A couple of newbie questions

[paulag1955]

Thanks. They should be able to access the data directly from my machine. If they can't be bothered (since it seems as though they can't be bothered to return my call), I will remember to mention it.

Since I can feel air trapped in my throat on occasion when I startle and awaken, I'm guessing that those clusters of OA events may be caused by the high pressure forcing too much air. Does that seem reasonable?

[sonicboom]

A few posts back Sleeprider suggested raising the minimum pressure from 4 to 6. Most people feel starved for air on 4 especially with the nasal pillows that your profile indicates you are using. I use relatively lower pressures than most and over time I have gradually raised my minimum pressure from 4 to 5.6. I have also turned off ramp and turned off EPR. Panic usually sets in when you feel staved for air. I would start by raising the minimum pressure to 5, adjusting EPR to 1 and then put the mask on while awake sitting in a chair and reading a book or watching TV. See how it feels. You will quickly know whether the "comfort" adjustments feel right if you are completely relaxed and breathing normally after 10 or 15 minutes. It is completely OK to adjust your own comfort settings as well as all of your other settings but lets just start with the comfort settings and see how you adapt. Sleep doctors and clinics just can't respond to the nightly or weekly needs to tweaking your own therapy. But by all means do continue to check in with them and see if they will ever respond with any input.

[paulag1955]

I just got off the phone with the clinic. They're going to lower my max pressure to 12. We'll see how that goes. I'm supposed to check back with them on Monday. I'll hear what they have to say and then decide if I'm going to make further adjustments myself.

SonicBoom, the thought of raising my minimum pressure is terrifying because I already feel like I can't breathe out.

[sonicboom]

Raising the minimum pressure to 5 with an EPR of 1 means the exhale pressure is 4 (5 setting -1 EPR). The machine can't go below 4. So if the setting is 4 and EPR is on (1, 2, or 3) the pressure can't be reduced any further. This is why I suggested sitting in a chair with the mask on while doing something else like reading or TV. This will allow you to acclimate to the pressure all the while knowing that you can take the mask off at any time. This will reduce or eliminate your anxiety over time.

[paulag1955]

I see what you're saying...I'm already breathing out against 4 (whatever the units are) so raising my lower limit shouldn't matter.

[sonicboom]

Exactly

[paulag1955]

I spoke with the sleep clinic yesterday. My max pressure was lowered to 12 and I had a much better night. AHI is still unacceptably high (I mean, I hope to be able to get much lower than 5 eventually), but more importantly, I was much more comfortable. I slept for almost 10 hours, and kept the mask on all night. I only woke once because my nose was hurting me and never had the feeling that I was suffocating. I'm going to lower my max pressure to 11 tonight and see how that goes.

[Apnea Infant]

Hiya Paulag1955

I would reduce EPR to 2 before reducing your pressure. This is as you have a lot of clear airway apneas (the maroon stuff) which are brought on by EPR. You have also only been on 12 for a night right? It is better to have a few days at a pressure to see a trend rather than 1 or 2 nights. This is also as you have a few obstructive apneas even at 12.

I also see that your minimum is at 4. You might get less apneas if you increase your minimum to 6,7 or 8. Ie capture your apneas before they have a chance to occur at low pressure levels.

[paulag1955]

Thanks for that input. I had forgotten that everyone so far has advised to raise my min pressure. I will do that tonight.

[paulag1955]

Okay, I left my max at 12, increased my min to 5 and set EPR at 2. Baby steps.