When your machine died .... did your AHI go up?

[Cpapian]

Leaks! Egads the bain of my existence.   I am a very heavy sleeper and I sleep at least part of the night on my stomach.  Anything can happen and the leaks don't wake me up.  I have had nights with 70% leaks and I slept right through it.

[Cpapian]

Last night I raised the minimum to 9. with great success.  AHI was 1.04 - only 3 obstructive events, the rest were clear airway events.  I forget to breathe all the time when I am awake, so am not surprised that I do it when asleep.

Not sure if I should increase the minimum to 10 now.  Any thoughts?

The noise from my machine changes every night.  Last night it sounded like a whine.  When I was waking up, my half dream state was trying to fit it to music.

After I rolled over last night, I stopped the machine briefly to mark the rollover.  

Here is my screen shots from last night. 

The first two are the regular screens, the third one is a close up of what the clear airway events look like.

[Sleeprider]

You're good! the whole point was to get you to a better place for comfort with less pressure variation and better results. You already did what was needed, but the continued variation in pressure is coming from flow limitation. If you go to 10.0, I'd say you should also take EPR higher to 2. If you can get the flow limit chart into the mix, we can see what we're dealing with.

[Cpapian]

I think the flow limit chart is on the second screen shot.  It's funny I never really knew what it was, so I just ignored it.  I looked it up on the wiki and it seems pretty straightforward. 

Looking at the flow limit chart, I don't know if it is a lot or normal.   But I do see more towards the end of my sleep.  I notice when I am slowly waking I am often swallowing air.  I think at that point, I am so relaxed that my tongue is not staying up top like it should.   Also, that is the time I am more likely to be sleeping on my back.

[Cpapian]

So last night, I did try the minimum at ten and epr at two.  AHI was a little higher 1.55.  The clear airways and obstructive events don't look a lot different to me.

I don't know what to make of the flow limits.  

Here are the screen shots from last night.

[Sleeprider]

I don't see enough difference here to say you should use higher settings. Use what is more comfortable. You win either way compared to the old settings.

[Cpapian]

Okay.  That's good to know.   Both were fine in terms of comfort.  

Thanks for all your help Sleeprider.  That little tuning has helped a LOT in terms of energy.

[Sleeprider]

Looks greatly improved. Since you seem to tolerate EPR well, I'm going to suggest you take the setting to 3 and we can see if it puts you in an even better place.

[Cpapian]

I didn't sleep at all the night before last, but here is last night's screen shots and results.

I moved the EPR level to 3.

The results are not great, but I think it has more to do with the quality of my sleep.  It seemed as if I woke up numerous times last night.  This is unusual for me and an uncomfortable night's sleep.  It could be because the noise of the machine (which is ever evolving) or the fact that I was overtired.  The DME said my replacement should come in 2 - 3 weeks.  So one week down and 1 - 2 to go.  I hope it is sooner rather than later, but it has to clear customs to get here.

I will try again tonight and hope for a better night's sleep.

Here is last night.

[Sleeprider]

In terms of numerical differences, the increase in EPR reduced flow limitation by a small amount with 95% from 0.09 to 0.06. You gained 20 mL tidal volume which translated to an increase of only .25 L/minute minute vent. Your 95% pressure increased due to more OA events. I think you have to be the judge of comfort, and should give each setting a chance; however I think your previous setting of 10-14, EPR 2 looks pretty good and wins so far.