I've posted relevent parts of my SS here:

www.av8r.org/albums/cpap/index.htm

My questions/observations are as follows:

My doc set me up at 11cm. After reviewing the data, it looks to my untrained eye that I actually did better at between 8-9cm. I was only at 11cm for 9 minutes out of the entire study and again...it looks like I was doing worse at that pressure than at some of the lower numbers. I called my doc and he was very nice going through the numbers with me and said that it would look that way if you looked at just the data, but that his experience tells him to use the higher pressure at least for now. I didn't get an APAP (yet) so unless I complain about not sleeping I'll have to wait 6 weeks for the first card read and followup with the doc.

Based on the data provided, what do some of you think about my using the higher pressure to start? Doesn't it seem like an APAP might be better applied if I'm interpreting this datat correctly?

My thoughts are that I don't want to use any more pressure than I need to. Based on what I've read here and other places, you want to use the minimum pressure that you can get away with.

Thanks in advance for your thoughts.

Z

Hi,

I'm not very good at interpreting this stuff and hopefully others can shed some light.
But it is curious why they should recommend the 11 when the 8 seemed sufficient.
You had more problems at 11, including snoring, if I've read this right.  
I'm wondering if at that higher pressure you were having problems with the mask and breathing, having leaks perhaps.
I know that my graph showed they tested at higher pressures beyond what seemed to work, and they recommended the lowest possible pressure.
If you get an auto cpap and that works for you, then maybe it might not matter.  And maybe the decision was based on how you were sleeping, side vs on back (don't recall if your report said).  I've heard things are worse when you're on your back, so maybe if you're a side sleeper they decided to opt for the higher pressure in case you end up sleeping on your back.  But I'm only speculating based on nothing.  It couldn't hurt to keep asking the doctor for more specific reasons why the higher pressure.

Keep us posted on how things go.


Linda

Thanks, Linda..

I did not get an APAP although not for lack of trying.  They gave me a RemStar Pro II w/CFLEX and HH.  I slept mostly on my back during the study and while I have only had the machine for 2 days, have slept mainly on my back due to the mask leaking while on my side (FP HC 407)  They issued me the HC407 as they had no HC405's in stock.  The 407 is killing the bridge of my nose, but that's another issue for another thread!

My concern is that from what I've read, many people are over perscribed on pressure.  With so little of my study (9 minutes) being at the 11cm, I'm concerned as to why that is the magic number.

I don't want to create an awkward situation with the doc, so I'm hoping to get enough data to talk with him again before my 6 week followup.

Anyone else care to chime in???

Any sleep lab techs on here??

Hi Z:
All things considered, I think 8 cmH2O looks pretty good, too.  You've got a good AHI, REM and SWS sleep, and supine time there.  And at 9 cmH2O you've got some central apneas, which might suggest that 9 is too high.  The snoring %'s on 10 and 11 (how can you have 180% snoring?)  might not really be snoring.  Snoring in PSG is usually just a digital vibration signal, and could also be something such as a mask leak.
The only thing that seems a little out of place is the 19 desaturations you have at 9 cmH2O, most of which seemed to occur at the end of the night.  I wonder if that was the rationale behind trying 11 cmH2O.  Strange they would occur there, when everything was so well controlled at 8.  I wonder if they could be artifact or as a result of some mask leaks.  BTW, the MD could tell that by looking at the raw data.  You're right about the time spent on 11, it's not sufficient to decide anything. I'd press the MD as to the rationale behind the decision to go to 11, and take a closer look at those events at 9 to see if they were in fact valid and not artifact, or a lot of wake/sleep transition (in and out of sleep, not really usable to determine optimal CPAP pressure) at the end of the night.
sleepydave

Thanks for taking the time to review this, Dave.  I think my next step is to talk to the person that runs the lab here and ask them to review my pressure setting.  At 11cm, my mask is obviously more prone to leaking (at least in my simple mind's logic) which may be the least negative effect I could experience.

This doesn't really give me warm fuzzies towards my doc, but we'll reserve judgement till I've talked to him again.

Once again, thanks for your time.  This is a great service that you're providing!

z