APAP VS AP Dynamic

[larrygreg]

So I laid off cpap for a while (like 9 months).  

Got a new Lowenstein Machine with humidifier.

New philips dream wear under the nose nasal cushion (best mask ever for me at least)

After analyzing in oscar , I see that I am  a mouth breather with leakage.

Got some tape last night, but I could only take 3.5 hours of therapy.

My AHI for the night is 23.01

Min pressure 7
max pressure 11

using the assisted relief that Lowenstein provides

Oscar shows I started at 7,  went to the maxed out at 1

Funny thing, the night before, I had an uninterrupted sleep for 7.44 hours the day before.

min 4.5
max 10
AHI 24.68

Oscar shows pressure went from 5 to 10 and peaked.  

So confused on what to do.  
Should I up the max pressure to 13 or 15 and see how high it goes 
I am hoping I dont need more than 15, but now I see my leakage is very low thanks to the tape

Thanks all

[Old Steve]

You really need to post your OSCAR charts for anyone to be much help.

[larrygreg]

This was last nights sleep.  I think I have to lower the pressure.

Now that I figured out Oscar (or at least I think) I attached the good night sleep I had as well.

Please let me know if I should re arrange the oscar charts in any specific order

Thanks for the help

[larrygreg]

So I think my pressure last night was way too high.  Definitely going to lower it.  

I included my best sleep that I had so far as well.

My AHI is high.  

Wondering if I should change the softpap settings

[Phaleronic]

You need higher pressure, you have tons of events happening and it's because the pressure is too low (flow limits are crazy high as well)-start with moving your min pressure up to 10cm, and increase max pressure to 15cm)-softpap can be set to 1 for now but I'd really probably just turn it off completely until we get this under control.

[OpalRose]

larrygreg,

Welcome back!

I merged your two newest threads.  Please keep all your questions and charts in this thread as you'll receive more targeted advice if your history is in one place.

Thanks!

[larrygreg]

You need higher pressure, you have tons of events happening and it's because the pressure is too low (flow limits are crazy high as well)-start with moving your min pressure up to 10cm, and increase max pressure to 15cm)-softpap can be set to 1 for now but I'd really probably just turn it off completely until we get this under control.

Will turn off the soft pap. 
Don't know if I can tolerate that pressure. 
Wondering should I set my max to 20 and see how high it goes. 
With a pressure of 16 last night it woke me up after 4 hours. 
At least at the lower pressure I slept through the night

[larrygreg]

So I posted before for advice and got some advice to up my pressure due to flow limitations.  I was reluctant to up the pressure as it was very uncomfortable.  Decided to drop the pressure to more tolerable levels.
Saw a setting on my machine for dynamic apap.

Saw this
APAP (autoCPAP) Two algorithm settings (standard & dynamic) on APAP to best suit patient needs. Standard maximises patient acceptance through lowest possible pressures. Dynamic is more responsive to flow limitations for maximum numerical result and proactivity.

What a game changer!!

For the first time I had a deep sleep indicator.

Looking to see how I can get this better

My Lowenstein software registered 
AHI 9/H
oHI 1/h
cAI  5/h
cHI 10/h

Here is the oscar data as well 

I went to bed around 8 something and woke up after almost 5 hours.  Not going to chug water before bed

   

[Jay51]

You still have a lot of Hypopneas (H's).  Sometimes, applying positional apnea techniques can help lower these.  A few things that you could try if you want are:  lowering your pillow height; possibly trying side sleeping instead of back sleeping - if you sleep on your back), and the last resort if both of those do not reduce your H's is trying a soft cervical collar.  

Great job figuring out the difference between standard and dynamic settings.  

Here is some reading on positional apnea:     

• 5.3Positional Apnea
  

[larrygreg]

I am a side sleeper. 
I have a soft cervical collar. 
Will lower the pillow 
Started taping my mouth, that really helped with the leaks. 
Also going to up the pressure but only 2 points for now 
Maybe bump up the minimum as well and hope for the best