Opinions on numbers welcomed

June 30 to Oct 1 2010 (94 days)

Daily Mask Usage 8.64 hrs
Apneas 1.4 p/h
Hypopneas 0.6 p/h
AHI 2.0 p/h

Centrals 0.4 p/h (included in Apneas figure)


Last 2 Months August Sept Change

Daily Mask Usage 9.09 8.31 -0.78
Apneas 1.8 1.2 -0.6
Hypopneas 0.6 0.6 0.0
AHI 2.4 1.8 -0.6

Centrals 0.6 0.3 -0.3

95% Pressure 10.3 10.3 0.0

I purchased my CPAP machine thru my local pharmacy, which specialises in providing CPAP assistance. My pharmacist, (Rebecca), predicted on Day 1 that provided I kept up my compliance, the numbers would improve over time. So far, that is happening.

Between June 30 and Sept 20, I was running on MIn 4 and Max 20. I found the min to be too low. When I put the mask on, I felt like I would need to suck in air to get going. On Sept 21, Rebecca upped the min to 6.0. Interestingly, she did it by ramping me up from 4.0, and when the pressure reaches 6.0, it doesn't go below 6.0. I didn't know that you could use the ramp feature with a APAP.

My baseline sleep study on June 20 this year was:

Apneas 4 p/h
Hypopneas 29 p/h

AHI 33 p/h

Congratulations on such low numbers so quickly.

If these were my numbers, I would notice that clearly, my pressure is best closest to 10.3 (95%)
If I liked ramp, I would set it to 10 minutes starting from a pressure of 9, since it takes me about 10 minutes to fall asleep.
Once I got the feel for that, I might try it without ramp. At a pressure of ten, I find it very comfortable to fall asleep.

Reason: There is no point in starting with a lower pressure if the body needs 10.3.

Mammal wrote:June 30 to Oct 1 2010 (94 days)

Daily Mask Usage 8.64 hrs
Apneas 1.4 p/h
Hypopneas 0.6 p/h
AHI 2.0 p/h

Centrals 0.4 p/h (included in Apneas figure)

Code: Select all

Last   2   Months                     August           Sept              Change

Daily Mask Usage                     9.09              8.31               -0.78
Apneas                                     1.8               1.2                 -0.6
Hypopneas                                0.6               0.6                  0.0
AHI                                           2.4               1.8                 -0.6

Centrals                                    0.6                0.3                 -0.3

95% Pressure                             10.3              10.3                0.0

I purchased my CPAP machine thru my local pharmacy, which specialises in providing CPAP assistance. My pharmacist, (Rebecca), predicted on Day 1 that provided I kept up my compliance, the numbers would improve over time. So far, that is happening.

Between June 30 and Sept 20, I was running on MIn 4 and Max 20. I found the min to be too low. When I put the mask on, I felt like I would need to suck in air to get going. On Sept 21, Rebecca upped the min to 6.0. Interestingly, she did it by ramping me up from 4.0, and when the pressure reaches 6.0, it doesn't go below 6.0. I didn't know that you could use the ramp feature with a APAP.

Hi, while your pressure setting seems low, you also seem to be doing fine. Have you considered raising the pressure from 6 to 7 to see if you feel even better?

Thanks Julie and Dreamdiver.

The starting pressure situation has caused me some angst. I rang my sleep specialist in mid Sept and told him about my problem, that I felt the pressure was too low, and that I had to suck in air consciously, for the first 10-15 minutes. This is what he said to me:

" Your AHI of 2.0 is very good. As it is under 5.0, that is what we are looking for. The length of time you are in apnea, is insignificant, so I don't believe
that it is necessary to increase the pressure. Re the breathing, you will get used to it". And then he was off the phone in a flash.

He comments just didn't sit right with me. I felt like they were the comments of someone who has not worn a CPAP mask in his life. In my opinion, when you put the mask on, you should just continue breathing normally, not have to concentrate on sucking air. This is both annoying, and makes it hard to get to sleep. Also, day after day, I kept reading on this forum, that 4.0 is too low a starting pressure, and that you should calibrate it about 2-3 under your, 95th percentile, which would of been 7 for me.

About 1 week later, I went and saw Rebecca my pharmacist, who looks after me on a day-to-day basis. (She is not connected to my sleep specialist). She had no hesitation in upping my starting pressure at all. I didn't pay attention when she did it, and when I got home, I noticed that it still started on 4.0, but ramped to 6.0. It is a bit better, but I'm still not satisfied. This has only happened in the last 10 days.

I have a follow-up appointment with the sleep specialist on Oct 18. I will raise this with him then. I want him to give me a solid reason why I should not increase the mimimum pressure. I know about the issue of central apneas, but surely raising the minimum by a few points wouldn't cause a problem in this area?

[quote[I noticed that it still started on 4.0, but ramped to 6.0.[/quote]

You might just want to turn the ramp off. I bet that starts you at 6.0 since that's the setting you're ramping up to.

Robysue,

When it comes to health matters, I'm quite a cautious person. But jeez it gets frustrating when you go to various medical practioners, and you get conflicting advice, and in the meantime, you continue suffering. It seems to me sleep specialists want to diagnose you, point you to a machine, and then hope you go away. Without Rebecca, (my pharmacists'), help, I don't know where I would be, and all you's guys too.

Hi..... great numbers! I wonder if you have the clinician's manual for your machine....the one that allows YOU to get 'under the hood' and make adjustments? You can get it easily, if you don't have it. Seems like you have good support, but, honestly, why is it necessary to keep asking these folks to do this stuff for you when you can do it for yourself? The empowered patient is pro-active, takes charge of their own health, and knows they can handle things. Of course, we are talking about the adjusting numbers on a machine, and if more serious health issues are in play, you should be seeking a doctor's input.

You can access your clinician's manual here: http://members.cox.net/robelliott1/S9%2 ... %20eng.pdf

Mammal wrote:I have a follow-up appointment with the sleep specialist on Oct 18. I will raise this with him then. I want him to give me a solid reason why I should not increase the mimimum pressure. I know about the issue of central apneas, but surely raising the minimum by a few points wouldn't cause a problem in this area?

You have an S9 Autoset. It can tell when you're having a central apnea regardless of pressure and accordingly won't react. I would show my doctor the 95th percentile pressure of 10.3 for the last two months and tell him/her that I am changing my min pressure to 10 and my max pressure to 15. I wouldn't be rude, but I wouldn't in any way imply that I'm asking permission to change my pressure. Ramp can be done away with entirely. It's not required or prescribed. It's more of a help for people with high pressures. You can elect to use it or not. If I found myself uncomfortable falling asleep at 10, that's when I'd use the ramp starting at a pressure that I am comfortable with - maybe 8 or 9 - but a 95th percentile pressure of 10.3, really suggests your body is happier at that pressure, eh?

It can be a little scary at first, but with good research, help from other forum members, our doctors and results corroborated by our own machines, many of us on this forum have taken full control of our therapy and view the sleep docs as a sounding board more than as rule-setting omnipotent beings. For me the key has been to learn what I can and take control of my own therapy.