pressure range questions

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lynninnj
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pressure range questions

Post by lynninnj » Thu Aug 11, 2022 1:53 pm

So I went for my compliance visit after one month. Turns out I didn’t have an SD card but they did have some data to provide me. I bought an SD card today and put it in so hopefully moving forward I will have more information available to me.

So it looks like my overall AHI for the month was 2/hr.

The pressure settings on the machine were 8 to 16 cm.

The range of pressures that were actually seen were:

9.7 max (avg)
9.1 (95% avg)
8.1 median avg

Is it me or does it seem like dropping the low end of the range to something more like 6 cm makes sense?

That’s what we actually wound up doing but I wasn’t sure if it actually made sense. LOL

Thoughts?

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Julie
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Re: pressure range questions

Post by Julie » Thu Aug 11, 2022 2:45 pm

The more you lower the min. setting, the worse your AHI will be - I'm sure that after all this time you should have learned that, but you really, really need to use Oscar if you want help - get it overwit, it's not that hard.

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Pugsy
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Re: pressure range questions

Post by Pugsy » Thu Aug 11, 2022 2:52 pm

Your machine isn't going very far above the 8 cm minimum.
You could probably lower the minimum a little and not have any adverse affects.
Up to you if you want to experiment. It may or may not affect the AHI depending on what your AHI is composed of and if the lowering happens to allow the airway to collapse or not which will depend on your body and how much you lower it.

You have been using 8 cm min though and if you do lower the minimum you may find it a bit uncomfortable. You might feel a bit air starved.

I suggest that you get OSCAR up and running and once you get the SD card and full data that you look at things first to see what's going on as it is right now.

At any rate I don't advised dropping the minimum below 6 cm until we for sure see what is going on or not going on.

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lynninnj
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Re: pressure range questions

Post by lynninnj » Thu Aug 11, 2022 3:49 pm

Julie wrote:
Thu Aug 11, 2022 2:45 pm
The more you lower the min. setting, the worse your AHI will be - I'm sure that after all this time you should have learned that, but you really, really need to use Oscar if you want help - get it overwit, it's not that hard.
As I stated above there was no sd card.

I am fairly tech savvy even tho i am not ready to build a battery that could zap my precious machine.

Nothing to get over.

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lynninnj
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Re: pressure range questions

Post by lynninnj » Thu Aug 11, 2022 3:53 pm

Pugsy wrote:
Thu Aug 11, 2022 2:52 pm
Your machine isn't going very far above the 8 cm minimum.
You could probably lower the minimum a little and not have any adverse affects.
Up to you if you want to experiment. It may or may not affect the AHI depending on what your AHI is composed of and if the lowering happens to allow the airway to collapse or not which will depend on your body and how much you lower it.

You have been using 8 cm min though and if you do lower the minimum you may find it a bit uncomfortable. You might feel a bit air starved.

I suggest that you get OSCAR up and running and once you get the SD card and full data that you look at things first to see what's going on as it is right now.

At any rate I don't advised dropping the minimum below 6 cm until we for sure see what is going on or not going on.
4cm left me air hungry.

I was told the machine adjusts automatically. I can’t see it leaving me hungry for air for very long but we will see.

I will be watching closely now that I have an SD card. I can’t believe I never looked closely enough to see if there is one in there.

I’ve been watching all the sleepyhead videos so will be interesting to see what the numbers look like tonight.

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Julie
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Re: pressure range questions

Post by Julie » Thu Aug 11, 2022 5:34 pm

The machine adjusts automatically to the highest number you set the minimum to... e.g. 9 (vs 4), and lowering the max setting can keep the min. from rising when needed if the max is set too low (capping the min), which you can learn what's usual on Oscar... e.g. if the min. never goes above 8, you theor. could set the max as low as 10, but leaving it high (e.g. 20) is ok too. But without Oscar, you can't see how high the min. goes on given nights... ahem.

lynninnj
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Re: pressure range questions

Post by lynninnj » Thu Aug 11, 2022 5:40 pm

Julie wrote:
Thu Aug 11, 2022 5:34 pm
The machine adjusts automatically to the highest number you set the minimum to... e.g. 9 (vs 4), and lowering the max setting can keep the min. from rising when needed if the max is set too low (capping the min), which you can learn what's usual on Oscar... e.g. if the min. never goes above 8, you theor. could set the max as low as 10, but leaving it high (e.g. 20) is ok too. But without Oscar, you can't see how high the min. goes on given nights... ahem.
what are you going on about?

Maybe you should reread my posts. You don’t seem to understand.

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Pugsy
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Re: pressure range questions

Post by Pugsy » Thu Aug 11, 2022 6:27 pm

lynninnj wrote:
Thu Aug 11, 2022 3:53 pm
4cm left me air hungry.

I was told the machine adjusts automatically. I can’t see it leaving me hungry for air for very long but we will see.
That's why I suggest NOT going all the way down to 4 cm minimum as a new minimum pressure.

And it is very possible that if you didn't fall asleep right away because of air hunger the machine wouldn't ever move off 4 cm until you actually fell asleep and the apnea events started to happen....BUT if you aren't comfortable and you aren't asleep and it stays at 4 cm it's just going to be miserable.

No sense in being miserable. Since you have been used to 8 cm for a month you might even find that going down to 6 cm starting point isn't all that comfortable either.
I once did some experiments where I ended up using 13 cm minimum for just one week and then I decided to drop it down to 10 cm and it was extremely uncomfortable for me. I had been using 10 cm minimum for quite a while and just a week at 13 caused me to really notice the air hunger when I went back down to 10. Now I knew what it was and I managed to tolerate it but it took 3 nights for me to be back to being okay with 10 cm minimum. It was definitely uncomfortable.
Remember comfort is important as well because if we can't get comfortable we can't sleep so great and without sleep none of this really matters does it?

It's hurts nothing to maybe use a little more minimum pressure than what might be technically needed to stent the airway open if it means that you don't feel air starved and you can go to sleep readily.

Once you get your SD card and sleep with it in your cpap machine so you can see what OSCAR can show you I think you will have a better understanding of it all.

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lynninnj
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Re: pressure range questions

Post by lynninnj » Thu Aug 11, 2022 6:36 pm

Pugsy wrote:
Thu Aug 11, 2022 6:27 pm
lynninnj wrote:
Thu Aug 11, 2022 3:53 pm
4cm left me air hungry.

I was told the machine adjusts automatically. I can’t see it leaving me hungry for air for very long but we will see.
That's why I suggest NOT going all the way down to 4 cm minimum as a new minimum pressure.

And it is very possible that if you didn't fall asleep right away because of air hunger the machine wouldn't ever move off 4 cm until you actually fell asleep and the apnea events started to happen....BUT if you aren't comfortable and you aren't asleep and it stays at 4 cm it's just going to be miserable.

No sense in being miserable. Since you have been used to 8 cm for a month you might even find that going down to 6 cm starting point isn't all that comfortable either.
I once did some experiments where I ended up using 13 cm minimum for just one week and then I decided to drop it down to 10 cm and it was extremely uncomfortable for me. I had been using 10 cm minimum for quite a while and just a week at 13 caused me to really notice the air hunger when I went back down to 10. Now I knew what it was and I managed to tolerate it but it took 3 nights for me to be back to being okay with 10 cm minimum. It was definitely uncomfortable.
Remember comfort is important as well because if we can't get comfortable we can't sleep so great and without sleep none of this really matters does it?

It's hurts nothing to maybe use a little more minimum pressure than what might be technically needed to stent the airway open if it means that you don't feel air starved and you can go to sleep readily.

Once you get your SD card and sleep with it in your cpap machine so you can see what OSCAR can show you I think you will have a better understanding of it all.
Thanks Pugsy. It’s set to start at 4 like always and ramps up to 6 (rather than eight). Will see what happy. When I lay down I have gotten used to 4 and it’s only a five minute ramp time. The jump to 8 always seemed a bit much as well.

We shall see. Thanks.

(Have fun ! I’m jealous!)

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palerider
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Re: pressure range questions

Post by palerider » Thu Aug 11, 2022 10:50 pm

lynninnj wrote:
Thu Aug 11, 2022 3:49 pm
I am fairly tech savvy even tho i am not ready to build a battery that could zap my precious machine.
There is no way that a battery could 'zap' your 'precious machine.

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Re: pressure range questions

Post by lynninnj » Fri Aug 12, 2022 5:51 am

palerider wrote:
Thu Aug 11, 2022 10:50 pm
lynninnj wrote:
Thu Aug 11, 2022 3:49 pm
I am fairly tech savvy even tho i am not ready to build a battery that could zap my precious machine.
There is no way that a battery could 'zap' your 'precious machine.
I hear you saying you can plug the machine into anything even an improperly assembled battery backup and guarantee it won’t get damaged. Am I reading that right?

Because I’m not quite ready to try to assemble battery back up.

But I’m not intimidated even the slightest to take the SD card out and look at it like someone was suggesting.

btw zap was a figure of speech but im pretty sure you absolutely could damage your machine if you are like me and don’t know what you’re doing

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lynninnj
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Re: pressure range questions

Post by lynninnj » Fri Aug 12, 2022 9:56 am

Soo.....one month plus one night into this and here's what I've got.

https://sleephq.com/public/db86a48d-62e ... d14ce595e4

It felt like a good night to me. Its interesting being able to see individual events. I will look at it more closely when I get time but want to try to figure out which are real events and which are me lying awake, if possible.

I feel pretty good about the lowering of the CPAP pressure settings, judging by the averages shown there. It was set on 4 ramp to 8 with max of 16 and now its 4 to 6 with max 14.

Time for a deep dive!

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Dog Slobber
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Re: pressure range questions

Post by Dog Slobber » Fri Aug 12, 2022 10:15 am

lynninnj wrote:
Fri Aug 12, 2022 9:56 am
I will look at it more closely when I get time but want to try to figure out which are real events and which are me lying awake
Some rules of thumb I use to help me identify "real" vs awake apneas:
  • Event(s) near the beginning or end of a sleep session should be treated as suspect.
  • Fake events can be flagged as OAs, CAs, or Hs.
  • Flow rate volatility, prior to an event is probably fake.
  • Start to learn your own flow rate while awake vs asleep. You can do this by looking at your flow rate at times when you know you're awake. Look at it at various zooms levels.

lynninnj
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Re: pressure range questions

Post by lynninnj » Fri Aug 12, 2022 10:25 am

Dog Slobber wrote:
Fri Aug 12, 2022 10:15 am
lynninnj wrote:
Fri Aug 12, 2022 9:56 am
I will look at it more closely when I get time but want to try to figure out which are real events and which are me lying awake
Some rules of thumb I use to help me identify "real" vs awake apneas:
  • Event(s) near the beginning or end of a sleep session should be treated as suspect.
  • Fake events can be flagged as OAs, CAs, or Hs.
  • Flow rate volatility, prior to an event is probably fake.
  • Start to learn your own flow rate while awake vs asleep. You can do this by looking at your flow rate at times when you know you're awake. Look at it at various zooms levels.
Thank you!

I saw a few "events" that didn't seem like they were quite right, like I might have been awake. Then I saw some that were def me asleep.

Is it typical to grab a deep breath after an apnea event? I am kinda surprised that some suggest I went right back to peaceful gentle breathing but I guess that is kinda what the CPAP is supposed to do?

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Dog Slobber
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Re: pressure range questions

Post by Dog Slobber » Fri Aug 12, 2022 10:32 am

lynninnj wrote:
Fri Aug 12, 2022 10:25 am
Dog Slobber wrote:
Fri Aug 12, 2022 10:15 am
lynninnj wrote:
Fri Aug 12, 2022 9:56 am
I will look at it more closely when I get time but want to try to figure out which are real events and which are me lying awake
Some rules of thumb I use to help me identify "real" vs awake apneas:
  • Event(s) near the beginning or end of a sleep session should be treated as suspect.
  • Fake events can be flagged as OAs, CAs, or Hs.
  • Flow rate volatility, prior to an event is probably fake.
  • Start to learn your own flow rate while awake vs asleep. You can do this by looking at your flow rate at times when you know you're awake. Look at it at various zooms levels.
Thank you!

I saw a few "events" that didn't seem like they were quite right, like I might have been awake. Then I saw some that were def me asleep.

Is it typical to grab a deep breath after an apnea event? I am kinda surprised that some suggest I went right back to peaceful gentle breathing but I guess that is kinda what the CPAP is supposed to do?
For an Obstructive Apnea, yes; for a Central Apnea, no. Stop breathing for a bit, then when you restart your first breath will be deeper than usual

But, that doesn't mean that you will always have a recovery breath after an obstructive event.