My charts & data

[fozsleep]

I'm going to be the voice of dissent here.  Your test results indeed point to clusters of apnea/hypopnea accompanied by snores which suggest positional apnea and might offer an opportunity for the low or no CPAP therapy. However you had persistent RERA throughout the night associated with low SpO2, and these arousals are very disruptive to sleep quality. I presume that without CPAP, you will have fairly persistent upper airway restriction which is apparently easily treated at fairly low pressures.  

My observation of your CPAP results is that you are at pressures of 4-9 with EPR at 3.  All of your centrals occur at the higher pressures when EPR is at full extent. In my opinion the EPR is providing pressure support that minimizes flow limitation, but pressure is mostly increasing on flow limits (the flow limit graph is mostly cutoff). If I was optimizing your CPAP, I would select a pressure range of 6-9 at EPR 2.

Bottom line is I think you benefit significantly from CPAP, even at low therapy pressures, but your pressure range and EPR need optimized.

Thanks for the input.  I'm not really sure what flow limitation is about, I'll need to look that one up.  Last night I tried the 4 pressure setting, but as Melman indicated it was too restrictive and I felt uncomfortable trying to breathe.  I gave up after an hour and adjusted it up to 5 - 5.5.  No OA's overnight and just one CA, but at the end of the night there were a bunch of RERA's.  I may try different low pressures during the day when I have spare time to see how they feel. 

My wife is doing really well on her machine with scores of 0 or less than 1.  Although she is having trouble getting used to the mask. We are now two peas in a pod with our machines, so life is good!  Merry Christmas and Happy Sleeping to all!!

[Gideon]

Apnea is 80 to 100% obstructed
Hypopnea is 50 to 80% obstructed
Flow Limit is less than 50% obstructed

All for 10 or more seconds.

They are all Basicly the same

[Sleeprider]

If you zoom in on the flow rate graphs, you can see the shape of the flow. Above the zero line is inhale flow, and if the top of that is rounded, you have pretty normal flow that increases rapidly to a peak, then falls off rapidly to zero where exhale occurs. Flow limitation is a flattening or even slowing rate of flow during inhale (flat top or downward slope). We have a couple wiki articles that help explain it.

http://www.apneaboard.com/wiki/index.php...Limitation
http://www.apneaboard.com/wiki/index.php...ailed_look

[fozsleep]

If you zoom in on the flow rate graphs, you can see the shape of the flow. Above the zero line is inhale flow, and if the top of that is rounded, you have pretty normal flow that increases rapidly to a peak, then falls off rapidly to zero where exhale occurs.  Flow limitation is a flattening or even slowing rate of flow during inhale (flat top or downward slope).  We have a couple wiki articles that help explain it.

http://www.apneaboard.com/wiki/index.php...Limitation
http://www.apneaboard.com/wiki/index.php...ailed_look

Well Sleeprider I think you were spot on with the Flow Limitation.  Last night I did another low pressure session, set between 4.4 and 5, using the P10 nasal pillows.  Looking at the inspiration curve they are definitely flattened most of the night.  I think I'll now try your recommended settings for a few nights and see what happens.  I have a slightly dull head this morning, unfortunately I confounded the experiment with a few glasses of wine last night!

[Sleeprider]

Your pressures are extremely low with no range and no EPR. Why?

[fozsleep]

Your pressures are extremely low with no range and no EPR.  Why?

Well that was probably an uninformed decision on my part to see what would happen with minimal CPAP intervention.  Basically seeing if I could replicate my sleep study. I figured if CPAP was needed my AHI would dramatically increase with heaps of OA events etc.  I still question the legitimacy of the original study, however after the advice, explanations on the sleepyhead curves and well, great mentoring on the forum, I am approaching the whole thing with a much more positive attitude.

I've now set the machine to min 5, max 10 with an EPR of 2.  I'll try for a few nights (or maybe a week or two)  and see what happens.  I also realize that my sleep apnea is probably quite episodic. Sometimes I get into  a very deep sleep and other nights I sleep very lightly.  Looking at just a few nights probably doesn't tell the whole story.