Hi from new member

[ajack]

It's up to you, there are many roads to Rome. You can readjust as you go, nothing is set in stone. In a lab, setting are adjusted after minutes. Going by the median and 95% numbers, I'm confident in saying you need more pressure, You can also experiment with positional therapy for any cluster events.

[Gideon]

one night does not make a trend.  

Your AHI is under 5, the Pros will consider you treated.  This (to me) is a flag to take it slow and easy.  Give each change a while to work out, the smaller the change the longer the interval between changes, 3-7 days.

While i can see your numbers going to 12 to 16 as ajack suggested, I would take a more conservative approach, 11 to 15 then wait 3-5 days and evaluate, then possibly going to the 12-16.
PR devices are slow to respond so it is important to help them out with a smaller band than ResMed devices so don't be surprised if you end up with a smaller range when done.

Fred

[Sleeprider]

I'm with Fred on this one. We just made a pretty big change, and I'd like to give this more time to see how it shakes out. One thing I notice is that the obstructive events tend to cluster. That usually suggest a positional component that may be fully resolved using an ergonomic pillow or the soft cervical collar. Many members have moved to the soft cervical collar to keep their head and neck in alignment and avoid the chin-tucking that can obstruct the airway regardless of pressure.

We can pretty much disregard the VS2, but we are still seeing flow limitations, snores and obstructive events, even at the maximum set pressure of 14. I would not hesitate to add a bit more maximum pressure, but encourage you to also consider whether chin tucking, back-sleeping or other positional issue might be present. The most important question is, how do you feel at this higher pressure? Is it pretty tolerable?

[Shin Ryoku]

I find the 10-14 range tolerable and didn't wake up overnight as had been happening when my range went up to 20. I also feel well today. Well rested, no headache, not fatigued.

I did notice that my events seem to come in clusters. I usually fall asleep on my side or stomach, but I have no idea if I stay that way. Someone should make a mask that reports its position!

I will do some reading about collars and pillows. Would love to try those and see the effect!

[OpalRose]

Although I agree “somewhat” with the slow and steady approach.  I say “somewhat” because you are using a Phillips Respironics machine, and this brand is slower to react to apnea events than a ResMed machine.  I think when making a change, that giving it at least 4 to 5 days is a good idea to let things settle.

The bottom line is watch your 90% pressure reading.  Your minimum pressure should be no more than
2cm lower than that number.  I agree that the max pressure should be raised a bit too, as you are bumping up against that number.  

The other thing I notice is that you are using ramp.  It’s fine if you feel you need it, but it should be set to start closer to your minimum pressure, so that it’s not so far away from the minimum pressure.  

Your numbers are good, but there is room for improvement, but go by how you feel.

[Shin Ryoku]

Thanks, everyone. Is it possible to tell from the data whether I am mouth breathing at all while I sleep? I am wearing a chin strap but not taping.

[dracus]

Just a newbie myself but if you're breathing it would show up as a large leak.

Your %leak is pretty low.

[Gideon]

Thanks, everyone.  Is it possible to tell from the data whether I am mouth breathing at all while I sleep?  I am wearing a chin strap but not taping.

Sometimes, by the shape of the Leak chart.

[ajack]

also the machine reading of tidal volume can be reduced from mouth breathing, yours seem ok. I think leaks first, then re-eval later for any mouth breathing. Given you don't get a dry mouth, (tongue is like a dried up bit of leather) is another indicator you don't

[Shin Ryoku]

Thanks, all.  I think I'm getting closer to what I need for settings.  This was last night.



The problem is now that I can't stay awake at the higher pressures.  I don't know whether it's the pressure itself or the sound of the air venting on exhale, but I wake up and feel like I have to take the mask off to fall back asleep.  Is that just something I will likely get used to?