[Treatment] Auto Vs Fixed pressure...opinions?

[toby2111]

                Been on CPAP since 11th May so exactly a month now. Numbers were pretty good at the start but felt noticeably worse each morning. Using auto pressure. Woke up a few times with air blowing downmy throat.Was more tired,had more headaches,very grumpy,moody with brain fog. Spoke with sleep nurse,we trialled a few different masks but kept coming back to the F20 airfit as it was the more comfotable option. Nurse was happy with my low events but also concerned that I was feeling worse. She spoke with consultant who recommended switching to a fixed pressure of 8. Feeling slightly less tired during the day,headaches have eased but still grumpy,moody with a bit of brain fog. Anyone else experience something similar?Any recommendations? I'll attach some results using auto and some results using fixed.

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Fixed pressure results

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Fixed results

[Stubert]

Based on the flow limitation graphs and the P95 numbers in auto mode, your pressure seems to be too low, at 8 in fixed mode. It causes huge amount of flow limitation in REM sleep and oxygen drop. I do not think she did a good job of adjusting to 8.
Please let us see the pressure graphs, to see how the auto pressure responds during the nights. Put the pressure graph in instead of the AHI.
From what I see now, I would put it into auto mode, set pressure at 7 and max 13 - EPR 3 and sleep on your side.

[toby2111]

Thanks for your reply. Really appreciate your help and advice. What graphs exactly would you like to see? Is it the Pressure,Mask Pressure and Time at Pressure graphs? And do you want those when it was set at Auto only?Sorry,I'm new to all this so I'm unsure of a lot of things..

[Stubert]

Take a look here and yes from the nights with auto setting.

https://www.apneaboard.com/wiki/index.ph...ganization

[toby2111]

Pressure added to Auto results

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More results

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pressure

[Stubert]

The pressure is more than 8, in auto mode, most of the nights. Your leaks looks good, but could improve on some nights. The pressure does not generally rise because of leaks, but because you need it.
Look at the last night, here the median is 8.76, which means you where on a that pressure 50% or less, of the night.
Your doctor did really not study your sleep enough, as a fixed pressure of 8 is too little.
You have a lot of low limitation and need EPR to minimize them.
I would try and set auto pressure at 7.6, max at 14 and EPR 3 and see how that feels a couple of nights. And confirm your algorithm is set as "standard" not soft/for her mode.

[toby2111]

The pressure is more than 8, in auto mode, most of the nights. Your leaks looks good, but could improve on some nights. The pressure does not generally rise because of leaks, but because you need it.
Look at the last night, here the median is 8.76, which means you where on a that pressure 50% or less, of the night.
Your doctor did really not study your sleep enough, as a fixed pressure of 8 is too little.
You have a lot of low limitation and need EPR to minimize them.
I would try and set auto pressure at 7.6, max at 14 and EPR 3 and see how that feels a couple of nights. And confirm your algorithm is set as "standard" not soft/for her mode.

Ok,thanks for that. I'll make those changes for tonight and report back here after a couple of nights.
How do I confirm the algorithm?In the Clinical Menu,under Comfort settings,Response was set as Soft.....so change that to Standard?

[Stubert]

Yes change that to "standard", it reacts faster and better 

[toby2111]

Yes change that to "standard", it reacts faster and better 

Thanks very much. I'll report back later in the week. Appreciate your help.

[Deborah K.]

Also, it helps us help you if you change your Oscar screenshot a little. Please list the following, in the order listed: Event Flags, Flow Rate, Pressure, Leak Rate, and Flow limits. We need to see to the very bottom of the flow limits.