Do I need higher pressure if my AHI is still high?

Pugsy wrote:

avi123 wrote: JUST SHOW ME, black (or color) on white, data from your CPAP, proving your own results on it!!!

I don't have to prove a damn thing to you and I sure as hell am not going to try.
Doubt if it would make any difference. You would still pick it to pieces.
End of May 2009. Ozij..Den..and Rested Gal helped me do the very things I have told people I have done. Some of the reports are missing from photobucket but the bulk of it is still there. Search the forum if you wish. I really don't give a rat's behind.

May I add...Pugsy has held my hand since late March, early April of this year. I was "lost" before she found me...I have come a long way "baby" with her expertise of SDS...Without her - my CPAP machine would most likely be sitting in my closet collecting dust!

As far as the quote above: "YOU TELL 'EM, GIRLFRIEND"!!!

wolewyck wrote:This was mentioned briefly by another poster, but it's worth reiterating-- an AHI above 10 is too high. Something is not working for your setup, and you should definitely consult with your doctor about that.

One piece of information I haven't seen from you is what kind of residual events you are having-- are they obstructive in nature, or does your machine record them as (possible) central apnea events? Because it makes a big difference in how they would be treated. If obstructive apneas or hypopneas, then it is likely that your pressure settings are not quite right. But if your events seem to be central (neurological) in nature, then increasing your pressure settings is not likely to be effective and in fact may make things worse. Some people have central apnea events "naturally", and some, like me, get central events when put onto a CPAP or bilevel machine. In either of those circumstances, a doctor may prescribe a different type of machine-- ASV (adaptive servo-ventilation). These machines are more sophisticated (and more expensive) than CPAP, APAP, and bilevel machines. The ASV has been extremely effective for both me and for my dad.

wolewyck, what you been posting is exactly what I replied during the last 9 months to posters on this board who showed a drift toward CSAS and CompSAS with their data.

With my S9 Autoset not only that you can get daily data of CAI vs OAI but can do it over a longer period and check if you're drifting tward these ailments.

Checking this one month of my average event results tells me that by the definitions of CSAS and CopmlexSAS I am still far way:

What do you think about it?

My AHI was 20 on my original study and when I got bipap the titration study put me on 18/14 auto and showed some central apneas still. I was having daytime sleepiness and would wake up with my heart beating quickly. I don't know if the fatigue is from sleep apnea or blood sugar problems?
Sometimes on this setting I can get AHI 2 for 7day average or sometimes higher like 4. Now when I change the setting to 10/4 bi level it's more comfortable but i get an AHI of about 4 after one day of this. I feel like the 18/14 setting is too high and I am being exhausted by the high pressure? is this true?
I've read tonsil surgery can help OSA

avi123 wrote: Since I been on this board I have never seen from any of the posters, including you, Pugsy, BlackSpinner, Brenda, and others, who are often rendering medical advice about pressure changes, showing exactly what they did and how they carried out their own process of AHI reduction by changing the CPAP pressure. I am not talking about PSGs, books, articles, stories, etc.


JUST SHOW ME, black (or color) on white, data from your CPAP, proving your own results on it!!!

I don't need to show anything. I don't have to experience problems in order to solve them. I know how to read and understand what I am reading. I learned CPR, I didn't have to have a heart attack to learn how to do it. I check my mothers blood and give her insulin, I don't have to have diabetes to do that. I drive on strange roads after reading a map. I even had a baby without ever having one before. I used to work a crisis line and keep people from committing suicide without ever once trying it.

So I am telling you avi - without even once trying it - to stick it where the sun don't shine, little boy.

sickwithapnea17 wrote:My AHI was 20 on my original study and when I got bipap the titration study put me on 18/14 auto and showed some central apneas still. I was having daytime sleepiness and would wake up with my heart beating quickly. I don't know if the fatigue is from sleep apnea or blood sugar problems?
Sometimes on this setting I can get AHI 2 for 7day average or sometimes higher like 4. Now when I change the setting to 10/4 bi level it's more comfortable but i get an AHI of about 4 after one day of this. I feel like the 18/14 setting is too high and I am being exhausted by the high pressure? is this true?
I've read tonsil surgery can help OSA

Welcome to the forum.
Would you please take the time to permanently add your equipment to your Profile. Here's how if you don't know.
wiki/index.php/Registering_Equipment_in_User_Profile
We can help you better if we know which machine you are using and where you are getting the results you are posting.
There is software available for some machines and it might help you a lot if you could use it. Again, different machines use different software.

You might also want to start a new thread with your problem so it can get the attention it deserves. Looks like this thread is going to go off on a tangent and I am afraid your problem will get lost by the wayside. If you are going to be changing your prescribed pressure to the extent that you have I strongly advise getting the software to see everything.
I don't use BiPap so not much help other than software but there are many BiPap users here to offer help.

Edit: Sounds like you have Respironics machine.. Please check your Private Message box for some additional information on software.

Avi, No one is blind here. Mostly everyone comes here with an open mind wanting some guidance and support and willing to take suggestions from experienced users. When I started I kept asking questions until I understood why certain adjustments were being suggested. The advice given was sensible, never extreme, or varied much from the research I was doing on my own. Even recently when my husband's therapy went off track after his recent illness and I couldn't fix it , every recommendation made to me was well thought out and considered the circumstances carefully. Thanks to the pros here who figured it out for me, he's on his way back. To answer your question about our CFP, he's done very well for us over the years and if he is ever diagnosed with OSA I will steer him right to this forum as my personal thank you to him. It's the least I could do for someone who has protected our financial life all these years. I am certain he will appreciate the expertise he finds here.

Maybe avi123 is right and which pressure anyone uses never matters and nothing said anywhere ever helps anyone about anything and no one knows anything about anything and if he can't make his therapy work for him then no one else should ever try to make their therapy work either and the cpap machines everywhere on the planet should all just be tossed into the fire and no medical researcher should use any measurements or data whatsoever for anything and we should all grow beards and shave our heads and move to the wild and let ourselves desaturate so we can cry in our beers and then skip REM and SWS completely until we can all get together to recreate a modern-man version of the monkey-water-hole scene at the start of 2001: A Space Odyssey and throw some bones up in the air until they all turn into spaceships.

But all in all, I think Pugsy said it best when she said:

Pugsy wrote:I don't have to prove a damn thing to you and I sure as hell am not going to try.
Doubt if it would make any difference. You would still pick it to pieces.
. . . I really don't give a rat's behind.

It's a shame about the Internet that no one can hear applause in a forum.

I still have no idea what avi123 is talking about. But that's OK. It's a public forum. I live in NYC. I'll share the streets with anybody, whether I have any idea what they're talking about or not. Some of the best conversations I've heard have been between imaginary playmates and lamp posts.

It's all good.

Hey Jeff, are you going soft on me? I guess you're going to let Pugsy fight your battles for you, shame on you!

DoriC wrote:Avi, No one is blind here. Mostly everyone comes here with an open mind wanting some guidance and support and willing to take suggestions from experienced users. When I started I kept asking questions until I understood why certain adjustments were being suggested. The advice given was sensible, never extreme, or varied much from the research I was doing on my own. Even recently when my husband's therapy went off track after his recent illness and I couldn't fix it , every recommendation made to me was well thought out and considered the circumstances carefully. Thanks to the pros here who figured it out for me, he's on his way back. To answer your question about our CFP, he's done very well for us over the years and if he is ever diagnosed with OSA I will steer him right to this forum as my personal thank you to him. It's the least I could do for someone who has protected our financial life all these years. I am certain he will appreciate the expertise he finds here.

But please think about it. A group of posters, which you regard as experience user, who know nothing about the morbidities of newcomers, took upon themselves the task of rendering medical advice about CPAP pressure settings (probably by following the Titration Task Force of the American Academy of Sleep Apnea guideline), while even experienced sleep MDs would not do it without the use of PSG equipment such as EEG, EKG, etc.

My own doctor who holds MDs in Internal medicine and Pulmonology medicine would NOT take upon himself to OK my request for boosting my pressure by one to two centimeters without a new PSG.

Avi, I tried but you've exhausted me! I guess I'll have to award the "Quotes of the Day" to Pugsy and jnk.

jnk wrote:But all in all, I think Pugsy said it best when she said:

Pugsy wrote:I don't have to prove a damn thing to you and I sure as hell am not going to try.
Doubt if it would make any difference. You would still pick it to pieces.
. . . I really don't give a rat's behind.

I still have no idea what avi123 is talking about. It's all good.

DoriC wrote:Hey Jeff, are you going soft on me? I guess you're going to let Pugsy fight your battles for you, shame on you!

Actually, I was really kinda hopin' YOU'D fight my battles for me!

avi123 wrote: . . . My own doctor . . . would NOT take upon himself to OK my request for boosting my pressure by one to two centimeters without a new PSG. . . .

Wow. Strict doc! Although, given your reports, I agree with him completely, in your case. It is obvious you do need professional help, especially with your therapy.

Speaking of which, do you have your doctor's permission to read and post in this forum? I mean, is your doc OK with your being influenced by the thoughts of fellow patients when it comes to issues like proper pressures? If he doesn't want you to do anything in respect to your own therapy, he may be very upset to know that you read and post here.

Or could it be that you feel that you know better than your almighty doctor about what is good for you, as far as what you read and say, and so would choose to read and post here despite the wishes of a trained medical professional? If so, seems to me that your choosing so flagrantly to contradict your doctor's wishes for you by your getting and giving advice here outside the doctor-patient relationship could be a matter of your being actively involved with the very thing you are preaching against. Perhaps you could best make your point by boycotting.

My (nonprofessional) advice to you is get the PSG, listen to your doctor (solely, if that is your true conviction), and then stay out of forums, since you claim not to believe in patients' sharing with other patients what has helped them live a better, healthier life. To stay here while holding to your beliefs would only be confusing to yourself and others while creating inner conflict in you that might make your condition(s) worse, right?

The only other reason you would read or post here, with your stated convictions, would have to be a wish to troll, right?

For those of us with conditions that have responded to self-tweaking, many of us feel an obligation to pass on to other humans what we have learned here about the process of optimizing pressures. It has made our lives better, we have seen it make other people's lives better, and a number of highly trained, respected, medical professionals have applauded what is done here. Many doctors and sleep associations list cpaptalk.com as a valuable resource for patients to learn from.

Of course, just as some medications work for one patient but don't work for another, if the help provided here is not for you, avi123, and you don't believe this is a proper platform for helping others with their personal choices in respect to their own medical therapy, then, by all means, instead of spending your time attacking the help others are receiving, you may wish to listen solely to your own doctor, thereby sticking firmly to your own principles, including not reading and posting in places that you don't think patients should be reading and posting on matters they should not read or post about.

Was that better, Dori?

Too many well said words Jeff..........but the man can only see what he wants in graph form. It's a form of blindness I think...............if only he'd take a verbal fast!

scrapper wrote:Too many well said words Jeff..........but the man can only see what he wants in graph form. It's a form of blindness I think...............if only he'd take a verbal fast!

I just didn't want Dori to think I was a wimp!

jnk wrote:

DoriC wrote:Hey Jeff, are you going soft on me? I guess you're going to let Pugsy fight your battles for you, shame on you!

Actually, I was really kinda hopin' YOU'D fight my battles for me!

Was that better, Dori?

THAT'S MY BOY!!

avi123 wrote:
My own doctor who holds MDs in Internal medicine and Pulmonology medicine would NOT take upon himself to OK my request for boosting my pressure by one to two centimeters without a new PSG.

Avi your doctor wants money, lots of it, he is not really concerned with your health. Mine told me to read my data and do what I want, as I was obviously competent to do so, as long as I kept my AHI below 5. Oh I just realized your doctor doesn't believe you are capable of being smart enough to manage your own health. Have you given someone the authority to sign your papers yet? My sister does that for my mother with dementia. She couldn't remember what she was in the hospital for (pace maker), she thought she had fallen.