Optimal pressure, flow limitations

Hello,
I am new to this forum, but I have been on PAP for about 1and1/2 years. Diagnosed with moderate apnea (AHI 18/hr) with not too much sleep achieved in the titration(just over an hour).
I will try to be specific so as not to bore you all. I was started on very suboptimal pressure of 5 and thanks to my whining/complaining was upped to 7 , still felt terrible ,finally I was put on pressure 8. I got the software to read my data and could see that I was still having apneas/hypoapneas and feeling no improvement . So more complaining to my doc who of course was happy since my ahi with cpap was below 5 (it was running around 2-3). Finally he put me on Auto 8-16.
Around the time I was put on auto I seem to develp stomach problems (reflux or acid taste in my throat). The auto seemed to work better in terms of getting into Rem as I started dreaming, but the machine seemed to crank up the pressures depending on flow limitations. My 90% would range from 10 to 11 to 12 to 13 (this last one when I narrowed the range from 10-16). My reflux got so very bad , one good day I decided to stop the auto and try running on straight pap and felt improvement with my stomach. And I have less apneas on straight 10 vs auto10-16. However, flow limitations are still there, the index runs around 1.5 with AHI less than 1. I am wondering,
can higher pressure than needed aggravate reflux problems ?
could I still be too high on pressure 10? why I cannot get rid of the flow limitations? I have tried antiacid meds unsuccesfully (am having endoscopy soon).
Could reflux cause flow limitations? the flow limitation index runs around 1.- to 2 regardless of pressure it seems.
I thought that running on auto would take better care of events and eventually "cure" my stomach but that didn't happen, it just got worse.
I want to stop feeling tired but all these pressure fluctuations have been pretty recent , so probably my body needs time to rest again. But the nagging question in my mind is:
what if I am not on the right pressure and I stay there and not get better?
Sorry for brainstorming here, I hope you can share any experience/suggestions on this,
Thank you,
Dreamrobot

Welcome, may I suggest that you register as a member and list your equipment (in text) in your signature. You will get much more specific help that way.

sorry, I thought I did, but I guess I took too long writing my first note,
my profile should show up now ,
thanks,
Dreamrobot

Hi,
So I finally got a sleep study to try to find out why I am not feeling less tired/groggy and having the esophageal reflux.
I tend to do lousy on sleeping at the labs so finally after exhausted I was able to zonc out for about 2 hours straight and hit rem for about
37 min (from the data) with no apneas or hypoapneas, yey!
I wanted to post my graph because I ask my doc about the arousal tick marks I had during rem, I had about 25-30 arousals during that Rem period,
and 3 jerks (due to the marks being so light it didn't show up on my scan copy).
How can that happen? I mean have this many arousals mostly in rem and not change to a different sleep stage?
Like I mentioned I got a generic answer about people having more arousals during sleep studies due to being in uncomfortable
environment. Unfortunately if I was doing great I wouldn't care about this but my husband does mention that sometimes in my sleep I do move my head or
make noise or throat/nose? noises. In the morns, when I wake up I still feel like I have to take deep breaths as if I wasn't getting enough air,

I would appreciate any thoughts , or any experience having similar problem with unresolved reflux with cpap,
I am hoping this is just a matter of having the right pressures

thank you,
Dreamrobot

How about posting a recent Daily detailed report from the your EncoreViewer software?

Sorry, can't comment on the sleep study report and the arousals noted in REM except perhaps the arousals simply weren't enough to snap you out of REM staged sleep. We also don't know what criteria is used to score an arousal.

Hi Pugsy,
I will try to get a report tonight (I lend my machine to my dad since his is not data capable, and am using his, but I'll switcharoo them).
I actually learned to post the graph from your explanation in other posts on how to do the photobucket trick,
thanks,
Dreamrobot

so, lucky me I developed a cold with painful throat and nasal congestion, my favorite type . I was thinking I wouldn't be able to post a graph but then
I thought , what the heck, for entertainment purposes, here it is :
I usually use no humidity at all with the room humidity being 50-60% on average but since I took OTC nasal congestion stuff I had to finally use passive, tried humidity on
1 but made my nasal congestion worse.
Anywho, don't know how deep I was able to sleep but I felt I did sleep on the second half of the night, just woked up with painful throat and one nostril completely clogged.
I have my CPAP set to auto but running straight pressure, I got a good advice to not overworry bout my flow limitations but I was so curious to see what they would be like with my
nasal congestion I just couldn't help it ,I'm a curious cat; once I get over the cold I might switch that to off .
But I did lower my pap pressure by 1 cm from what I am prescribed and my stomach was way better, no rivers of acid swimming up my throat , yey
ok enought mambojambo here's the graph, ta da:



wha u think, not bad right?

Dreamrobot wrote:wha u think, not bad right?

Not bad at all. Leak line great. I wouldn't worry about the flow limitations now either. Wait till the cold is done and give your body time to adjust to the pressure (aerophagia wise) and then see if an increase back to prescribed pressure helps with the flow limitations if they persist.

Thanks Pugsy,
I plan to post once this cold resolves, for some reason the mild nausea came back today (not always predictable in my acid reflux symptoms) and i felt in the night as if the pressure was too much, I had to lower it half a point. It might have been the fact that I took sudafed which really opens my sinuses. I still had very few apneas (3) but I was waking on and
off.
thanks, take care,

Dreamrobot