Advice re: changing CPAP settings

[fyrfyter43]

These are the last 2 nights, followed by an overview from when I started on CPAP, showing the pressure change and resulting increase in AHI.

[Gideon]

Your events are currently mostly Hyponeas (H) That would call for a pressure increase, BUT

Why was it lowered?  Were Centrals (CA)  high at 13?  if not set it on auto from 6 to 13 and let's see what happens over night.

[fyrfyter43]

No, centrals weren't high at 13 (avg. 0.28 compared to 0.26 at 6 cm). He had me go for a follow-up sleep study after a year. It seems to me that he likes to send everybody for an annual study. During that study, my AHI was below 5 at 6 cm, so the doctor had the DME change it.

Even at 13 cm, most of my events were hypopneas.

[Sleeprider]

Fyrfyter, nice to see you here. Don't get hooked into more studies. My suggestion is to simply put your machine in auto mode with minimum pressure 6 which is working for OA, but you need a maximum pressure probably at 11.0 just to be sure the hypopnea can be dealt with. Fixed pressure is great for some people, but most find the auto pressure to be much more effective.

For predominately hypopnea events, you would respond better to bilevel therapy, which can use pressure support during inhalation to increase tidal volume and offset the hypopnea. I seriously suggest you move your PAP therapy away from a specialist that likes you to pay for tests so much, but as long as you're paying for those services you should ask why he has not tried BiPAP which is designed to deal with hypopnea. Bilevel machines are available on Amazon for about $700 so don't get pulled into another study, you don't need it.

[Hydrangea]

My sleep studies were ~$1,500 each. Your sleep dr seems to be unashamed about his monopoly.

[fyrfyter43]

Thanks everyone! I set my machine for auto, min 6, max 20. I'll see how it goes tonight. Tomorrow's a busy day for me, but I'll try to get back on here with a screenshot from tonight.

And I agree, I will be looking for a new doctor. I'm a bit nervous about switching right now, though, as insurance has denied the claim for my last study, and I know it took almost a year to settle the claim from the original one.

Oh, and yes, he is awfully proud of the service he provides. He bills $9900 for a study with titration.

[Gideon]

That I as absurd.

[Sleeprider]

Throw the bum out. You don't need titration studies, and you have a diagnosis. Get your primary care doc to take over this task by requesting that he manage your sleep apnea. We can help if you have any questions.

[Newbee2016]

Oh, and yes, he is awfully proud of the service he provides. He bills $9900 for a study with titration.

Don't think you want to help upkeep his fancy sets of wheels and probably a yacht berthed at the marina....!

[Gideon]

Throw the bum out.  You don't need titration studies, and you have a diagnosis.  Get your primary care doc to take over this task by requesting that he manage your sleep apnea.  We can help if you have any questions.

IMHO THIS is what makes sense for you to do.
If you should ever need a sleep study, I'm sure we will recommend it based on what we see in your data, the the tear in the calendar.

You are in good hands here.