CPAPtalk.com

Hawthorne wrote:It is raising the MINIMUM pressure that is going to make a difference - not the upper pressure.

Ditto...I agree with Hawthorne and 49er.

Your machine is always trying to "fix" things and isn't able to do a good job preventing in the first place with the lower minimum.
There's a good chance that if the minimum pressure was more optimal you wouldn't be spending as much time up near the maximum either. You are consistently spending the bulk of the night up around 15 cm now. If we were seeing this only randomly that would be one thing but you are up there every night. There's a good chance that with a higher minimum the maximum may stabilize a bit lower.

Here's an old example that shows what I mean. Different machine than yours but I think you will be able to see what we mean.

viewtopic.php?f=1&t=39869&st=0&sk=t&sd=a

I don't know if 11 cm will be needed (it might be) but I suspect at least 10 cm probably is going to be needed to do the best job at preventing stuff in the first place. Go up slowly though. 0.5 cm increases for a few days to allow for the body to adjust and make the increases easier....besides we might get lucky and find out that we don't need quite as much minimum as we thought.

Also..it's possible that the rather wide fluctuations in pressure are disturbing factor to sleep quality and you may not even realize it.
Tightening the range with a little more minimum pressure may also help if the pressure changes themselves are affecting sleep quality.

I'll take the lower pressure up to 9.0 tonight and report results tomorrow.

04November2013
95th Percentile Pressure 14.0
90th Percentile Pressure 14.0
AHI 5.0
Pressure Plateau Time 0%
High Leak Flow Time 1%
NRI 0.25
EPI 3
---
Lower: 9.0 ---
Upper: 16.0 ---
Smartflex: OFF
Delay: 0
Delay Pressure: 8.5
Mask: Full Face Mask

-Still feeling tired this morning.
-will give it another day before making any changes.

05November2013
95th Percentile Pressure 12.5
90th Percentile Pressure 12.5
AHI 5.0
Pressure Plateau Time 0%
High Leak Flow Time 0%
NRI 0.50
EPI 3
---
Lower: 9.0 ---
Upper: 16.0 ---
Smartflex: OFF
Delay: 0
Delay Pressure: 8.5
Mask: Full Face Mask

-Still feeling tired. Yawning a lot.

06November2013
95th Percentile Pressure 12.5
90th Percentile Pressure 11.5
AHI 4.5
Pressure Plateau Time 0%
High Leak Flow Time 0%
NRI 0.00
EPI 7
---
Lower: 9.5--- made this change last night.
Upper: 16.0 ---
Smartflex: OFF
Delay: 0
Delay Pressure: 8.5
Mask: Full Face Mask

-Feeling better than yesterday, but still a bit tired.

-NEW MEDICATION: Sturgeron 25mg (for nausea and dizzyness), Nexiam 40mg (for reflux). Started this lunch time yesterday.

08November2013
95th Percentile Pressure 14.5
90th Percentile Pressure 14.0
AHI 5.0
Pressure Plateau Time 0%
High Leak Flow Time 0%
NRI 0.50
EPI 9
---
Lower: 9.0--- made this change last night.
Upper: 16.0 ---
Smartflex: 2-- made this change last night.
Delay: 0
Delay Pressure: 8.5
Mask: Full Face Mask

-Still a bit tired.

-NEW MEDICATION: Sturgeron 25mg (for nausea and dizzyness), Nexiam 40mg (for reflux). Started this lunch time 06Nov.

09November2013
95th Percentile Pressure 15.0
90th Percentile Pressure 14.5
AHI 9.5
Pressure Plateau Time 1%
High Leak Flow Time 0%
NRI 0.25
EPI 7
---
Lower: 9.0--- made this change last night.
Upper: 16.0 ---
Smartflex: 2
Irnd: 3 -- made this change last night (was 4, going to change back to 4).
Ernd:3 -- made this change last night. (was 4, going to change back to 4).
Delay: 0
Delay Pressure: 8.5
Mask: Full Face Mask

-I'm not that tired, although I only slept for 6,3hours.

-NEW MEDICATION: Sturgeron 25mg (for nausea and dizzyness), Nexiam 40mg (for reflux). Started this lunch time 06Nov.

Although your AHI is up a bit (quite possibly temporary as things adjust to the changes), I think it is good that you are experimenting with Smart Flex again, and trying different roundings.

This could be good for fine tuning your therapy. Just don't change to many things at a time and do leave each setting for a few days before making any more changes.

10November2013
95th Percentile Pressure 11.0
90th Percentile Pressure 11.0
AHI 5.0
Pressure Plateau Time 0%
High Leak Flow Time 0%
NRI 0.75
EPI 3
----- I think I'll leave the below settings like this for a while (5days). These settings seem to be comfortable.
Lower: 9.0
Upper: 16.0
Smartflex: 2
Irnd: 3
Ernd:3
Delay: 0
Delay Pressure: 8.5
Mask: Full Face Mask

-I'm just slightly tired, had a good 7,8hours sleep.
-NEW MEDICATION: Sturgeron 25mg (for nausea and dizzyness), Nexiam 40mg (for reflux). Started this lunch time 06Nov.

Leaving things as they are right now for 5 days is a good idea. Your 90-95% has come down - your AHI is good.

The 5 days will give things time to adjust and you data may even improve over those days without changes.

You said these settings feel pretty comfortable so it's best to leave them as they are for that period of time. After the 5 days you may want to do some more minor tweaking. I really think you are good right now.

11November2013
95th Percentile Pressure 13.0
90th Percentile Pressure 12.5
AHI 5.0
Pressure Plateau Time 0%
High Leak Flow Time 0%
NRI 2.00
EPI 6
----- I think I'll leave the below settings like this for a while (5days/maybe more). These settings seem to be comfortable.
Lower: 9.0
Upper: 16.0
Smartflex: 2
Irnd: 3
Ernd:3
Delay: 0
Delay Pressure: 8.5
Mask: Full Face Mask

-I don't feel tired, had 6,9hours sleep.
-MEDICATION: Sturgeron 25mg (for nausea and dizzyness), Nexiam 40mg (for reflux). Started this lunch time 06Nov.

12November2013
95th Percentile Pressure 9.5
90th Percentile Pressure 10.0
AHI 3.5
Pressure Plateau Time 0%
High Leak Flow Time 0%
NRI 1.50
EPI 4
----- I think I'll leave the below settings like this for a while (5days/maybe more). These settings seem to be comfortable.
Lower: 9.0
Upper: 16.0
Smartflex: 2
Irnd: 3
Ernd:3
Delay: 0
Delay Pressure: 8.5
Mask: Full Face Mask

-I don't feel tired, had 7,5hours sleep.
-MEDICATION: Sturgeron 25mg (for nausea and dizzyness), Nexiam 40mg (for reflux). Started this lunch time 06Nov.
-Stopped taking my Prexum and my ecotrin a week ago (Tuesday 5th Nov 2013)! - Doc said that my blood pressure is fine, I don't need to take this meds.

This data looks great! I think you have your cpap dialed in well! Interesting that you stopped those meds and things seemed to get better. Often meds we need to take can affect therapy.

On the other hand, the fact that you are now getting treatment for your sleep apnea, could well mean that your blood pressure has improved and you no longer need these meds.

At any rate, you are doing very well and the fact that you are no longer feeling as tired is also a good sign that your therapy is optimal for you now.

Hope things continue to go well! You have stuck with your therapy and are now "dialed in". Things can change as time passes though so you need to keep an eye on your data and how you feel. Good for you!

Hawthorne wrote:This data looks great! I think you have your cpap dialed in well! Interesting that you stopped those meds and things seemed to get better. Often meds we need to take can affect therapy.

On the other hand, the fact that you are now getting treatment for your sleep apnea, could well mean that your blood pressure has improved and you no longer need these meds.

At any rate, you are doing very well and the fact that you are no longer feeling as tired is also a good sign that your therapy is optimal for you now.

Hope things continue to go well! You have stuck with your therapy and are now "dialed in". Things can change as time passes though so you need to keep an eye on your data and how you feel. Good for you!

Agree with Hawthorne and also wanted to congratulate you alexchetty for sticking with your therapy. I am so happy you are now being rewarded for your efforts.

49er

Thanks Hawthorne and 49er.

I will continue to monitor my treatment and post regular updates of my progress.