How am I really doing?

[wxmcpo]

I have been on Bi-since April 2015. Trying a variety of pressure settings from set pressures of 5-9 and 4-7 as well as VAuto setting didn't seem to be working for me. My AHI would rarely be below 5, which is considered treated. I finally decided in late May to try a lower pressure and put it at 3-6. I have seemed to respond well to that and according to Sleepyhead my AHI over the last 30 days is 3.08. Below are a couple of graphs that show (1) the last night I had the machine on VAuto and (2) a more recent night with the pressure set at 3-6.

Last night of VAuto


A recent night with pressure set at 3-6


I also made an album with 4 images of the second graph, but more detailed centered around 4 episodes during the evening to give a more detailed look.
http://imgur.com/a/LjlRO

I am hoping to get some feedback on whether the lower pressure setting is actually helping me or if I am missing something and basically getting a false positive. Thanks

[0rangebear]

I looks like you making frequent changes. If that is correct I would recommend you allow a few days or a week at the same setting.

A sample of 5-7 is a much better reference that a sample of 1-3.
your body does not respond the same every night. Therefore a larger sample will give the folks in the forum a better opportunity to analyze your data.

Also when making changes they should be in small increments and systematic so you know the effect of each change.

Many people never find there sweet spot because they make too many changes to quickly and then become frustrated with the conflicting data

3-5 is considered good by many. If you feel good

How do you feel?

[chill]

I agree with OrangeBear. It takes me from 3-4 night minimum to see the effective result of a change. Don't forget: it is you, not a machine, that mask is strapped to. That is one large analog input to this. It can take a while for your mind to decided to accept the change and respond to it.

I also see that you have a large percentage of central apnea consistently. While your AHI is not high, I wonder if an ASV machine might produce better results. A lot of people get these in the early stages of treatment, but usually not at a ratio that high.

[wxmcpo]

I have left the pressure setting at 3-6 since 23 May. Most nights my AHI numbers have been in the 2 to 3 range with an occasional 4 something. Last night it was over 6 for the first time in almost a month. The weird thing is when I had it set on VAuto it seemed my pressure needed to actually be higher because according to the first graph attached above my 95% numbers were 6.9 to 9.88 so it's weird that setting the pressure down to 3-6 has actually seemed to produce the best results. I am not the best at reading the sleepyhead graphs so I was just wondering if someone saw something in them that I am not seeing and that I should be aware of.

[DeepBreathing]

Your chart from 9 May shows >30% large leaks. With such prolonged leaks you can't have much faith in the results. Your later chart, on the other hand, shows negligible leaks.

I have to say it seems very unusual that you're getting improved results with such low pressures. As Chill mentioned the ratio of central apneas is way high, but the total number is reasonably low. It's hard to know what to suggest to improve your situation - if you're feeling good then maybe the settings are right.

[wxmcpo]

Your chart from 9 May shows >30% large leaks. With such prolonged leaks you can't have much faith in the results. Your later chart, on the other hand, shows negligible leaks.

I have to say it seems very unusual that you're getting improved results with such low pressures. As Chill mentioned the ratio of central apneas is way high, but the total number is reasonably low. It's hard to know what to suggest to improve your situation - if you're feeling good then maybe the settings are right.

Maybe the improved results only last for a short time as 3 of the last 4 nights my AHI has been 6+. Will give it a couple more days and then try bumping the pressure back up if it doesn't seem to be working any longer. Just when I thought I had it all figured out.

[green wings]

Hi, wxmcpo. I think it would be good if you started a thread called something like "Need Advice about Central Apneas" so that people who have primarily central apneas and use ASV machines will be sure to take a look at your graphs.

For you to be having practically no obstructive apnea events at such low CPAP pressures puts you in a whole different camp from most of us obstructive sleep apnea people.

[wxmcpo]

Hi, wxmcpo. I think it would be good if you started a thread called something like "Need Advice about Central Apneas" so that people who have primarily central apneas and use ASV machines will be sure to take a look at your graphs.

For you to be having practically no obstructive apnea events at such low CPAP pressures puts you in a whole different camp from most of us obstructive sleep apnea people.

Thanks for the advice. I created the new thread.