Expermenting with my auto settings

A little back ground first. I have been on my auto since April, was titrated at 18, experimented with my numbers and found that 9 gave me the best AHI (usually 1.0 and less). Been running the auto at 9-16, rarely ever went above 12 and feeling great but........over the course of the last 3 weeks or so I have been slipping back into the old feelings. Tired during the day, wanting to take several long naps daily, not as alert), you know the feelings. I have switched masks around, numbers still great, no increase in AHI, just not feeling up to par. Also, the pressure of 9 was starting to bother my ears for some reason, So.....2 nights ago I started experimenting with my settings, lowered them to 5.5-12, had an AHI of 5.6 (very high for me) but slept good all night, woke up feeling great, full of energy, no nap,etc. WOW. But the 5.6 AHI bothered me so last night I upped the settings to 7-12 had an AHI of 3.2 but feel like I could climb mountains!!

Ok now I need your help, lets figure out what is going on. First I have very few apneas, mostly hypops. My numbers for the 2 nights are:

AHI of 5.6 = OA 0.6 and H 5.0

AHI of 3.2 = OA 0.4 and H 2.8

My thinking is that the auto does not respond to hypops and increase the pressure like it does with an apnea event and the reason my numbers are much lower with a setting of 9 is because it takes that high of constant pressure to help prevent the hypops. I can live with that ....

But.........

Why have I gradually starting feeling pre-cpap and why when I lower my settings, get higher AHI numbers but FEEL GREAT!

Sorry for the long post, just need to talk to someone who would understand.

Feeling lost,
Gilda

mommaw;

I have the same equipment as you, have been on cpap 11 years, and since getting the auto i have tried many ranges. yes i can use the smart card readings,but most of the time i prefer to go by how i feel. check a range for a least 4 or 5 days etc. i found for me it is best to keep a tight range around the titrated pressure in my case it is 16 to 20 with the c/flex set at 3 due to the high pressures. i have been at this range for about 6 weeks and i feel the best most of the time there and it is probably where it will stay! if you can tolerate your titrated pressure i would set your range around your titrated pressure of 18 also in a tight range somewhat as i have and i beleive it may help you get back to feeling good again most of the time. for me the 3 c/flex setting works very well exhaling against the higher pressures. if you do try it i would give it at least 5 days to see how it works for you.
i am going by guest because the site keeps logging me out!

Best to you,

steve,
ufo13

Steve,
Thanks for the reply. I will do as you suggested and pay attention to what my body says rather than what some numbers show. I discussed with my sleep doctor before changing my pressure to the 9-16 range froim the tritrated pressure of 18, he monitored my numbers and agreed that I needed to stay at tthe 9-16 range. He stated that I was the 2nd patient he had put on an auto that had been tritrated wrong at the sleep lab.

Thanks
Gilda

mommaw, thanks for a timely post. I've been tweaking my APAP settings for the last few weeks also, trying to get back to those first weeks' rested feelings. I was titrated at 16 cm and have experimented with settings from 4 to 20 cm to 5 to 10 cm to currently 9 to 14 cm. I suspected my initial titration was too high plus I had problems with my UltraMirage FF mask making rude noises and waking up from too much pressure.

Long story short, I'm still not feeling well rested in the mornings (things are definitely better than pre-APAP, however). I try to get a full 8 hours sleep each night. I wake once, maybe twice for bathroom breaks. Steve, I'm going to take your advice and set up my range tonight from 14 to 18 (+ 2 cm from titrated pressure. Also I've switched over to the DreamFit mask and that seems to help keep my AHIs way down. We'll see what happens tomorrow.

I did notice that it was possible to set the range way too low and woke up feeling totally exhausted. Be careful on that.

Overall, though, this therapy WORKS!!!

TXKajun:

I think the range you have set may be perfect for you as it was for me! Please let us know how it goes tonight and as i said i would give it 4 or 5 nights to get a real feel for it. But i noticed a big difference the first night i tried the tight range, and it has been set there since.
Also like to tell you i greatly enjoy your posts also, very interesting and informative. Hope you are feeling much better tomorrow!
And yes this therapy WORKS! But sometimes you have to tweak a little.

My best to you,
steve,
ufo13

I learned the hard way not to listen to your numbers to tell you how you feel. Listen to how you feel and just look at the numbers. So many times the numbers can vary due to outside factors that have virtually nothing to do with anything you may be doing wrong with your therapy. I had started to become obsessed with my AHI's every morning and it means nothing if you have an AHI under 1 every day if you don't feel well. And if you have an AHI of 5 but feel great, common sense tells you which should be your choice. As long as you're being compliant, which is what is really important, and you feel great, God bless. Chances are, if you leave the settings alone, you will go back to the original low numbers and start to feel better without all the worry or readjusting.

By the way, Steve, try clearing your browser's cache and cookies and you won't keep getting signed out. Titrator taught me that one and he was right. After doing that, I never got signed out again. So I do it often as a precautionary measure, but you just have to remember to log in again after you do it .

Have a great night, all.

An update, I have decided to NOT d/l my data for a few days to rely on how I feel instead of numbers as you all have suggested. I still am feeling a lot better with the setting of 7-12. Going to leave it at that for the next few days and see what happens.

Lori, I follow your posts and you are always full of encouragement and great advice.

Steve and TXKAJUN, thanks for the advice, I will just listen to my body for awhile. I'll check my numbers next week and see where I am.

I met with my GREAT DME today, (yes she is great) and picked up my new ACTIVA mask, can't wait to try it out tonight. I am very fortunate in having a great DME to deal with. (King DME in Ky). We discussed my theory that the auto does not respond with a pressure increase for hypops and she stated that was correct, and that it was important to keep my pressure high enough to deal with them.

Thanks all for the replies,
Gilda

Gilda,

I appreciate your kind words, thank you. I went through sort of the same situation you are going through and truly started obsessing on the numbers. It's not worth it as long as you feel well. If you didn't feel well and even if the numbers were bad, that can atill be attributable to outside factors; and given time, even with doing nothing at all but waiting it out, you start feeling well again and the numbers return back to normal.

I kept playing with straight cpap, then auto and back to straight cpap. Turned out it had nothing to do with therapy at all. That's why we can save ourselves a few gray hairs and just go by if we're feeling well.

I hope you continue to feel well. That's the whole idea of this thing anyway, no?

Interesting. My titration was 9, and my auto keeps me there most the time, although some nights it goes to 11. I have it set at 6-12. I was messing with it more earlier, but have been leaving it alone lately. My AHI has been under 3, and leaks under 30, especially with my activa, not so good with the swift

Guest,

Maybe you think the Swift is giving you worse leak rates because you don't know what the standard is for your pressure. I am attaching the link to the post that is now a part of CPAP FAQ that I posted for Yawn a little while back showing the vent flow rate chart for the Swift so you can check. Hope you find it's not as bad as you think. You have to scroll down a bit but it's there.

viewtopic.php?t=4788&start=15

Gilda,

Have you tried using your auto in CPAP/CFLEX mode with a single pressure setting? You might try that for a week or two and see what happens.
From reading your first post of this thread, I was wondering if we have the same "sleep doc"......mine seems to like the high pressures, too. He prescribed me at 18, too. I found that a setting of 10 works quite well for me.

Best wishes,

Den

Dan,

I have not tried setting for straight cpap yet but after I give these setting a little time, I plan to try it. My first machine was a bipap set at 18/14, it worked good but the pressure sure was hard to handle. I used that for 2 months, then the doctor agreed to test the auto, which I kept.

I don't think we have the same doctor, mine is in Ky but I would definitely recommend him to anyone!

Sleep well,
Gilda

ooops The above was me, forgot to sign in.

Gilda