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RE: Lower AHI and FLs with lower pressure - Zorki1c - 02-27-2020

Ive been on CPAP about 7 years. They started me with a pressure of 11. After a month dropped it to 8. That got my average under 5 but just barely. Then they dropped it to 6 and done then my ahi is seldom over 2 and usually around 1. I just used fixed pressure. I’ve messed with Autoset but never get as consistent results as I do with fixed pressure.

RE: Lower AHI and FLs with lower pressure - sleepyp - 02-29-2020

Just a quick update.
Results have been consistent, last night's OSCAR graph attached. Average AHI for the last 8 nights is 1.2, that includes one night of 5.6 when I had a really stuffy nose.
As you can see, the CAs are all short in length and follow a deep breath/sigh, I'm not going to worry about those and consider last night to be AHI=0.

For someone who is 192cm (6'3") and 90kg (198pounds) I've been expecting my minute vent to closer to the higher end of the "normal" range.
It's consistently in the 5.8-6.2 range since using lower pressures, though I have often suspected my lung capacity isn't great anyway.

[attachment=20489]
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I'd say I've finally found CPAP settings that work for me.  Thanks
Does anyone know some good CPAP settings for keeping a 20 month old in their own bed all night?   Dont-know

RE: Lower AHI and FLs with lower pressure - Geer1 - 02-29-2020

Cage with a lock and earplugs? lol

Yeah centrals occurring after an odd breath are normal (at least at those low levels) and lots wouldn't be scored in a PSG.

RE: Lower AHI and FLs with lower pressure - Sleeprider - 02-29-2020

It's good that you tolerate the EPR at 3 with pressure at 7.0. In spite of the CA events this should produce comfortable and effective therapy, and your CA events will likely attenuate slowly as this pressure becomes your new normal.   I knew you were going to arrive at a good place when you posted this:

Quote:Lessons I've learned in the last 5 months that I'd tell my younger self in hindsight:
* The sleep study is the key. In my case - no CAs or OAs in sleep study. Therefore I should have known that CAs and OAs after CPAP were/are treatment emergent. That's right, OAs can be treatment emergent too if your doc sends you home with an auto machine set 4-20. Knowing that, coupled with the knowledge shared on this forum would have gotten me to a solution quicker
* Hypopneas (in the absence of OAs) require very little pressure to solve, and they seem to respond even better to a little pressure support. The AirSense is a superior machine to the Dreamstation in this instance. Resmed incorrectly call their PS feature "EPR". It's not expiratory pressure relief, it's inspiratory pressure support and should be named accordingly to avoid confusion
* More pressure is not always more in CPAP world, in fact in some cases less pressure is more. There seems to be consistent dogma on CPAP forums that one should use auto mode and leave maximum at 20cmH2O to "see where the machine goes". You often see people saying that the machine "won't go there unless it needs to", and that's simply not true. Any machine simply responds to what it detects based on it's response algorithm. It may be that this is good advise in the majority of cases, but certainly not all cases, and I don't think it shouldn't be so universally advised. If you experience treatment induced apneas (CAs and OAs) beyond a certain pressure and the machine crosses your "pressure threshold" in auto mode then you're in a world of misery. Maybe my case is in the minority, but minority lives matter too!  [Image: smile.gif]
* A slack jaw is the enemy of CPAP treatment. If your mouth is prone to dropping open then cervical collar and mouth taping seem to be the best immediate resolutions. This includes for FFMs, which I also tried for a long time, FFM don't really protect against an open mouth in the sense that accurate event detection and response is still compromised, plus it significantly increases leaks. Tongue suck may work eventually for some people, but I'm buggered if I can master it  [Image: wink.gif]