New, very tired, and need help

[beckysmith]

Good morning! I lowered my max IPAP to 13.0 and my AHI has been lower the past 3 nights. I don't really understand what any of the other graphs or numbers mean. I ordered the graphs like you said. Thanks for your help and feedback.
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I can send Friday and Saturday nights also if you want to see them.

[Sleeprider]

It looks like you have reduced the CA events quite a bit, and slightly increase OA. It might be good to see your overview chart so we can see the trend. On your daily charts, only the first one with events, flow, pressure, snores and flow limits are needed. You can delete the other two. It would be better if you posted charts to imgur and linked here because it gives us continuity and history. By using attachments, you end up deleting that history, and it is hard for us old guys to remember what was going on before.

As I recall, your AHI was closer to 17-18 last time we spoke, so cutting that in half is good progress. The bigger question is how are you feeling with the therapy? You are still in your first month, and we are continuing to see mixed apnea at a fairly high rate. Hopefullly we will continue to see positive progress, but if this does not reduce significantly by next month, you are going to have the ASV discussion with your doctor.

[Sleeprider]

I wrote down what you had back on page 2.
Last week AHI of 16.8, OAI 4.33 and CAI of 10.63 at PS 4 over 9-20
Currently AHI of 10.1, OAI 3.76 and CAI of 4.11 at PS 3 over 9-13
Respiration rate is low at 9 bpm median, but volumes are normal.

So your progress is mostly in the central apnea and obstructive is improved. This means the suggestion I gave last week worked as hoped. I don't see any benefit from further refining those pressures at this point since the obstructive and central events are about even. What we're hoping for from here is further spontaneous reduction of events. We can try to further tune the pressure, but with events fairly even, I'm hesitant to mess with this so soon. The next step is going to be PS 2 over 10-12. That will be essentially a fixed bilevel with only 2-cm pressure support. The idea being to drive down OA and further reduce stimulating CA. It's your choice if you want to give this a try.

[beckysmith]

I will try again to figure out how to use the Imgur to upload files. I'm attaching the overview; however, on November 10-14, I didn't have the SD card in, so those days aren't accurate. I'm still very, very tired, but I also have a lot going on with moving and working a lot of hours. I was very happy to see the AHI go down.
I have been using the machine a full 2 months now.
   

[beckysmith]

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This is Saturday night..my lowest AHI to date.

[Sleeprider]

Your trending in the right direction, particularly AHI and time in apnea. I'm a bit confused what was going on from 11/10-11/15 where there is a gap in some of the data.

[beckysmith]

I forgot to put my card in, so it couldn't store all of the information.

[beckysmith]

Good morning! Here is last night's fun...
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[Sleeprider]

Not much change. It looks like you need a bit more EPAP to deal with flow limitation, hypopnea and the OA. The CA is looking pretty reasonable now. How would you feel about increasing EPAPmin from 10 to 11? Leave everything else the same for now.

[beckysmith]

I can do that.
I don't really understand what flow rate or limitation means, but I'm game for anything..
Thank you!