Just Curious

so Dave are you saying that more pressure upon exhale is better for keeping airway open or not? I just put my pressure relief on 3 , which gives me the most relief, it's more comfy. I wonder if that gives too much time for my throat to collapse before next inhale though?

cindjo717 wrote: I just put my pressure relief on 3 , which gives me the most relief, it's more comfy. I wonder if that gives too much time for my throat to collapse before next inhale though?

The PR S1 and other older Respironics machines with the various "Flex" options don't really drop the pressure on exhale all that much. Instead they do a small drop and it is based on your own breathing or flow. A setting of 3 on a Respironics exhale relief feature isn't a 3 cm drop like ResMed machines.
Not sure about how the Devilbiss machines handle it.
You can read about how the Flex options work here...http://aflex.respironics.com/
When I experimented with the different settings I found them to be more of a rhythm change than a noticeable drop in pressure. BTW I have used a ResMed S9 machine in CPAP mode with a setting of 3 and there is no comparison to their EPR drop of 3 and Respironics Flex of 3. Feels hugely different. For some people who are using ResMed machines that 3 cm drop might allow some events to sneak past the defenses.

DoriC wrote: Pugsy, Of course I'm curious about that 4.67 AHI! Were there any factors that caused it, leaking, arousals, dreaming,etc.? Not just on the report but anything you yourself were aware of? I have a hard time getting a handle on those kinds of nights because Mike doesn't tell me if he noticed anything different, so I just have to go by the data.

Dori...I felt like I slept well. I was surprised to see the report which is obviously not what I normally see.
No leak.. no nothing that bothered me that I was aware of. Only thing I can think of is that my back hurt me much more than usual that day and that night and perhaps I was just more restless that night. More tossing and turning and possible false positives for semi awake tossing and turning stuff. I don't remember an usually high number of awakenings from pain though but I suppose it could be a factor.

I don't sweat the occasional "off" nights. In fact all I do is shrug my shoulders and go on. I did chuckle with this one though because it is rather unusual for me and despite the overall look of it...I felt quite decent yesterday. If I had a week of "off" nights..then it would have my attention and I would do a bit of investigating.

Sometimes there simply are no black and white answers to those "off" nights.

Edit...I just went back and looked at the "off" night. 2.22 of that AHI was Clear Airway. So half of the AHI. I can offer my idea...I just imagine that I did more tossing and turning due to pain and probably held my breath a bit when turning over. I almost always will remember a handful of those "turning over due to pain" times. I am sure that I also do some turning over that I don't remember. On paper it looks rather ugly compared to my "good" nights but I felt quite decent (for me) yesterday.
BTW.. I had a huge number of Pug snores get scored also. Sarge slept up by my shoulder with his body under the covers and face sticking out...it was really cold for him. He doesn't like cold weather.

I have a different cpap but I think your exhale pressure release is the same as respironics c-flex. I think that feature helps me. My ahi has been very good but I will definitely keep that in mind if my ahi starts to increase.

DaveLP wrote:I changed early last year from a non-data compatible machine to an Intellipap Auto and found myself ranging in AHI from 8 to 15. I ordered the Smartlink SW and started looking at the data. What I found was that I almost never had an actual blocked airway apnea, but lots of hypopneas, which are periods over 10 seconds of 50% or less inhale /exhale amplitude (tidal volume, I guess). I also had very few or no NRI counts and leaks were well within range for the mask.

I fought and tried different settings for months and finally turned off Exhale Pressure Release. I had noticed that with EPR on almost all settings there was virtually no pressure to breathe out against compared to my Respironics M100 manual machine. Soon, I was getting AHI numbers in the 4-5 range, which is considered normal for the firmware in the Intellipap, which scores differently than some other auto machines. I think that maintaining pressure on exhale was keeping my airway open and possibly signaling my brain to control my breathing a little closer. FWIW, I'm seeing AHI numbers that I like.

Pugsy wrote:

DoriC wrote: Edit...I just went back and looked at the "off" night. 2.22 of that AHI was Clear Airway. So half of the AHI. I can offer my idea...I just imagine that I did more tossing and turning due to pain and probably held my breath a bit when turning over. I almost always will remember a handful of those "turning over due to pain" times. I am sure that I also do some turning over that I don't remember. On paper it looks rather ugly compared to my "good" nights but I felt quite decent (for me) yesterday.

Pugsy, thanks for that insightful observation. I'm pretty sure you've given me the answer and that's Mike's situation almost every night. I keep wanting to dismiss his bad hip because he so rarely ever complains of pain(or anything else for that matter) but I know he's uncomfortable, more some nights than others. And he is restless and does have a hard time turning over because of that hip injury and I've observed him holding his breath and changing his breathing pattern many times. So I guess I have to stop trying to achieve "perfect" data by messing with the settings too often, and just be satisfied with how much better he now feels during the day. Now we'll see how long my new found wisdom lasts!