week, or next month.

Hopefully that's an explanation that will allow you to make a more informed decision about why setting the max pressure lower is not a smart thing to do if you're not suffering from aerophagia.

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kidchameleon
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Re: New to CPAP, need help choosing right pressure.

Post by kidchameleon » Wed Jun 29, 2022 8:09 pm

Thanks a lot for the explanation! I didn't know exactly what to do, but I'll be sure to keep the maximum on 20cm
Anyway, here are my charts from the past 3 days. I didn't get too much sleep since my schedule this whole week has me getting up at 5am. Sleeping late is a really bad habit I need to work on, I know.
https://imgur.com/a/J7v7v3T
To clarify, I'm using a chin strap and a soft cervical collar. I tried sleeping on my side, but I keep waking up on my back. I even tried putting a pillow between my legs, I'm not sure what else I can do.

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Re: New to CPAP, need help choosing right pressure.

Post by Dog Slobber » Thu Jun 30, 2022 10:08 am

Your minimum is not high enough to address a lot of your needs. Perhaps it's positional, perhaps REM sleep.

Move your minimum to 12m leave it for a few days, then we can compare and re-evaluate.

BTW the statistics page is a great way of comparing therapy setting changes. It keeps track of averages based on changes. It's very valuable when optimising, so long as people give each change time, and you only change one meaningful value.

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kidchameleon
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Re: New to CPAP, need help choosing right pressure.

Post by kidchameleon » Thu Jun 30, 2022 6:34 pm

Okay, I'll change it to 12cm starting tonight. I'm gonna try my best to sleep on my side and see if that makes a difference. I'll post the results in a few days.
And I'll be sure to check out the statistic page, it sounds interesting, thanks for letting me know.

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kidchameleon
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Re: New to CPAP, need help choosing right pressure.

Post by kidchameleon » Mon Jul 04, 2022 6:28 pm

So on July 1st, I decided to buy myself a sleep backpack to keep myself in the same position on my side.
https://m.media-amazon.com/images/I/51t ... L1000_.jpg
It definitely keeps me sleeping on the side, but I haven't noticed any difference. Hopefully it ends up helping eventually.
I also decided to switch to my full face mask on July 3rd, just because I don't like wearing too much stuff on my face with the chin strap and collar. I still kept the collar though. I sleep well with the full face mask and nasal mask, so there probably isn't too much of a difference.
Here are my results from the past 4 days.
https://imgur.com/a/148sGLa
Thanks!

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Re: New to CPAP, need help choosing right pressure.

Post by zonker » Mon Jul 04, 2022 7:04 pm

kidchameleon wrote:
Mon Jul 04, 2022 6:28 pm
So on July 1st, I decided to buy myself a sleep backpack to keep myself in the same position on my side.
https://m.media-amazon.com/images/I/51t ... L1000_.jpg
It definitely keeps me sleeping on the side, but I haven't noticed any difference. Hopefully it ends up helping eventually.
I also decided to switch to my full face mask on July 3rd, just because I don't like wearing too much stuff on my face with the chin strap and collar. I still kept the collar though. I sleep well with the full face mask and nasal mask, so there probably isn't too much of a difference.
Here are my results from the past 4 days.
https://imgur.com/a/148sGLa
Thanks!
while i get that you want to get this therapy straightened out and start reaping the benefits, you may want to bear in mind that it's best to make one change at a time. give that one change time for you to get used to, like maybe a week. then, you can make another change and see how that goes.

this is a long marathon, not a short sprint.

good luck!
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kidchameleon
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Re: New to CPAP, need help choosing right pressure.

Post by kidchameleon » Mon Jul 04, 2022 8:00 pm

You're right, it's hard to be patient with how tired I've been feeling. I understand it'll be much quicker if I take it slowly. I wasn't expecting an immediate change, just wanted to clarify how I felt so far.
As for my pressure, should I keep it the same or raise it a little more?

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Pugsy
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Re: New to CPAP, need help choosing right pressure.

Post by Pugsy » Mon Jul 04, 2022 8:08 pm

2 reasons for clustering of events...usually
1....supine sleeping
2....REM state sleep worse OSA requiring even more pressure.

If you are for sure you stayed on your side then the only thing left is REM related stage sleep.

Do you happen to know if your OSA is worse in REM or not? It's fairly common so wouldn't surprise me. I have it myself.
In REM my OSA is about 5 times worse than in non REM sleep and sometimes I might need 6 to 8 cm pressure to deal with REM related events.

I would suggest that you use these settings for 3 more nights so that you have a week's worth of data and if you continue to see clusters like these 4 past nights...I would increase the minimum pressure 1 cm for a week...see how it goes.
You might need 2 cm more minimum but we never know for sure. Sometimes just 1 cm will work just fine. You are almost there as it is.
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kidchameleon
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Re: New to CPAP, need help choosing right pressure.

Post by kidchameleon » Mon Jul 04, 2022 8:56 pm

Before the backpack I definitely slept in a supine position. I've only used it for a few days so maybe it takes time to see a difference. If not, then it could be something REM related. I've woken up, like usual, in the middle of the night and found myself on my side.

I really don't know how things are in my REM sleep. Is there any way to find out, perhaps in OSCAR?

But alright, I'll keep the pressure the same and come back in a few days.

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Re: New to CPAP, need help choosing right pressure.

Post by Pugsy » Mon Jul 04, 2022 9:08 pm

kidchameleon wrote:
Mon Jul 04, 2022 8:56 pm
I really don't know how things are in my REM sleep. Is there any way to find out, perhaps in OSCAR?
A sleep study that measures sleep status is really the only accurate way to define REM.
OSCAR only reports what the machine collects in terms of data and the machine doesn't have any way to tell even if we are awake or asleep...much less sleep stages.

I mention it because the pattern loosely looks like a REM stage sleep pattern with more clustering in the last half of the night when we normally might have more REM.
You can google "sleep stages" and look at the normal hypnograms and see what I mean.
Since I have REM worse OSA I tend to look for that sort of thing because of my own experience. I had an in lab sleep study that documented my OSA being so much worse in REM.
You would need a sleep study that measured sleep for one thing and then the actual report for the other thing.
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kidchameleon
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Re: New to CPAP, need help choosing right pressure.

Post by kidchameleon » Mon Jul 04, 2022 10:22 pm

According to my sleep study, my REM AHI was 3.0. I'm not sure if that helps, especially since I didn't sleep well during the whole thing. I slept enough for them to diagnose me with sleep apnea though. Also, my non-supine AHI was much lower compared to supine AHI. Does that mean sleeping on my back would be better for me then?
I'll be sure to post pictures of my sleep study tomorrow. I don't have access to my laptop at the moment.

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Re: New to CPAP, need help choosing right pressure.

Post by Pugsy » Mon Jul 04, 2022 10:41 pm

REM AHI of 3.0....certainly far from bad but maybe you didn't get much REM.
Mine was 53 per hour in REM and 14 in non REM....pretty spectacular but I was getting very little REM because every time I would hit REM the events came so fast and furious that I woke up.

It could also be possible that there is both your supine sleeping worsening things with a tad bit of REM.

Either way...the fix is more minimum pressure if you still have clusters of OAs/hyponeas when you are on your side....doesn't matter what the reason is. You have no control at all over REM and you have already found out that it isn't so easy to control sleeping position.

I suspect you still need a little bit more minimum pressure to clean up your reports a little better. You are getting very close though.
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kidchameleon
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Re: New to CPAP, need help choosing right pressure.

Post by kidchameleon » Thu Jul 07, 2022 10:38 am

These are my charts from the past 3 days.
https://imgur.com/a/1VZZwfy
The first day I woke up and looked at my phone thinking it was already time to get up for work. Unfortunately it was only 3am and the bright light kept me up and I couldn't get back to sleep. The days after that were the same as usual.