Machine or operator adjustment?

[comatose]

Hi everybody,

Newby here, a naughty newby no doubt

Yes, I have been fiddling with my settings and NOT being patient and waiting before changing em again!

I had a home sleep study and the result was 30 appneas/hour up to 65 secs holding my breath after I breathed out, lol
I always wanted to die in my sleep anyhow, just not quite yet tho..........

The sleep doc sent me to a cpac shop and they rented me a machine for 4 weeks, at the end of that I bought one for a chrissy prezzy to myself.

So.... to the point.....I don't tink it's working too spectacularly and I have to wait until the 4th of feb till I get the proper sleep test at the hospital, not so far away I spoze...

I tried upping the pressure for a couple of nights to 15 but the AHI went up and I didn't feel too flash after and had more hypopneas, so I thought I would drop them down to 13.6, that didn't achieve much either so I thought you guys and gals might have some bright ideas that I could try?

I did try adjusting the EPR from 1 to 2, (on the Wednesday chart) I think I might try with it off as some have suggested in other posts that I have read in this forum.

The first 11 days of the summary graphs were with a nasal mask, my cakehole sounded like a leaking compressor hose

Any input appreciated ......regards, Jon

[Surly]

I have not used ResScan for some time however it looks to me like your need to raise your pressure settings, not lower them. Your device is spending much of the time at the highest pressure and it's not enough to arrest the continuing events. Ideally, the lowest pressure setting should be high enough to eliminate as many events as possible without causing large numbers of Central Apnoea's. The higher pressure setting allows to device to respond to any remaining events. That's the theory anyway.

[zonk]

Hi comatose, welcome aboard
When leak at the the bottom end (you can see more clearly 10 January chart) ... there were no apnea events scored during these periods

So what we need is similar leak line at the bottom for most part of the night, its easier said than done

Edit: It looks the machine want to go higher to deal with those clusters, I would set upper pressure to 20 and let the machine do its proper job, would only go higher if needed. If you need higher pressure, might be a good idea to discuss BIPAP with your doctor

[Peter_C]

It's boring and no fun to say and do this, but... honestly, once you change a setting, your body needs time to get adjusted to it, and then you need a few days to see (watching data) whether it was a good change or not. For me, something as simple as changing masks makes me go wonky for a few days alone.

By all means, learn about the various different settings, and what they do and how they change the data, but actual pressure settings out to be made a little at a time, with a week (or maybe two) between changes. Just my free advice

[trish6hundred]

Hi comatose,
WELCOME! to the forum.!
Hang in there for more responses to your post and best of luck to you.

[comatose]

Thanks for your replies people,
I kept bumping my pressure up every few days, each increase would cause sore lungs for the first couple of days in the morning. I got up to 17 cmH2O for a couple of nights and backed it off to 16.8 due to filling myself with air, I also was bringing up the lower pressure at the same time as the higher pressure. Bringing up the pressure does not seem to be making much of a difference to my AHI, as Zonk said, maybe I need to go on BIPAP? Or maybe use it for longer at higher pressure?
I use a full face mask and have the leaks well and truly under control, the other night I tried a chinstrap to try to alleviate my snoring, epic fail? According to the snore graph my snoring was worse than normal and the pressure stayed at it highest setting pretty much all night and my AHI was 15.9. my AHI is often about that but that morning I was really under the weather when I got up.
This Thursday night I go for my 1st sleep study at the hospital, some or all may be revealed then.
Last year, when trying to find out why I was crook I found out that I have an enlarged thyroid and an inflamed esophagus, apparently these conditions do not have anything to do with the apnea problem, hmmm dunno about that? I have been crook like this for 20 years, more on than off. The doctors I have seen over the years were useless, a couple tried to put me on sedatives and I told them to shove them, you know where, my mother inlaw diagnosed me.

here is a screenshot of last night

[Bladskinner]

Are u sleeping on you side in the first 10 or so days and then switched to your back? Because it looks like it was helping with hardly any ahi and less pressure.

[DeepBreathing]

What happened on 1 December? There's a big change in the pattern on that date.... never mind, I found the answer:

The first 11 days of the summary graphs were with a nasal mask, my cakehole sounded like a leaking compressor hose :Oh-jeez:

Maybe you should revisit that mask?

Echoing what others have said - if you change pressures every day your body will never adapt and you won't get a true indication of what's working and what's not.

[c0reDump]

Echoing what others have said - if you change pressures every day your body will never adapt and you won't get a true indication of what's working and what's not.

Yet Doctor's are writing prescriptions based on titration studies, where the techs are changing pressures every 10 minutes...

[DeepBreathing]

Echoing what others have said - if you change pressures every day your body will never adapt and you won't get a true indication of what's working and what's not.

Yet Doctor's are writing prescriptions based on titration studies, where the techs are changing pressures every 10 minutes...

Yeah - I think it's crazy! The place I went to didn't do that. They provided an autoPAP machine on day 1 and reviewed the results after a week, then adjusted pressures, then reviewed after another week. This goes on for a month. Each week you go in and see the therapist who reviews your progress listens to what you tell them and makes adjustments for the following week. (Also changing the mask if you need to).

In my case I had a high percentage of centrals so the process went on somewhat longer, trying both the Philips and ResMed ASV machines.

The basic premise is that very frequent changes of pressure won't give you a valid result, which is why I much prefer my procedure to a one-night titration study.