[Pressure] Pressure max/min clarification and change I made

[richapple]

Hi, all. I'm a new PAPper, and after a little more than a month I've figured a change was needed and want to bounce my logic off you. (full discloser - it's based on an observation made by someone at a Facebook group page.)

With not really any improvement (ResMed AirSense 11 APAP mode, Pressure Min at 5, Pressure Max at 8, EPR set to On at 3), this had been a typical Pressure graph on OSCAR:

   

With the observation being that the Pressure is flatlining a lot at 8, and that such means that the machine wants to push more air to clear obstructive sleep apnea (FB person suggested, and does sound logical), I changed it to Max 10 and it was still flatlining some. So went to Pressure Min at 7, Pressure Max at 12, yielding the following:

   

So #1 - For me, from looking at these, is this probably a good thing for me to do? (Yes, have had better nights sleep for the answer to "how does it feel?" And yes, I asked my doctor via a secure email system my provider uses, and he kind of must not have understood what I was asking with these numbers I spelled out. He said it only matters how I feel, and sure, raise the Max to 9...)

#2 - The Pressure Min setting must kind of be moot, just for startup, right? EPR at 3 says when the attached nose is breathing out, back off pressure by 3?

And I guess #3 - Is this correct that Pressure hitting the Max and staying there (flatlining) is because the machine does detect an insufficient airway and does want to (apologies to Sly and the Family Stone) Take Me Higher?

thx

[PaulaO2]

I'd increase again. Say to 14 or 15.

Not sure what you are asking about #2. With a min of 7 and an EPR of 3, that means the CPAP drops to 4 on exhale. You can try to raise you min to 8 to see if you can tolerate that.

You don't say above (maybe I missed it) how long you waited between changes. The idea is not to go by one night's worth of data, but to gather that data and change accordingly. So you can leave it where it is for a week or so, see if it keeps bouncing against the top each night, then increase again.

[richapple]

Thank you, PaulaO,

I will sit at 12 another 5 days or so, and if it does keep hitting 12, I'll increase the Max. I've been at 12 just two nights, and was at 10 just one night, but flatlining at 10 made me think "why mess around?"

#2... I was figuring EPR 3 means it will drop 3 from whatever the pressure is at the moment. Or I guess that is what that means. And now if at the Min of 7 I could drop down to the 4... But yeah, I'm sure I could tolerate a Min of 8 (usually have been breathing out with the pressure at 5 anyway), so when I go to 14 and hope the Pressure doesn't bump its head at all, I'll do the Min of 8 too.

But good to know to let settings go for a while and look at more data!

[Melman]

It will be helpful to see more than just your pressure graph. Please see the links below for how to organize and post your OSCAR data.
The most useful charts for diagnostic purposes are:

• Event Flags
  
• Flow Rate
  
• Pressure
  
• Leak Rate
  
• Flow Limit
  
• Snore
  

[PaulaO2]

Yes, that is what EPR means. It is Exhale Pressure Relief. So if you have a min of 7 and an EPR of 3, that means the lowest your machine will go in inhale is 7 and on exhale it will drop to 4.

For now, leave the EPR alone and maybe raise the lower to 8.

Typically, you want the max to be one or two higher than you actually need so that if the need for more does come up (and it will) you will be treated.

[richapple]

Thanks, PaulaO2 and Melman,

Paula - Yes, going to let the pressure settings sit for a few more days, and 8/14 probably will be my next settings attempt. At 12 Max, which is where I have it, the chart line does bump its head on 12 quite a bit. Short flatlines...

Melman - Saved the links and will get it more together. Hopefully hosting more complete OSCAR info for further posts...