Page 1 of 2

Long time CPAP user, pressure set to 15.0 permanently

Posted: Sun Jun 08, 2025 9:59 pm
by tsarchasm
I wonder if I should be turning the pressure down a bit. I am a highly motivated and enthusiastic cpap user, but my clinic has kinda ghosted me, I get plenty of supplies and the DME is in contact. Can you take a look at my latest OSCAR report and suggest if I keep on keepin on or make adjustments. Aerophagia is pretty extreme.
Image

https://imgur.com/a/QI5YsBN

Re: Long time CPAP user, pressure set to 15.0 permanently

Posted: Mon Jun 09, 2025 5:13 pm
by ChicagoGranny
You seem to be breathing well - low AHI, reasonable FLs, low leak level.

In order to see if a lower pressure would work well, we need to see the pressure line in APAP mode. Since you seem willing to experiment, you might try APAP mode, minimum pressure 12, maximum 16, EPR 1. If you really need 15 pressure, the machine will get you there fairly quickly.

Then, post another chart in this thread the next day.

Re: Long time CPAP user, pressure set to 15.0 permanently

Posted: Mon Jun 09, 2025 5:48 pm
by tsarchasm
Thank you for the reply. Not really sure how to make these modifications to my equipment. Is there a guide for this process or an external resource you can point me to?
Late breaking news: Old person figures out Internet and locates a guide on his own. Thanks, I'll modify this and get some new results.

Re: Long time CPAP user, pressure set to 15.0 permanently

Posted: Mon Jun 09, 2025 6:23 pm
by ChicagoGranny
tsarchasm wrote:
Mon Jun 09, 2025 5:48 pm
Old person figures out Internet
We old people developed the Internet! :lol:

Re: Long time CPAP user, pressure set to 15.0 permanently

Posted: Tue Jun 10, 2025 3:08 am
by Nocibur
tsarchasm wrote:
Sun Jun 08, 2025 9:59 pm
I wonder if I should be turning the pressure down a bit.
Ahh, DWing!

One of the most popular titration techniques!

Right up there with Wall/Spaghetti!

Now that you're SuperCyber try using SleepHQ to see if anything actually needs to be fixed before you go fixing it.

Re: Long time CPAP user, pressure set to 15.0 permanently

Posted: Tue Jun 10, 2025 8:23 am
by tsarchasm
It felt like a better night in APAP mode.
Image
Set it for 12 - 16
https://imgur.com/a/gFIiQ64

Re: Long time CPAP user, pressure set to 15.0 permanently

Posted: Tue Jun 10, 2025 12:49 pm
by ChicagoGranny
You spent most of the night at or near 12 pressure. If it were me, I would try tonight with minimum pressure 11.

Yeah, SleepHQ.com (free account) is easier to use, and we can see more details. It will redact all your personal information from the link you post in this thread. To prevent a long uploading time, select the 30-days of data option if it pops up.

Re: Long time CPAP user, pressure set to 15.0 permanently

Posted: Tue Jun 10, 2025 5:58 pm
by tsarchasm
ChicagoGranny wrote:
Tue Jun 10, 2025 12:49 pm
You spent most of the night at or near 12 pressure. If it were me, I would try tonight with minimum pressure 11.

Yeah, SleepHQ.com (free account) is easier to use, and we can see more details. It will redact all your personal information from the link you post in this thread. To prevent a long uploading time, select the 30-days of data option if it pops up.
Thanks, I'll adjust it down to 11 for tonight.
Here's my sleepHQ page, not sure if I did that right.
https://sleephq.com/public/teams/share_ ... a58ebbb3d0

Re: Long time CPAP user, pressure set to 15.0 permanently

Posted: Wed Jun 11, 2025 2:54 am
by Nocibur
I have look of surprise!

Given the amount of FL I would not have expected APAP to result in in any significant pressure changes, but not only did that occur, when significant FL did appear, it did not respond despite obvious FL with arousal (RERA):
fls.jpg
fls.jpg (73.13 KiB) Viewed 5317 times

Re: Long time CPAP user, pressure set to 15.0 permanently

Posted: Wed Jun 11, 2025 3:09 am
by Nocibur
Eventually, after some FL that it decides is significant (and just who does he think he is, anyway), it tosses in some response:
fls1.jpg
fls1.jpg (67.34 KiB) Viewed 5317 times
IYAM, at least in your case, the ResMed algorithm might not be the best choice.

For that matter, given the apparent resistance of the FL to CPAP/APAP, maybe rethinking the whole mode thing might be appropriate.

As well as a visit to the ENT guy to find out what's flopping around down there creating all that FL (not that I would necessarily start carving up stuff, but at least figuring out what needs to be fixed).

Re: Long time CPAP user, pressure set to 15.0 permanently

Posted: Wed Jun 11, 2025 12:30 pm
by ChicagoGranny
tsarchasm wrote:
Tue Jun 10, 2025 8:23 am
Which positions do you sleep on? Sides, back, stomach?

Re: Long time CPAP user, pressure set to 15.0 permanently

Posted: Wed Jun 11, 2025 3:55 pm
by tsarchasm
ChicagoGranny wrote:
Wed Jun 11, 2025 12:30 pm
tsarchasm wrote:
Tue Jun 10, 2025 8:23 am
Which positions do you sleep on? Sides, back, stomach?
Sides and back, never stomach. Last night's sleep quality wasn't as good as usual. I think I was missing the firehose of air when the cpap starts.

Re: Long time CPAP user, pressure set to 15.0 permanently

Posted: Wed Jun 11, 2025 4:41 pm
by ChicagoGranny
I second the idea of a consultation with an ENT. She will examine your upper airway during the first visit and give you an evaluation.

In the meantime, use the settings that give you the best day. Do the evaluation near bedtime. Was I energetic today? Did I have excess sleepiness? Am I fatigued but not stressed near bedtime?

Re: Long time CPAP user, pressure set to 15.0 permanently

Posted: Thu Jun 12, 2025 3:27 am
by Nocibur
Nocibur wrote:
Wed Jun 11, 2025 2:54 am
...when significant FL did appear, it did not respond...
The algorithm uses a number of parameters to determine response. Perhaps it didn't detect TI stretching:
fls2.jpg
fls2.jpg (44.29 KiB) Viewed 4878 times
IIWM, I would totally change inspiration approach and throw a BiPAP at it.

Re: Long time CPAP user, pressure set to 15.0 permanently

Posted: Fri Jun 13, 2025 7:53 am
by musculus
Nocibur wrote:
Wed Jun 11, 2025 2:54 am
I have look of surprise!

Given the amount of FL I would not have expected APAP to result in in any significant pressure changes, but not only did that occur, when significant FL did appear, it did not respond despite obvious FL with arousal (RERA):

fls.jpg
Hi Nocibur
How many RERAs do you see here, 3 or 5?