Finding 95%

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Pugsy
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Re: Finding 95%

Post by Pugsy » Sun Jul 22, 2012 9:29 pm

DoriC wrote:So on the 3/30 data, the higher pressure seems to correspond with an increase in your leak rate, right? Otherwise, your data is completely boring!
I think the higher leak rate is just a coincidence. It is well below where the machine might have been chasing a leak. I think the pressure increases weren't related to leak at all. It you look the "worst" leak was right between 2 periods of increased pressure.
The larger leak ended right before the 4 AM mark and the second stage of increased pressures started about 4 AM and lasted well past any time with much leak. I have seen other reports with similar increases in pressure and no leak at all to speak of. I just found those 2 because they were close by each other in my Photobucket album.
These reports are from when I used the M series machine and I have on occasion seen it chase leaks and when it did it looked entirely different and was pretty obvious. I chose them because of the 90% numbers.

See this one. Pretty much zero leaks but still had the pressure increases. REM events are likely culprits when I see these spikes. They seem to come an go in a pattern where I would likely be in REM stage sleep and since I am known worse in REM it is a fairly safe assuption.
Image

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napstress
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Re: Finding 95%

Post by napstress » Mon Jul 23, 2012 9:34 am

Pugsy wrote:Real scientific measurement...I eye ball it. (....) You can get the MaP from the Encore reports if you want to go into that much detail. Remember, I am lazy and don't do any more work than I have to and I wasn't trying to isolate an effective 90% pressure because I have no need to try straight cpap.
I had a feeling you were going to say this! I tend to get obsessive about details. A friend of mine recently pointed out that it's probably this obsessing-about-the-details that's causing the insomnia to begin with!

This is what things look like when I "zoom out" even more. I welcome any speculations as to what range and/or CPAP pressure I might try next.

Pressure: 5-8, AHI: 2.9, Avg 90%: 7.3, Avg CPAP: 5.9:
Image

Pressure: 5-9, AHI: 3.0, Avg 90%: 7.6, Avg CPAP: 6.2, Sleep consolidation the best it's been:
Image

Pressure: 6-10, AHI: 3.4, Avg 90%: 8.3, Avg CPAP: 6.7, Sleep consolidation swiss-cheese-like, again, possibly from allergies and/or aerophagia:
Image
Epworth Sleepiness Scale: 14
Diagnostic study: overall AHI: 0.2 events/hour; overall RDI: 45 events/hour
Titration study: AHI: 6.1; RDI: 27; CPAP pressures: 5-8cm

Not-tired behind my eyes and with a clear, cool head!

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Pugsy
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Re: Finding 95%

Post by Pugsy » Mon Jul 23, 2012 12:07 pm

napstress wrote:I had a feeling you were going to say this! I tend to get obsessive about details
And I had a feeling your were going to say what you did about the minute details.
I can see in your situation where things aren't yet to the point that you feel like you are "as good as it gets" thing.
Presence of allergy symptoms is going to make experimentation not exactly optimal but it is what it is.

I think if I was in your shoes and with same history and was going to try straight cpap pressure I would go with the higher 90% number that offered the best overall sleep consolidation.
I did try straight cpap when I got the ResMed VPAP so that I could feel what EPR was like.. I did it 2 nights. First night I used straight cpap at 9 cm and my AHI was higher than normal (I think it was around 7) so I then increased it to 11 cm which was my overall average when using APAP and things were pretty good and didn't do any further experiments. AHI was down to 1.0 and while I do realize that was only one night and I could very easily have had one of those nights where my pressures never would have increased even if I had been on APAP. I had no need to further experiment with with straight cpap.
I think if I was going to use cpap and be in your shoes where the reports look fine but I didn't feel as good as the reports look and there was the possibility of UARS in the background then I would probably use CPAP at the 90% number instead of the average. Especially since the overall pressures are relatively low anyway.

It's a bit of a crap shoot anyway. The actual difference between 7.3 and 7.6 or even the 8.3 is really very small and you know that if you were on APAP then the numbers will vary that much anyway. I don't think you are going to see any huge differences in your reports though. I think you are going to have to try to base results on how you feel but that is going to be real hard to do especially with allergy season symptoms. But hey, sometimes maybe an experiment under the worst conditions will work.
Is there ever really an ideal time when everything is static anyway?

If it were me and I was thinking that UARS thing and from what I have read sometimes it needs more pressure then I would probably give 7.6 or even 8.0 a trial on straight cpap.
Just remember though. I am a bit of a maverick and fly by the seat of my pants a lot and don't put every little piece of data under the microscope all the time. I go on how I feel. Like the time I tried turning AFlex off. I felt horrible and have no desire to experiment to see if I can reproduce the results.

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napstress
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Re: Finding 95%

Post by napstress » Mon Jul 23, 2012 4:31 pm

Pugsy wrote: napstress wrote:I had a feeling you were going to say this! I tend to get obsessive about details
And I had a feeling your were going to say what you did about the minute details.

Pugsy wrote:It's a bit of a crap shoot anyway. (....) Is there ever really an ideal time when everything is static anyway?
This is true, and, as you might guess, maddening to me.
Pugsy wrote:I think if I was going to use cpap and be in your shoes where the reports look fine but I didn't feel as good as the reports look and there was the possibility of UARS in the background then I would probably use CPAP at the 90% number instead of the average.
I so appreciate your remembering the details of my situation. What a treasure you are, Pugsy!
Pugsy wrote: I am a bit of a maverick and fly by the seat of my pants a lot and don't put every little piece of data under the microscope all the time. I go on how I feel.
I wish I could feel. For a while there I had been able to distinguish between "Clear," "Partially Clear," "Tired," and "Wasted Exhausted." But I seem to have lost that ability, and now am always in the last category.

Yes, I think I'll check out straight 8 and see how that goes. If inconclusive, maybe 5.5-9.5. See if that 90% of 7.5 varies consistently one way or the other and build a range from there.

Thanks for talking me through this, Pugsy.
Epworth Sleepiness Scale: 14
Diagnostic study: overall AHI: 0.2 events/hour; overall RDI: 45 events/hour
Titration study: AHI: 6.1; RDI: 27; CPAP pressures: 5-8cm

Not-tired behind my eyes and with a clear, cool head!