Beware of finding possible false optimal settings

Hi,uu

Many of you might remember I used to visit the forum frequently, but I have been away for some time. I discovered something that I thought might be applicable to some other here, hence this post.

I have been using cpap every day for abt 3 yrs, ever since it was recommended to me. With help from people here and intense experimenting, I settled on an unusually low pressure of about 4.5 for me as optimal, with my docs full approval. I may have complex apnea or some other conditions which appear to give me less sleep as the pressure was increased (actually ahi was significantly higher above pressure 4.5). Things went well for about 2 years, at least so I had been thinking. But when I started developing some insomnia and tiredness, ahi started creeping up to 7-10, another sleep study was done. The second one showed a pressure of 8 or so, actually close to the very first one. So I started using the pressures around it, and was betting lower ahi immediately. I used to get ahi 4 to 5 before, now I am getting ahi of about 1.5 and times less than 1.0.

It turns out for me the critical problem before was not the higher pressure than 4.5, but using the variable pressure. I simply cannot tolerate variable pressure, any pressure change at all, it seems, will wake me up, and results in much higher ahi. So when I was experimenting to find my optimal pressure, going to fixed help, but I fell into the trap, which has been hinted at this forum in some very knowledgeable members, that when you do adaptive searching to find the optimal pressure it is very easy to select a suboptimal pressure value. Mine goes lower towards about pressure 5, then increases up to about 7, and then starts falling down to much lower ahi at about 8.5!!

I am getting really much better sleep now. I decided to wait for about 6 months before writing this post just to make sure I was not giving another false advice. Now I easily sleep 8 hours almost every night, and interestingly if I shorten it by going to bed much later than the usual time, even for one night, I immediately feel it the next day. During the first two years, whenever doc or others asked am I feeling much better with cpap, I would say, yes, I think so. But I could not see thins type of black and white difference when I was missing a few hours of sleep. Perhaps my mind and body had got somewhat used to the constant struggle state before.

Happy Holidays!

Cordially,
feeling_better

Nice to see you posting here again, feeling_better!

Quite a few people have reported on this forum that they do better using one straight CPAP rather than varying pressures (autotitrating.) One of the good things about having an autopap is it's like having two machines in one -- can be set for "CPAP" mode at a single pressure, or autotitrating mode to vary the pressure in a range.

Glad to hear you've found what works best for you.

Hope you keep "feeling_better" ... and_better, and_better!

That's the quest, finding out what works for you. Things change, so we need to keep monitoring our lives well, so we can find the correct path we need to go down. Jim