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Permalink Reply by Judy on March 9, 2012 at 4:59pm

MORE IMPORTANT than the numbers is HOW DO YOU FEEL??

 

If you are feeling rested, clear headed, etc. the numbers don't mean diddley-squat. If you are still exhausted, foggy, better than before but not as good as you should, well, then we do prefer to see the AI <1.0 and the AHI =<5.0

 

If you do need to improve your results then a pressure change of 0.5 to 1.0 cm for one solid week and then a good look at the data and how you feel, followed if needed, by another 0.5 to 1.0 cm pressure increase for one solid week and another look at the data and assessment of how you feel is in order. Your data numbers are close so make gradual changes, just 0.5 to 1.0 pressure change at a time for one week at a time.

 

CPAP data is not as accurate as an in-lab PSG w/all the data the PSG can provide BUT the value of CPAP data is in the resulting data TRENDS. PSG data for more pin pointed accuracy and CPAP data for trends are complimentary to each other and can get us to our "sweet spot" of therapy.

 

PSG data is limited in that it is only a collection of one night of data, CPAP data is limited in what PAP can detect and report but can indicate trends over multiple nights of sleep. We don't sleep the same every night. And we usually sleep better in our own home and bed than in strange surroundings and strange beds. So think of the sleep lab PSG and the fully data capable CPAP as complimentary tools to improve our sleep.

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Permalink Reply by Perry mcNeal on March 9, 2012 at 8:35pm

Thank you Judy,

How do I set the pressure higher on an automatic machine?

Perry

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Permalink Reply by Judy on March 9, 2012 at 10:17pm

First off what brand and model of APAP? The method varies w/the brand. Second it would probably be a good idea for you to get a copy of the Clinicians Manual for your APAP. IF someone here can't tell you where to get a pdf of the Clinicians Manual ask over at cpaptalk.com, there are several people there who can provide the information on where to download a pdf of the manual you need.

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Permalink Reply by Mary Z on March 10, 2012 at 8:16am

As Judy says what's most important is how you feel.

What is the range on your AUTO- the high and low numbers your machine is set for?

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Permalink Reply by Perry mcNeal on March 10, 2012 at 12:18pm

Thank you so much for your comments.  My Machine is a ResMed Auto Set II.  Settings are as follows:

EPR Level three full time

Minimum Pressure - 11.6

Maximum Pressure - 17.0

Mirage Full

tube length - 3mm

No humidifier

I do have the clinicians manual but it doesn't address this problem or am I just missing it?

Perry

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Permalink Reply by Mary Z on March 11, 2012 at 9:05am

The clinicians manual should have a section telling you how to get into the setup menu.

Your settings actually look pretty good and you might want to talk to your doctor if you don't feel as well as you think you should.  I have found out I don't know as much as I think I do and have begun to shy away from giving layperson advice on changing settings.  My own attemps at self titrating have not been successful. Since your pressure is usually 13.2  your machine only has to adjust up a little bit to get to the pressure you need.

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Permalink Reply by Perry mcNeal on March 11, 2012 at 11:49am

Thank you.

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Permalink Reply by Mary Z on March 11, 2012 at 2:33pm

Perry, in the discussion "can anyone actually sleep??" Judy gives a good description/instructions on setting and AUTO machine which may help you improve your numbers. Here it is:

 

 

If you had an in-lab titration study then setting the APAP pressure range 1-2 cms under your titrated pressure and 3-4 cms above your titrated pressure may get you better results. The key USUALLY is to find that 90%-95% pressure, add 1 cm for a week and see what your averaged AI for the week was. When you find the bottom pressure that consistently gives you an AI <1 then you work on finding the higher pressure to reduce your AHI to <5.

So the lower pressure to control the apneas, the higher pressure to control the hypopneas gives you the pressure range for YOU.

Keep in mind: one change at a time, one week at a time.

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Permalink Reply by Judy on March 11, 2012 at 4:45pm

Thank you, Mary Z. I want to stress making only one change at a time and waiting one week between any changes to see the 7 night's of data before making any further changes. One night does not the entire story tell, especially PAP data vs PSG data. PAP data is good for indicating TRENDS rahter than just one night of results.

 

Also, 6 months of data averages include the difficult first few nights or weeks of data. What do the last 30 days and last 7 days of data look like? Just something else to look at before you attempt making any therapy changes.

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