Tec5 wrote: ↑Fri May 06, 2022 5:42 pm
Thank you Pugsey,
It seems that you read and understood my last post relating
my experience with the reaction time for my Resmed machine.
You gave a lot of detail and explanation in your reply, and if I can be so bold I would summarize your comments with two words:
It depends
Lots of factors, and as you have said repeatedly (again paraphrasing) 'nothing hard and fast, very little cast in concrete'.
Perhaps that's why dataql (a week ago) questioned PR's apparent global, universal statement that 4-20 is stupid.
And thank you for your politeness and attention.
Yes...the only hard fast rule when it comes to cpap is there are no hard fast rules.
"It depends" is something that probably goes with every statement said relating to most things apnea related or therapy related.
PR really does believe that 4 - 20 is stupid for most people. He is quick to offer his opinion. That's just how he is and he is certainly entitled to his opinion and he is free to voice his opinion here however he wishes to voice it.
To be honest...I tend to feel the same way about that setting because most of our experience here isn't because the doctor was wanting to offer a workable pressure setting but instead the doctor or DME hadn't done their homework or understands actually how auto adjusting mode actually works in terms of optimal settings for someone.
If you go back and re-read what I said quite a while back it's the same thing I said here
So the setting of 4 cm minimum starting point might work out okay if someone only needs 7 or 8 cm to hold the airway open optimally....it's going to fail miserably if there happens to be a need for 14 cm pressure to hold the airway open and prevent the collapses.
Apparently you are one of those people that the 4 to 20 works just fine and the machine probably never even goes near 10 cm. I am happy it works for you especially since you have a problem with aerophagia with higher pressures. You are very lucky. The majority of cpap users out there aren't so lucky.
To be fair when you went off on both of us wanting "proof" or "reason for stupid"....your tone wasn't very conducive to either one of us wanting to go into depth explaining our reasoning behind our opinions. I saw a whole lot of attitude and not much real desire to learn. Maybe or maybe not...that wasn't your intention but that's what we saw and from the lack of other people responding to you...I am feeling others felt the same by the lack of response from people I know could have given the same speech I gave above.
You hijacked (again) someone else's thread instead of starting your own to discuss your particular situation. Again...not a good thing to do when "asking" for clarification of something or help. It's considered poor etiquette and plain rude and then you got ruder. Shouting and being a general PITA. Again continuing to hijack someone else's thread.
Let me tell you....that was one of the things that really annoys me...seeing someone getting their thread hijacked.
I finally decided that I wanted no more hijacking and the only way to stop it was give you the best answer I had...it depends. Plus others reading it will likely take away a bit more understanding how auto adjusting works.
The OP in this thread does happen to be one of those people who a setting of 4 - 20 is stupid and lazy way of doing things by either his doc or DME or both. He's a veteran cpap user who already has been using a minimum of 10 for years. He knows what his body needs from past reports and what he saw (and felt) with the factory default settings. I suspect that the DME just got lazy and left the machine at the factory defaults because the doc didn't specify anything else and no one thought to maybe ask the patient what the past settings were...that's the lazy part.
It could have been harmful to the OP if he hadn't realized what the problem was and fixed it himself.
So is the setting of 4 - 20 stupid or potentially harmful....it depends....it can be either or it can be perfect for someone.
It all depends on a lot of variables.
I suspect that if you had a couple of OAs happen that your machine will respond rather quickly because you are also having a rather active FL graph. It's not horribly horrible but it is fairly active....and your machine will twiddle its little thumbs DURING the apnea events but as soon as the event has passed the machine will probably respond fairly quickly but more because of the FLs than any OAs.
My situation is entirely different...I don't have much activity at all on my FL graph...I just have never had much FL reporting.
To give you an idea how boring my FL graph is. Compare it with yours. I also don't have any nasal congestion to confuse the machine into thinking I am having FLs.
I don't have FLs driving my pressure at all and my machine doesn't respond quickly at all to OAs or hyponeas unless I have more than one or two in a really close time span. For one OA that is random and rare...my machine won't do a thing.
But it doesn't really need to do something just to prevent something that is already random and rare and was brief and didn't disturb my sleep.
If you are having much nasal congestion that might explain that activity on your FL graph...and the poor machine will still try to kill it with more pressure but more pressure won't fix FL graph activity that is related to nasal congestion. It doesn't know that though...all it knows is the air flow is reduced and usually that is a warning sign that the airway is trying to collapse and its job is to stop the collapse....hence the more rapid response to FLs in your pressure graph.
I don't know if you have any nasal issues or not but I mention it because if you do...and your problem with aerophagia the machine might be wanting to kill something with more pressure that more pressure won't kill...but more pressure could very well open the door for the aerophagia monster to come calling. So if that is the case...in your situation I would limit the maximum as well if the machine is going to where the aerophagia monster finds the door open.
Nasal congestion ugly FL graphs...we have to treat the congestion with the usual methods...OTC decongestants, nasal rinses or whatever works for the person.
That's my freebie unsolicited advice about what I saw on the FL graph you posted. I don't remember if you have ever said anything about nasal congestion and if nasal issues aren't the reason for the activity on the FL graph...just file what I have said for the next time you get a cold or flu and do have some real congestion going on. Your machine will still try to kill it and most likely not only will you be miserable with the cold...you will have a bad belly ache as well.
So to conclude this sermon....I am climbing down off my soapbox.
Should you have further questions about your settings or results PLEASE start a thread of your own and accept the fact that a good chunk of any answer anyone will give will be ....It depends.
The more information we have the less "it depends" you will see but you will always see some.
This goes for any other newbies reading this...please don't just plop a report in front of us without any history or background information and expect a decisive answer. We don't have any crystal balls here and all you will get is magic 8 ball answers.