New (advanced data) user - Where should I begin my protocol?

Since I was diagnosed (formally) with OSA in Sept. 2006, I have been using my Resmed Compact at the prescribed setting of 9cm with pleasing results. I don't know if it is because: I regained 55 pounds I lost since having my sleep studies (so same weight now as during study), I am now 40 years old, or I have been reading this forum a lot (possible psycho-somatic response/doubt), but I have been feeling like my therapy is not as effective now as it initially was(miraculous).

I am currently awaiting delivery of an M Series APAP with C-Flex and, while waiting, wanted to see what the recommended course of action should be for me to conduct my own "analysis" with my new, data-capable, APAP machine. Although from my reading here I certainly don't think anyone would criticize me for trying to "help myself" in this, I will throw in that I am a paramedic of 15 years and have a good understanding of the physiology, anatomy, etc. of this.

So I wondered - how should I go about this for the most effective results?
My first instinct is to:

-Start out using this in straight CPAP on 9cm and analyze a few nights of data

-Then (based on those results) maybe set it to 9cm lower threshhold and maybe 12cm or so upper and use it in APAP for a few more nights of data

-Then (based on those results) set it to 9cm lower and 15 or so upper for a few nights until I find that magic number that seems to give me the lowest incidence of AHI

-Then use it (with that newly-found setting) in straight CPAP for a few nights AND with that setting as a minimum in APAP for a few nights and compare the data for both.

The above example is just that - and I understand that after the first set of data I may end up not using 9cm as my minimum for anything - all based on what I find. So does that sound like a reasonable protocol, or is there something I could do safer(always comes first)/better/easier? Also, where should the C-Flex come into play in this? At 9cm I have not had much complaint about exhalation pressure (figured that was what kept me from snoring) but I want to use this to my greatest benefit.

On a very good note, I will say that I am still nowhere near the train wreck, headache-ridden, ill-at-the-world-on-arising person that I was before getting my studies and CPAP. Thanks in advance for any and all experience/suggestions y'all can offer (this forum ROCKS!!!), and HAPPY NEW YEAR!!!

Tracy

I'll let others more experience comment on your plans. EXCEPT to say that one or two nights is NOT enough to make an evaluation to your response to any changes. A week for EACH one change would be a much better choice of time frame. I know that makes for slow slogging and is rough on an impatient patient, but if you wanna do things right .... it is much the better way to go.

ycartf wrote:Since I was diagnosed (formally) with OSA in Sept. 2006, I have been using my Resmed Compact at the prescribed setting of 9cm with pleasing results. I don't know if it is because: I regained 55 pounds I lost since having my sleep studies (so same weight now as during study), I am now 40 years old, or I have been reading this forum a lot (possible psycho-somatic response/doubt), but I have been feeling like my therapy is not as effective now as it initially was(miraculous).

I am currently awaiting delivery of an M Series APAP with C-Flex and, while waiting, wanted to see what the recommended course of action should be for me to conduct my own "analysis" with my new, data-capable, APAP machine. Although from my reading here I certainly don't think anyone would criticize me for trying to "help myself" in this, I will throw in that I am a paramedic of 15 years and have a good understanding of the physiology, anatomy, etc. of this.

So I wondered - how should I go about this for the most effective results?
My first instinct is to:

-Start out using this in straight CPAP on 9cm and analyze a few nights of data

-Then (based on those results) maybe set it to 9cm lower threshhold and maybe 12cm or so upper and use it in APAP for a few more nights of data

-Then (based on those results) set it to 9cm lower and 15 or so upper for a few nights until I find that magic number that seems to give me the lowest incidence of AHI

-Then use it (with that newly-found setting) in straight CPAP for a few nights AND with that setting as a minimum in APAP for a few nights and compare the data for both.

The above example is just that - and I understand that after the first set of data I may end up not using 9cm as my minimum for anything - all based on what I find. So does that sound like a reasonable protocol, or is there something I could do safer(always comes first)/better/easier? Also, where should the C-Flex come into play in this? At 9cm I have not had much complaint about exhalation pressure (figured that was what kept me from snoring) but I want to use this to my greatest benefit.

On a very good note, I will say that I am still nowhere near the train wreck, headache-ridden, ill-at-the-world-on-arising person that I was before getting my studies and CPAP. Thanks in advance for any and all experience/suggestions y'all can offer (this forum ROCKS!!!), and HAPPY NEW YEAR!!!

Tracy

Although there MAY be slight differences in the way you respond to the different brands of machines, I think your idea of starting out at the pressure you've been using is an excellent one (and what I would have recommended). It's important that you establish that "benchmark". Too many people who switch from (non-data capable) CPAPs to APAPs, don't try out their prescribed pressures first......they just start out with really wide-open settings and then get frustrated because they're leaking and snoring and the pressure is going crazy.

Depending on what you see, you may only have to slightly tweak your settings. Also, since you've been using straight pressure for this long, you might find out the same thing that I (and others) did......that changing pressures disturb your sleep. But.....maybe not.

As far as your weight gain goes.....well, you're the paramedic......
(in other words.....get some data before making a diagnosis)

Den

What Slinky said about at least 1 week between changes and what Den said about starting at your previously titrated pressure - imho both are great advice!

Mindy

Don't rely on the LED data

You need the software.

Starting at your old titrated pressure sounds good.

Once you have the software in place, you can start bumping up the max pressure but again very slowly even with the software in place.

It would help also to get a copy of your titrating PSG and examine that for events especially centrals before you put the xpap in auto mode.

OK friends, what's the difference between "I concur" (which I ran into twice today) and I agree?

Great plan, Tracy, with great additional suggestions by all.

O.

ozij wrote:OK friends, what's the difference between "I concur" (which I ran into twice today) and I agree?

Great plan, Tracy, with great additional suggestions by all.

O.

Nuttin'. (nothing)......They're synonyms.


Den

concur cost you most than the "nickel" word agree - maybe it is a "dime word"

it also takes you longer to type - 6 letters versus 5

I just like to sound eddy-cated iz why I use concur.

I ain't eddy-kated so I wuld youse agree