[Pressure] Please help

[AHG1974]

I think on both night I started with ps of 6 the then switched it back to 5. I just really didn’t feel comfortable moving the ps without the insight of others. I started with resmed v8 I think with no auto 11-15 was the average settings. Always had masks leaks. 4 ahi was average. Got AirCurve prescription and thought I was in heaven with the auto feature and not much mask leak. But I think with the lower pressurer even though my ahi score pretty good my sleep not the best. Main reason for getting new computer to see data. No insurance, working at Dollar General living with parents after being devorced two years. My thoughts now are looking at the data several events at the lower pressures under 10 sec that don’t get flagged is affecting my sleep and breathing from what I see zooming in on the flow. It’s started to make me more sleepy during the daytime. Last June my chest started getting  Tight and breathing became worse. I stopped smoking got on blood pressure meds. I got lots better heath wise. I still use nicotine. I been monitoring my bp hr o2 temp for month now with only hr below 60, will cont

[AHG1974]

Couple times day 60hr. Sorry my phone typing started running real slow so I posted and continue here. My 02 go to about 88 late in my sleep jumps right back up during the day. Been using smart watch. And pressure wraist cuff for readings. Seem to be close. I ordered CMS50d(a)+ hope it work with Oscar, be here next week. I feel my breathing during the day has slowly started to get worse. Just want to make sure I on the best settings possible and hope my breathing gets better. I say going on about four or five months noticed little changes in my breathing.

[AHG1974]

I just hesitatd to change epap/ipap ps. To much without the help of someone more knowledgeable. I change to 6epap tonight and post in the morning. Great appreciated.

[Ockrocket]

Thank you for the fast response. I will read and post as directed. Just got new computer. Been about two since I used one. Used to look at sleepyhead data back then but that’s about it. Used iPhone to take those please forgive me. I didn’t won’t to use up to much space and it was the simple thing to do. Sorry.

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What charts are going to be the best to post? I seen min of 3 is that for one post or the whole thread?

Welcome to Apnea Board.. and the challenge of trying to post data and screenshots.

Hang in there, keep following the suggestions on how to do it all and you will get there.

While you are getting it all worked out with how to post data and so forth I have rotated the screenshot of your report and attached it here to make it a little easier for people to read. 

Getting everything working to maximum benefit is a process over time, CPAP/APAP is not an "instant fix" for sleep apnoea, so be patient and take it one step at a time. 

I would suggest you don't make multiple changes all at once, change one thing and give it a couple of weeks or so before the next change so each change has time to stabilise, that way you get an accurate assessment of positive or negative results.

[Sleeprider]

Good job getting the chart posted. I am on the same page as Bonjour after seeing you have obstructive and central apnea distributed through the night. The OA events really call for a higher EPAP min, and I agree 6.0 is appropriate. The CA can be reduced by cutting back on pressure support which is currently 6.0. Your machine is capable of adjusting pressure support in increments of 0.2 cm. If 5.0 is not enough PS for you, then try a setting like 5.4 or 5.6. Your central events are not severe, but we know you will benefit from a slightly lower PS to reduce that rate. Other than that, the therapy looks quite good. I was thinking your expiration time was on the long side, but it calculates out to 1:2.17 which is normal, so nothing of concern there.

[AHG1974]

    Thanks again for all the support. Last night went well. Seem to feel little better today time will tell. my sleep study suggestion pressure range from a ps of 4to6. That was ten years ago. Fours years ago got my resmed vauto with prescribed 4-20 with ps5. I have stayed with ps5 95% of the time and never went above or below 4 or 6 just because of my sleep study. I just felt that only me looking at data I didn't wont to change it that much until better input like now on apneaboard. I always wondered if something should change sometime being at lower pressures then what my sleep study suggested now that I on auto machine. Just to much movement and needs dialed in.  When I zoom in on the flow my little events not getting flag decreased and shorted so the change of epap from 4 to 6 really helped. Again thanks here my chart from last night if the last couple hours was not there it be even better. First time in several months i slept over 7 hours strait.

[Gideon]

OK
It is clear that we have an 'open slate' for settings.
Sleeprider often takes things a bit faster than I do and that's OK, usually, we are going in the same direction, we both have the same goal, that is to optimize your treatment.

Your numbers are good, so how you feel and receive the changes are very critical on where we go. In the end, I have a preference to set a BiLevel PS =4 simply because that cannot be achieved on a lessor (CPAP) machine, therefore, demonstrating efficacy with settings that cannot be achieved on a CPAP.

I want to see what pressure, lower pressure you are comfortable at without impacting either your obstructive or central apnea. This means slowly lowering both your EPAP and PS, PS is likely to go below 4, it is important to see what you best handle.

Your Medial EPAP is 6.6, increase your EPAP to 6.4 (looking at slowly going to 7)
and your PS = 4

Your comfort is important and we are making significant changes to what you have been using so be critical on what you perceive and how you feel and which settings 'feel' better.

[AHG1974]

Thank you  [b]Ockrocket [/b]for rotating my sleep study  paper and the support!

[AHG1974]

Thanks Bonjour and sleepy rider. When you said Cpap I just remembered right before I got my AirCurve, buddy of mine working and nursing home set me two Cpaps system one regular Cpap and auto Cpap with two different flex settings. Had no luck with straight Cpap but the auto was different story. Wish I could remember the settings but pretty sure my ahi was well below 5 after few adjustments. I thinking whatever flex I was using was only on  2 for the best results. Then got AirCurve and score was better. I do have auto Cpap system one 50 serious in the truck just in case I get stuck somewhere. Also the auto BiPAP  I talked about earlier at home. Just want to get the AirCurve dial in 1st since is better. Will try 4ps and move epap to 6.4 I think and post in morning. Sleep well everyone

[AHG1974]

Numbers look better but i did wake up four or five time with little mask leaks. I think I need to turn down the humidity 1 level. I still feel better then most of the days waking up. My breathing pattern changed little. I will post three zoomed in pic of wed, no changes , thurs, 5ps 6epap, fri, 4ps 6.4epap. I just wondering about the clyle and trigger still being on hery high? And the ti max on 4. probraby to early to tell if them need set back closer to normal?