CPAPtalk.com

LSAT wrote:Interesting concept, but some of you are responding to a post that is 6 years old....

I was wondering if anybody else noticed that all those posts were from 2010, (cept the stupidity from the unregistered guest today that started it all over again.)

palerider wrote:

DreamStalker wrote:That's incorrect advice. If one changes more than one parameter and without adequate sampling (ie. sufficient nights of data to get a representative average) .... they will just end up chasing their tail and have to start all over.

it's fine advice when one is trying to get in the ballpark. once in the ballpark, then it makes sense to take it slow.

Getting into the ball park is what "good" sleep studies are for ... but maybe some never get a "good" sleep study .... then yes they need some way to get into the ball park.

DreamStalker wrote:That's incorrect advice. If one changes more than one parameter and without adequate sampling (ie. sufficient nights of data to get a representative average) .... they will just end up chasing their tail and have to start all over.

You are thinking of a lab experiment that has to meet the rigors of science. This is real life. Anyone with a little knowledge and experience can change more than one setting at a time and follow what is happening.

The person who gets an APAP set 4 - 20 and needs a much higher min pressure, surely should increase the min after one night if the graphs justify it. Warmbodies is correct, no need to suffer for several nights at a min pressure of 4. Sampling size be damned.

WarmBodies wrote:

Look at the pressure line for a typical night. If the machine is spending very little time at lower pressures, then set your minimum pressure at the lowest pressure where it spends significant time.

<snip>

You describe the ideal way to titrate yourself using an APAP, and it is the way I titrated myself and occasionally check my settings.

You should post here more often.

DreamStalker wrote:

palerider wrote:

DreamStalker wrote:That's incorrect advice. If one changes more than one parameter and without adequate sampling (ie. sufficient nights of data to get a representative average) .... they will just end up chasing their tail and have to start all over.

it's fine advice when one is trying to get in the ballpark. once in the ballpark, then it makes sense to take it slow.

Getting into the ball park is what "good" sleep studies are for ... but maybe some never get a "good" sleep study .... then yes they need some way to get into the ball park.

it's often forgotten that we have good nights, and bad nights, and if you have an especially good night, or bad night when you have your sleep study, then the results are going to be non-representative of the normal nights sleep, and adjustments will have to be made...

too many people put too much stock in the results of a couple hours of sleep in a lab.

palerider wrote:

DreamStalker wrote:

palerider wrote:

DreamStalker wrote:That's incorrect advice. If one changes more than one parameter and without adequate sampling (ie. sufficient nights of data to get a representative average) .... they will just end up chasing their tail and have to start all over.

it's fine advice when one is trying to get in the ballpark. once in the ballpark, then it makes sense to take it slow.

Getting into the ball park is what "good" sleep studies are for ... but maybe some never get a "good" sleep study .... then yes they need some way to get into the ball park.

it's often forgotten that we have good nights, and bad nights, and if you have an especially good night, or bad night when you have your sleep study, then the results are going to be non-representative of the normal nights sleep, and adjustments will have to be made...

too many people put too much stock in the results of a couple hours of sleep in a lab.

The echo is beginning to go round and round ... I don't perceive a disagreement. To optimally (in time, effort, and efficacy) titrate CPAP/APAP therapy, working with the law of averages is the best approach (ie. working with one parameter at a time while being patient and collecting sufficient data for several nights before tweaking adjustments for the exact reason that each night inherently adds variability to the data).

wrote:working with the law of averages is the best approach (ie. working with one parameter at a time while being patient and collecting sufficient data for several nights before tweaking adjustments for the exact reason that each night inherently adds variability to the data).

Thanks to the timeline graphs in Sleepyhead, adjustments can be made after one night. I agree with Sheffey. If the AHI is high because the minimum pressure is too low, then raise the minimum - no need to live with it for several nights.

Duck wrote:

wrote:working with the law of averages is the best approach (ie. working with one parameter at a time while being patient and collecting sufficient data for several nights before tweaking adjustments for the exact reason that each night inherently adds variability to the data).

Thanks to the timeline graphs in Sleepyhead, adjustments can be made after one night. I agree with Sheffey. If the AHI is high because the minimum pressure is too low, then raise the minimum - no need to live with it for several nights.

Yep. Agree with whom ever you like and do what you want .... that's pretty much exactly what I do.

It still doesn't change the fact that each night will be somewhat different from the previous one(s) or the one(s) that follow. Tweaking your machine adjustments after each night can be fun if you have nothing better to do.

I optimized my titration to a long-term sub-zero AHI with a Respironics M series APAP almost 10 years ago -- and yes we had advanced from clay tablets to cool digital color graphs way back then too .... and I've rarely had to mess with it since.

But that's just me ... I've moved on to optimizing other things in my life.

Whatever people. Do whatever you want. It's YOUR therapy, your time, your money, your health .... all of it, it's all yours.

DreamStalker wrote:Tweaking your machine adjustments after each night can be fun if you have nothing better to do.

It's not about "tweaking your machine adjustments after each night". If you know how to read and interpret the Sleepyhead charts and your mask is not leaking, you can find the correct pressure range in the first one to four nights. You might have to tweak them again as you age, or if you gain or lose weight.

"Have nothing better to do"? What could be better to do than spending a few minutes to make sure you are breathing all night long?

DreamStalker wrote:The echo is beginning to go round and round ... I don't perceive a disagreement. To optimally (in time, effort, and efficacy) titrate CPAP/APAP therapy, working with the law of averages is the best approach (ie. working with one parameter at a time while being patient and collecting sufficient data for several nights before tweaking adjustments for the exact reason that each night inherently adds variability to the data).

yes, I believe we're somewhat saying the same thing, just different aspects of it... and it seldom hurts to flesh out different views of a point.

Duck wrote:

DreamStalker wrote:Tweaking your machine adjustments after each night can be fun if you have nothing better to do.

It's not about "tweaking your machine adjustments after each night". If you know how to read and interpret the Sleepyhead charts and your mask is not leaking, you can find the correct pressure range in the first one to four nights. You might have to tweak them again as you age, or if you gain or lose weight.

"Have nothing better to do"? What could be better to do than spending a few minutes to make sure you are breathing all night long?

that's awfully optimistic, considering the variability of people's sleep, from night to night, hence the common recommendation that once you've got settings close to what they should be, leave things alone for a few days to see how things average out.

palerider wrote:hence the common recommendation that once you've got settings close to what they should be, leave things alone for a few days to see how things average out.

That's not good enough for me - no interest in "things averaging out" - I want good therapy every night. My goal was to get the AHI at 2.0 or lower as quickly as possible. I did get there quickly.

Yes, pressure requirements can vary from night to night. But the S9 Auto I have had for the last few years, responds very nicely.

CowFish wrote:That's not good enough for me - no interest in "things averaging out" - I want good therapy every night. My goal was to get the AHI at 2.0 or lower as quickly as possible. I did get there quickly.

Yes, pressure requirements can vary from night to night. But the S9 Auto I have had for the last few years, responds very nicely.

it still needs to be set appropriately to your needs. and it's the setting process that we're talking about.

palerider wrote:it's the setting process that we're talking about.

No, what you guys are talking about is the waiting-to-set process.

It's long been a pet peeve of mine that you guys tell people that are getting poor therapy to "leave it there for several nights". Nonsense! If you are getting events because the min pressure is set too low, raise the pressure the next night!

CowFish wrote:

palerider wrote:it's the setting process that we're talking about.

No, what you guys are talking about is the waiting-to-set process.

It's long been a pet peeve of mine that you guys tell people that are getting poor therapy to "leave it there for several nights". Nonsense! If you are getting events because the min pressure is set too low, raise the pressure the next night!

"you guys"... I advocate changes in pressure settings concomitant with the difference between where the setting currently is, and where it likely needs to be. if settings appear way off, make a big change, if settings seem close, make a small change and wait.