Encore software results

Thanks to Derek's TERRIFIC encore review/tutorial, I garnered courage to splurge on the software which arrived yesterday.

I titrated at 12 and was on that fixed pressure for 6 weeks to treat severe apnea. The doc was going to increase it to 14 when I convinced her to switch me to an auto, which she rx'd at 10-16. Just downloaded my first 2 weeks of data. Excellent numbers: AI .5; HI .9, AHI: 1.5, FLI 1. The pressure ran 10-11, only reaching 12 once for a minute. Couple questions:

1) I don't have any trouble with pressure level. Should I still try to tweak the lower pressure? Or not mess with a good thing?

2) Despite the great numbers and dramatic improvement on my heart conditions, I'm still pretty tired. My sleep studies showed very high number of spontaneous arousals (which doc couldn't explain). With these good numbers, is this as good as it will get? Has anyone been able to explain/address spontaneous arousals (not attributed to apneic events, restless legs etc) ?

My doc only looked at compliance, saying the event graphs were too confusing and she didn't have them~ which motivated my software purchase. I'm pleased with the good numbers, albeit an expensive affirmation. Thanks again to all the valuable contributors to this forum.

I'm glad the review was helpful

I don't like to prescribe for others, but seeing your results were so good, if I were you, I would be tempted to lower the minimum pressure a bit and see how you do. What's to lose?

In my case I was titrated at 12 cm, but I now have the minimum pressure set at 8cm, and it hardly budges from there. As far as I am concerned it's a trade-off between comfort and AHI. Whatever works...

Good luck!
derek

You might try as Derek suggested to reduce the lower limit to 8 or so. You might see your AHI go up a bit, but <5 is considered good.

Some of the recent posts regarding tweaking our range of pressure on the autopap have got me thinking. Might it be a better (and safer) method to start at a very narrow range around our titrated pressure and then open up the range slowly and see if we maintain or improve our AHI? This approach seems to begin with therapy closest to what is prescribed and then cautiously expands the range to get more benefit from the auto's self-adjusting feature. What do you guys and gals think?

I thought that was what everyone was doing. Resmed changes in .2 increments. PB 420E in .5 increments. Why not start at titrated pressure +/-2 and go from there. Tweaking lower for comfort as long as problems don't develop.

Cheers,

Chris

Wader, that sounds like a good idea to me (I'm not a doctor.)

With the software a person can see if they are bumping the ceiling of whatever upper pressure has been set. I don't think I'd bother raising the upper pressure unless I saw that I was hitting it a good bit.

But the lower pressure - yes - tweak away if one wishes. After all the tweaking is said and done though, I'll bet most find that a lower pressure not more than three cm H20 below the titrated (doctor prescribed single pressure) works best in the long run.

As Derek said, it's a tradeoff. Trying to get a lower AHI doesn't always equate to how comfortably we sleep with pressure coming in.

Mikesus mentioned that people are usually doing fine if the AHI is below 5. So, I wouldn't worry too much about whether the AHI is 1 or 2 or 3, as long as I felt equally well each morning.

The software is invaluable, imho. That, and "how you feel", are good ways to check how treatment is going.

I, too, had the spontanous arousals. I am curious if we may have another sleep disorder accompanying us?

What does everyone think about this "spontaneous arousal" thing? I am still waking up. Last night I was able to do two loads of laundry during the night, what is the deal?