Trying to narrow in on optimal settings

[ajack]

You can make large changes, if it's obvious. It's just that then, you leave it for a few days to settle. You can also use 7 or 30 day averages to fine tune. What you don't want to do. Is to react to normal nightly changes and be in a flux of raising and decreasing pressure.

[CPAPUserDave]

Bonjour: ".. we are not monitoring you live"

Yet

future endeavor for OSCAR???

[CPAPUserDave]

after 2+ weeks making the below changes, still have some interesting flow limitations going on. some look rather scary but with that being said, I am feeling better during the days as far as being more rested. Wondering if I am chasing something that I will not catch with this machine or should I keep increasing minimum pressure and see what happens. every time I raise minimum pressure, the 95% numbers rise. My gut tells me that improvement is still needed and then my body can start working on that sleep debt.

the increases in pressure did not disturb me that much. that is why a little aggressive in raising pressure. managing the mask leaks is probably the biggest hurdle that I have had to overcome. Just have to work on that a little more. big difference from 10.0 fixed to 95% at 16.0+ but I will win the battle. easier every night  

Appreciate any thoughts.

Dave


Date     Mode     AHI     IPAP     EPAP     EPR     MED      95%      MAX     "HDYF" (How Do You Feel)

6/14     CPAP      0.64    10.0       7.0       3.0     10.0      10.0      10.0      
6/15                  0.32     8.0        7.0       1.0      8.0        8.0        8.0

6/16     APAP      0.36     8.0       20.0      3.0      9.20    12.36      14.56      7/10 (10 being refreshed)     
6/17                  0.37     8.0       20.0      3.0      8.90     10.20     11.54      5/10
6/18                  0.24     8.0       20.0      3.0      8.86     10.36     11.60      6/10
6/19                  0.36     8.0       20.0      3.0      8.72     13.22     16.44      6/10
6/20                  0.48    12.0      20.0      3.0     12.14    12.82      13.76      4/10
6/21                  0.10    12.0      20.0      3.0     12.14    12.82      14.28      4/10
6/22                  0.20    13.0      20.0      3.0                                             7/10
6/23                  0.36    13.0      20.0      3.0      13.40    14.30     14.76      8/10
6/24                  0.25    13.0      20.0      3.0      13.26    15.02     16.32      7/10
6/25                  0.36    14.0      18.0      3.0      14.22    14.90     15.50      7.5/10
6/26                  0.12    14.0      18.0      3.0      14.06    15.32     16.12      8/10
6/27                  0.24    14.0      18.0      3.0      14.16    14.56     14.80      7/10
6/28                  0.21    15.0      18.0      3.0      15.28    16.38     17.20      8.5/10
6/29                  0.51    15.0      18.0      3.0      15.50    16.58     17.86      8.5/10
6/30                  0.36    15.0      18.0      3.0      15.36    16.54     17.44      8.5/10
7/1                    0.25    15.0      18.0      3.0      15.28    16.74     18.0       8/10

Tonight                        16.0       20.0      3.0      To Be Determined.....

[ajack]

No one is going to get a perfect night and there will be periods of irregular breathing and partial obstructions. It's better to see the daily charts, you can load them to imgur, if you can't attachem them all here. I was thinking to say, just going by the numbers, min13-14 looks on average about it, but then I saw your final line of 16. You can chase down the final events. You aren't lowering your AHI and you need to look at the chart to see if there are events that need fixing. The machine is finding stuff to raise pressure on, you need to look where the machine changes pressure and see if you think it's worthwhile.

[CPAPUserDave]

[attachment=13421][attachment=13422][attachment=13423][attachment=13424][attachment=13425]


Above are some screenshots of last night sleep. some 3-minute close ups of flow limitations (every two hours). pretty consistent all night long

Note I've change settings to 16.0Min   20.0Max   3.0EPR

once again, my 95% increased in correlation to minimum pressure increase. Why???
what is my machine trying to chase? I don't see anything but flow limitations which is pretty much all night long?

[Sleeprider]

Dave, time to ask yourself, where you were most comfortable, and stop chasing improvements.  Your results today are identical to where we started as shown on the following graph at a median pressure of 8.0.  Your tidal volume, respiration rate and minute vent statistics are nearly identical with slight improvement for flow limitation, but not so much that you'd notice.  find the pressure that makes you feel best, and long-term consider whether additional improvement will be worth an investment in a Vauto bilevel.   Between you and I buddy, this increasing pressure is not taking you anywhere worthwhile.  Go for comfort.

[CPAPUserDave]

Sleeprider: That is what I needed to hear. If raising pressure is not going to get me anywhere (and I guess there is data that shows that) then I'm all for comfort as long as it also makes me feel better/more rested the next day. Never felt totally rested the next day until started to raise pressure. seems like around the 13.0 minimum pressure is when started to feel more rested. I'm thinking I will start working my minimum pressure downwards towards that mark and see how I feel each day. (And I probably should NOT look at the numbers and concentrate on how I actually feel). If I can go even lower, then I will continue.

would not mind at all if I could loosen the mask straps, not have to deal with more numerous mask leaks, eliminate the dry mouth, ... 

 


Dave