CorruptAlligator - CPAP Problems

[CorruptAlligator]

That's a real good chart.  I'd leave it there for a couple days.  If you want bring max pressure down, your pressure is rising because of flow limits and EPR helps with that.  
This needs to be based mostly on how you feel.  Getting higher numbers and feeling better is great.

Even with my AHI number down, I feel much worse now due to more frequent waking during the night (which isn't visible in the chart besides the one I shut off for a brief period).  I'm waking up  3-4 times a night, and the last waking makes it much much more difficult to go back to sleep.  

What I'm noticing is that as I'm in the brink of falling asleep I get woken due to abrupt pressure, and when I check the APAP, it shows my pressure went up to 9 or close to 10!  Even when I'm not a sleep I see it hovering at 7.7, and my minimum is at 7.  I thought the APAP keeps the pressure constant a 7 until it knows I'm fallen asleep and then when Apnea is detected, it will boost it.  That's not what it seems to be doing.  It looks like it's boosting it even if there is no detection, and I really don't know why.

How do I keep it at 7 until I fall asleep so that it will only respond when I'm a sleep?  Can ramping do this?  If I have minimum pressure at 7, and I use ramp, does it stay constant until I fall asleep or ramp it up during the ramp period?

[staceyburke]

The ramp is a set time - the pressure will stay down for the length of time the ramp is set. It will rise in pressure when the time is up if you are asleep or not. During ramp you are not getting any therapy.

[CorruptAlligator]

The ramp is a set time - the pressure will stay down for the length of time the ramp is set. It will rise in pressure when the time is up if you are asleep or not.  During ramp you are not getting any therapy.

When I set it on auto, it seems to be ramping it up on it's own like when I didn't have the ramping on.  Although I assume ramping is the period when there is no therapy active.  How does auto ramp work?

So, you are saying that when I set a ramp period.  During this ramp period, does the pressure stay constant at my minimum temperature or "ramp" up to a pressure during the period because calling it "ramp" is counterintuitive if the pressure is held constant until therapy is triggered.

[Sleeprider]

In your last chart, your minimum pressure was set to 7.0 and it stayed there about 15 minutes until 22:45 when there is an abrupt increase due to flow limitations. For some reason, you changed your EPR from 3 to 2, even though you said in post #29

I think my EPR should be at 3 because it did reduce my AHI from when my EPR was 2.  So, I know my minimum and EPR at this point, but don't know the max.  I can try bringing down max to 10?  Any feedbacks are welcome guys.

Those flow limits were persistent and fairly high, so your pressure stayed elevated near 13 cm, which you found disruptive.  Flow limits ended at 23:50 and pressure gradually dropped.  In post #27 on 2/8 you tried a maximum pressure of 10.0. Surprisingly, you said that didn't help your CA events, and switched back to a maximum pressure of 15.0. This was followed by a good night with AHI of 1.3 and 95% pressure of 11.8.  Clearly, this is self-inflicted damage and you need to move EPR back to 3.

My recommendation is to set your minimum pressure at 9.0 and maximum pressure at 12.0 with EPR 3.  If you need ramp to get there, set ramp on Auto starting at 7.0 which you seem to tolerate, and the pressure will increase to 9.0/6.0 (inhale/exhale) once sleep breathing is detected.  The higher minimum pressure and more limited maximum is going to reduce your sleep disruption, and EPR is clearly needed for your flow limits. I really want you to quit spinning the knobs on your machine and sleep with this for more than one night. A big part of your problem is that you don't stick with anything long enough to know if it works or not, but react how you wake up in the morning with another change.

[CorruptAlligator]

Thanks for all your responses guys!  

[quote pid='383938' dateline='1613234496']
In your last chart, your minimum pressure was set to 7.0 and it stayed there about 15 minutes until 22:45 when there is an abrupt increase due to flow limitations. For some reason, you changed your EPR from 3 to 2, even though you said in post #29

I think my EPR should be at 3 because it did reduce my AHI from when my EPR was 2.  So, I know my minimum and EPR at this point, but don't know the max.  I can try bringing down max to 10?  Any feedbacks are welcome guys.

Those flow limits were persistent and fairly high, so your pressure stayed elevated near 13 cm, which you found disruptive.  Flow limits ended at 23:50 and pressure gradually dropped.  In post #27 on 2/8 you tried a maximum pressure of 10.0. Surprisingly, you said that didn't help your CA events, and switched back to a maximum pressure of 15.0. This was followed by a good night with AHI of 1.3 and 95% pressure of 11.8.  Clearly, this is self-inflicted damage and you need to move EPR back to 3.

My recommendation is to set your minimum pressure at 9.0 and maximum pressure at 12.0 with EPR 3.  If you need ramp to get there, set ramp on Auto starting at 7.0 which you seem to tolerate, and the pressure will increase to 9.0/6.0 (inhale/exhale) once sleep breathing is detected.  The higher minimum pressure and more limited maximum is going to reduce your sleep disruption, and EPR is clearly needed for your flow limits.  I really want you to quit spinning the knobs on your machine and sleep with this for more than one night. A big part of your problem is that you don't stick with anything long enough to know if it works or not, but react how you wake up in the morning with another change.
[/quote]

I will try the above and see how this goes.  What would be a minimum amount of nights to try out a new setting before complaining? lol  I did notice that my EPR was set on 2 this morning.  I will switch back to 3.

[Sleeprider]

I'm not trying to pick on you. Just give it the new settings 2-3 nights so we can see what variation it produces. I really think those settings will work out pretty well.

[CorruptAlligator]

In your last chart, your minimum pressure was set to 7.0 and it stayed there about 15 minutes until 22:45 when there is an abrupt increase due to flow limitations. For some reason, you changed your EPR from 3 to 2, even though you said in post #29

I think my EPR should be at 3 because it did reduce my AHI from when my EPR was 2.  So, I know my minimum and EPR at this point, but don't know the max.  I can try bringing down max to 10?  Any feedbacks are welcome guys.

Those flow limits were persistent and fairly high, so your pressure stayed elevated near 13 cm, which you found disruptive.  Flow limits ended at 23:50 and pressure gradually dropped.  In post #27 on 2/8 you tried a maximum pressure of 10.0. Surprisingly, you said that didn't help your CA events, and switched back to a maximum pressure of 15.0. This was followed by a good night with AHI of 1.3 and 95% pressure of 11.8.  Clearly, this is self-inflicted damage and you need to move EPR back to 3.

My recommendation is to set your minimum pressure at 9.0 and maximum pressure at 12.0 with EPR 3.  If you need ramp to get there, set ramp on Auto starting at 7.0 which you seem to tolerate, and the pressure will increase to 9.0/6.0 (inhale/exhale) once sleep breathing is detected.  The higher minimum pressure and more limited maximum is going to reduce your sleep disruption, and EPR is clearly needed for your flow limits.  I really want you to quit spinning the knobs on your machine and sleep with this for more than one night. A big part of your problem is that you don't stick with anything long enough to know if it works or not, but react how you wake up in the morning with another change.

Good news! My AHI went down to .73.  I did wake up 3 times during the morning however, but I do feel much better rested than from my previous posting/morning.  

Let me know if you any more tweaking from attached data or give it several nights to see if my wakings subside.  I think at least minimum of raising EPR to 3 from 2 made a difference. Because I know from previous experience my AHI went down from 2.45 to .85 from raising EPR from 2 to 3 and raising my minimum pressure from 5 to 7 with my max fixed at 15.

This is so interesting that my doctor recommended my setting at default setting of EPR = 2, 5 - 15 pressure, and giving it many months of time. Some bad advice, and it felt like he didn't want me to visit him about my settings.

[CorruptAlligator]

Recent raising of pressure caused insomnia, and was getting worse sleep.  I went back to minimum of 5 and max of 15, and I prefer minimum to hover around 5 for me to get into sleep easier.  In which I was getting better sleep. With better AHI, I was getting slow quantity of sleep, but with higher AHI, i was getting higher quantity of sleep. Higher quantity of sleep results in better rested feel. Not the AHI values. This is how AHI values actually fool us into thinking we got better sleep.

I don't know what it is, but I get abrupt pressure rise feedback from the machine which causes sleep disturbance. This started happening 3 days ago. I notice it does this when I'm in the brink of falling sleep (abrupt raise of pressure, and it could be just .2 or .4, but it's like a step function, so it's abrupt), and I could not fall asleep and cause insomnia.  My AHI was much lower, but I was getting much lower quantity of sleep due to not being able to fall asleep.
I could not deal with this so I set my pressure back to  5- 15, and I fall a sleep easier.  

I'm fine with low pressure at 5 when I'm awake as it doesn't feel like I'm getting insufficient sleep.


If we look at my OSCAR result, we can see  3 OA starting at 5:45 mark.  I was actually awake then and do not understand why it was detected as OA, and air abruptly rising like it did.  It seems like a false detection. This makes me question how accurate the apnea detection really is. Any lab actually tested how accurate the machine is in detecting apneas? The issue with these 3 OA is rise like a step function, and I do not know why it rises like that. It's a very sharp and rough quick rise that keeps one from falling asleep.

This is the issue I have with this machine.  I get this abrupt rise in pressure a times, and which keeps me from sleeping.

The theory must have been: If we narrow the range of pressure, then perhaps the pressure will not spike so much since narrow will contain the pressure. This is actually not true, it can go from 7 to 9 while I'm awake depending on what the autoset is detecting. I saw it rise like that while I wasn't even asleep.

What I need is to be able to be stable at the minimum value so that I can at least fall asleep before the machine does it's work while I'm asleep.

The machine also raises it's pressure over time slowly at times even without ramp on. I really do not understand why? Why doesn't it wait until it detects I fall asleep? Since it abruptly disturbs my sleep, I don't think it waits until I fall asleep or can really detect me falling asleep.

At this point, I have little faith this machine detects events accurately.

[SarcasticDave94]

The main reason for events now that you've lowered pressures is that the pressure was lowered. I'd go back to settings Sleeprider suggested on the 13th. You say you like low pressure to get to sleep. Set Ramp to 5 which is what you like and make it Auto duration.

[CorruptAlligator]

What is the reason behind minimum pressure of 9 though? I tried minimum pressure of 9, and it caused insomnia, and I couldn't fall sleep.

Are we saying put the auto ramp on 5 instead of 7? And keep the pressure in the range of 9 to 12?

Do we know how auto ramp actually works? Does it keep it on 5 until one goes to sleep? I saw it changing values upward even when I wasn't asleep or it seems like it expired after awhile, or perhaps from false detection of sleep? Right now, my biggest issue is falling asleep so that I don't get that step function pressure change while I'm trying to sleep.