Help with Sleepyhead data - please

[Dagmar1]

I am posting two sets of graphs, in pdf.

I've increased pressure marginally, and over a long time period. Staying at each pressure for long periods of time to give it a chance.

Still feeling like it is not right, that I have Hypoxia in the morning.

From the graphs, it looks like the pressure is staying right at the maximum and is not varying. Does that mean that it should be increased? or is it set to CPAP even though it says it is on APAP on machine settings?

Thank you.

[Carbon]

Your APAP range is very narrow at 5.8-6.6, and you spent almost all the time at that upper limit. It looks like you need to open up your top range a lot more to see what your real pressures should be. Maybe even take the top pressure to 12 (even 20 wouldn't hurt) and see what your real median and 95% pressures are.

You might start to have issues with more leaks at higher pressures, and maybe you will start to get more centrals, but the autoset machine will at least get your pressures a lot closer to what is ideal compared to your present levels, then you can fine tune from there

It also wouldn't hurt to nudge your minimum up to 6 - it may help you feel less air deprived when trying to get to sleep.

[justMongo]

It's set to Auto; but with a very narrow pressure window.
Min Pressure 5.8, max pressure 6.6 -- might as well be set to CPAP mode.

I can see you have flow limitation and snoring.
If it were me, I would consider increasing the max pressure.

Before you consider that -- how did you arrive at the settings you have?
Were they set by a doctor or other provider? Did you set them yourself?
Did you have a sleep study?

You've been a member for a while now... so, I'm wondering how you arrived at the settings your using...

[palerider]

http://www.apneaboard.com/wiki/index.php...ganization

[robysue]

Dagmar1,

It's hard to tell exactly what your APAP range is from the given data. But it does appear that you have it in a very narrow range and that the max pressure is somewhere around 6.6cm. The AHI is usually "acceptable", but on the one day of detailed data that you posted, there's some significant snoring going on. And you are reporting that you are still not feeling very well.

If you are not dealing with aerophagia problems, it is reasonable to open up that max pressure to something quite a bit larger (I'd suggest starting with max pressure = 10) to see where the machine wants to go in terms of the pressure. If you can tolerate a higher pressure, the reduction in snoring (and possibly flow limitations) may allow you to sleep better and that may in turn increase how well you feel during the daytime.

[Dagmar1]

Hi,
Yes, I had a sleep study done and start was 4-6, but I question the original titration if accurate. It was a two stage test, one night the polysomnogram, another night a month later for the titration, but not at the same lab as the first. My AHI was 41 per hour in the original study. I was unable to get a copy of the titration study.

I went back to the primary care doctor to ask if they would increase the pressure up to 7 or 8 since I felt air starved, and they said -no- (nurse practitioner). I have not gone back since it was such a firm -no-.

The RT increased the start rate to 4.8 for me which helped some, and I increased it further, as well as the upper range. I’m a bit uneasy with an insurance change as of the first of the year in case the data is pulled, and it is seen that I’ve increased the top range a bit. However, I need to do something to feel better and appreciate any advice you have.
Thank you.

---

Sorry,

I was unable to post the second PDF. Site said I had reached my max posting size.

[robysue]

Chances are the insurance company could not care less if it was you instead of your doctor who did the pressure increase. All they typically care about is the usage hours. If you're using the machine, they'll pay for it. If not, they won't.

[Dagmar1]

Chances are the insurance company could not care less if it was you instead of your doctor who did the pressure increase. All they typically care about is the usage hours. If you're using the machine, they'll pay for it. If not, they won't.

I was worried if I had to see the same primary doctor if it would become an issue.

Thank you.

[OpalRose]

Dagmar1,
You have been on Cpap for a while now, and you must have met compliance. Why are you worried about what your Doctor thinks? He apparently isn't helping you much.

It's time you take control of your therapy. Your pressure range makes no sense at all.
If that were me, I would set the range from a minimum of 6 to 10 and see where it wants to go.

Also, download Sleepyhead software so you will be able to track your data.
http://OSCAR Official Download Page ----> CLICK HERE ./

[Dagmar1]

Dagmar1,
You have been on Cpap for a while now, and you must have met compliance. Why are you worried about what your Doctor thinks? He apparently isn't helping you much.

It's time you take control of your therapy. Your pressure range makes no sense at all.
If that were me, I would set the range from a minimum of 6 to 10 and see where it wants to go.

Also, download Sleepyhead software so you will be able to track your data.
http://OSCAR Official Download Page ----> CLICK HERE ./

Hi OpalRose,

My health care team is not segregated as to a sleep doctor, and a primary it is the same. That said, there are very few insurance carrier options or doctor options in the area I live in and I don't want to have a doctor "fire" me which has happened to people I know in this area.

The change in insurance the first part of the year came with a warning by the DME I would need to do a face to face with my doctor to continue with supplies and payments on my machine. The doctor's office does pull data that includes pressure so I wanted to be sure that it was not an issue with me changing pressure before I saw them. It was a six month battle to be able to change insurance, and the new insurance did not become active until a month ago. It is still unknown if I have to do a face to face yet.

Not everyone has access to a personal computer to download software like SleepyHead on. It has taken some time to be able to do that for me. And, not everyone is comfortable running their own CPAP care. It is scary not knowing what the oxygen levels are, and how higher pressure could be impacting your lungs. On the other hand desperation has made me change the pressures, not medical knowledge and I hope that I can see some positive changes soon.

I was able to download SleepyHead just recently, and did take posted advice to up the pressure to 6-10.

Thank you.