[Treatment] New User Seeks Guidance

[SarcasticDave94]

Yes I'd agree. Keep working with your doc but maybe add a gentle nudge with something like "discomfort is still consistently higher, can we consider the ASV titration?". If the opening appears soon then take it, but still keep prepping doc that ASV is a goal for your therapy. Makes sense I hope.

[Gideon]

I'm not saying this is you.

Someone says "how do you feel?" What is your response? I'll bet it is something like "I feel fine.". You do that with your doc and he thinks everything looks normal enough, great, I'll see you next year for a follow-up.

Instead write out a lot of symptoms you are having

I am still having trouble falling asleep, and when I do
I am still waking up too many time
I still see an awake breathing pattern after I have CA events, etc.
Be prepared give him the list, it will then appear in your medical record.
Hey doc what is the best way WE caninimize those CA events and eliminate those awakenings? Do you think an ASV could do it.

You got the idea

[SarcasticDave94]

FWIW that's what I'm meaning when I suggest noting symptoms and complaints to tell doc.

Yep saying "I'm fine" will stop all further action into machine changes. In cases like this, you have to become negative, woe is me it's bad.

[Sleeper396]

Got it!  Thanks, Dave.

[Sleeper396]

Good strategy, thanks Gideon.

[Sleeper396]

I have a question about minimum pressures. My minimum pressure is 8, and I am spending 20% of my sleep time at my minimum pressure of 8 (with no ramp and no EPR). How do I know that my body does not want a lower pressure, say 7.6?  OA's last few nights were down to 1.65 index, and OSA's and H's are mostly gone -- yielding a total of just about 2 AHI. Do you think that I should test a lower pressure, or is there no purpose to it (and I will leave well enough alone)?

[SarcasticDave94]

If you want to try a lower pressure you can. View the results in what it increases in comfort and see if events increase.

PS there's a catch though, if ultimately you want ASV but prove high therapy effectiveness with CPAP, then you may inadvertently prove that ASV isn't really needed.

[Sleeper396]

If you want to try a lower pressure you can. View the results in what it increases in comfort and see if events increase.

PS there's a catch though, if ultimately you want ASV but prove high therapy effectiveness with CPAP, then you may inadvertently prove that ASV isn't really needed.

That is a "catch 22," and a good point; but I think that I should probably try to make the current therapy as effective as possible to see if the CA's will further reduce over the next few weeks, and perhaps I could remain with APAP.  Thanks for the alert.

[Sleeper396]

So for the last 2 nights, my AHI has dropped from an average of 3.2 (for the last 30 days), to below 1. Last night my AHI was .26, with only 2 hypopnea events. There were 0 CA's, which has been the source of the majority of my apneas.  The night before there were only 2 CA events and an AHI of .86. I watched the screen of the ResMed upon waking up multiple times, and most of last night my AHI was 0.  I am beyond amazed.  Is it possible that the machine is wrong? It is a brand new ResMed AirSense 10 Auto Set that I just purchased 60 days ago. Why would I be doing so well? I have been envious of people whose AHI was down so low, and now I am seeing it for myself. Could this be a fluke? I have been using a soft cervical collar for 2 weeks now, and it is working great. There is only one difference over the last few nights. I am sleeping on a different bed/different mattress. I am visiting with my family and sleeping on a bed which is completely different in firmness, etc., from the one that I use at home. It is very comfortable, with slight firmness. Could the mattress change be improving the AHI so dramatically, and even eliminating my CA's? Can I trust the ResMed machine data? Here are 2 nights showing last night's .26 AHI and another night of my typical AHI for the month, showing 3.7. Please give me your thoughts on this., as I am truly astounded (in a good way), but I need experienced input on how to interpret this change.  Thank you.

[SarcasticDave94]

I don't know why it couldn't be accurate. There's one night of good stats. A few more and you'd have a trend. Until then your trend is more like the one with AHI if 3.x, with some scattered event flags.

Did you sleep well on that night of .26 AHI?