Anyone do better with lower pressure?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Pugsy
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Re: Anyone do better with lower pressure?

Post by Pugsy » Thu Jan 04, 2018 11:24 am

Chase the statistic so that you can at least answer the question "would I feel better if the AHI is lower?" and be comfortable with the answer to the question.

You may or may not find your answer to why you don't feel so great with the AHI numbers though. I have been down that road myself.
Good numbers don't always mean good sleep or feeling good. So I don't want to rain on your parade....maybe you will be one of those people who can see and feel a marked difference with different AHI numbers. I hope you are.
I really, really wish that feeling/sleeping great was just related to the AHI numbers because I can get nice low AHI numbers pretty easily. That's the easy part. Feeling them now...not always so easy. Long ago I did the "would I feel/sleep better with more pressure minimum" experiment myself.
I discovered that with a minimum of 13 that I felt/slept and had no real difference in AHI. For me the answer wasn't related to sleep apnea or machine numbers or anything that I could fix with the machine.
But I did get an answer to my question even though it really wasn't the answer I had hoped for.

It hurts nothing to try to answer any questions we might have as long as what we might try doesn't turn around and create more problems.
I may have to RISE but I refuse to SHINE.

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Jay Aitchsee
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Re: Anyone do better with lower pressure?

Post by Jay Aitchsee » Thu Jan 04, 2018 12:37 pm

Rainmom17 wrote:Yes everything. Also head to toe neuro exam. Will get vestibular physical therapy starting in 3 weeks although neuro concluded there isn't anything really wrong with me. Vitamin D and ferritin are low-ish so I'm working on both of those. In perimenopause and progesterone is also low-ish, so that may be impacting my sleep and daytime energy levels.
Rainmom17 wrote:Thanks for the list. I do most of those things.
I can tell you that after I got my AHI to a satisfactory level, working diligently on Sleep Hygiene and getting my Serum Vitamin D3 level up to around 50ng/ml seemed to help provide the restorative sleep that a low AHI alone did not. When I started, my D3 level was less than 30. I brought it up by supplementing with 6000 IU per day and now maintain it with 2000 IU per day. I believe all the principles of good sleep hygiene are important, especially moderate daily exercise and caffeine avoidance. Do work to do all of Granny's Checklist, not just most.

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Comfortably Numb
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Re: Anyone do better with lower pressure?

Post by Comfortably Numb » Thu Jan 04, 2018 2:32 pm

Interesting discussion. Not that this has anything to do with the question but after reading some of yesterday's advice, I adjusted my minimum pressure to "the minimum needed to keep your airway open." So I raised my minimum from 7 to 9 since my titration showed the best results at 9. I also raised my maximum "to 2 cm above your 95% pressure." So I raised my maximum from 12 to 14. I ended up having the best uninterrupted sleep since I started last April. My AHI was 0.41, the lowest I've ever experienced. Of course this was only one night, but I don't ever recall improving my treatment when I experimented with lower pressures.

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Rainmom17
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Re: Anyone do better with lower pressure?

Post by Rainmom17 » Thu Jan 04, 2018 3:02 pm

Jay - my vitamin D tends to hover at 32 unless I really hit it diligently with 5000 iu/day. Which I'm currently working on. Limited sunlight here in the Seattle area.

Numb - congrats on your pressure setting changes. Will be interesting to see if it continues to pay off.

I never had a titration study (if I'm understanding it correctly). I had a "split night" but they didn't put a mask on me halfway through. Just got an email 6 weeks later with the results.

luvsbluberries
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Re: Anyone do better with lower pressure?

Post by luvsbluberries » Fri Jan 05, 2018 1:01 am

Speaking of limited sunlight, part of sleep hygiene for those of us in the Pacific Northwest includes the use of bright lighting to battle SAD (Seasonal Affected Disorder). It is pretty common to be dragging during the dark days of winter and maybe this is one of the factors coming into play, at least to some extent.

freetimecreations
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Re: Anyone do better with lower pressure?

Post by freetimecreations » Fri Jan 05, 2018 3:34 pm

Will someone explain why this user's CPAP machine is not raising max pressure above 11? Viewing the SleepyHead screen shot https://imgur.com/uM5evxG it peaks at 11cm but the Max Pressure is set to 14.5.
Thank You

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Mask: AirFit™ F20 Full Face CPAP Mask with Headgear
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Pugsy
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Re: Anyone do better with lower pressure?

Post by Pugsy » Fri Jan 05, 2018 3:37 pm

freetimecreations wrote:Will someone explain why this user's CPAP machine is not raising max pressure above 11? Viewing the SleepyHead screen shot https://imgur.com/uM5evxG it peaks at 11cm but the Max Pressure is set to 14.5.
Thank You
Because the machine either doesn't have time to go to where it needs or it doesn't sense the need to go higher for some reason or other.

Just because a machine can go higher doesn't mean it will go higher.
I may have to RISE but I refuse to SHINE.

freetimecreations
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Re: Anyone do better with lower pressure?

Post by freetimecreations » Fri Jan 05, 2018 5:05 pm

Oh I see, The second Sleepyhead post it went to 12.5
Trying to stick to Rainmom17 topic about not feeling well after CPAP. Does the graph https://imgur.com/uM5evxG show high leaks and does that confuse the machine's complex algorithm?

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Mask: AirFit™ F20 Full Face CPAP Mask with Headgear
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Additional Comments: Pressure 10.6cm-13.2cm EPR 2 Contec CMS50F
Last edited by freetimecreations on Fri Jan 05, 2018 5:15 pm, edited 1 time in total.

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ChicagoGranny
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Re: Anyone do better with lower pressure?

Post by ChicagoGranny » Fri Jan 05, 2018 5:09 pm

freetimecreations wrote:Does the graph show high leaks and does that confuse the machine's complex algorithm?
Which graph are you referring to?

freetimecreations
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Re: Anyone do better with lower pressure?

Post by freetimecreations » Fri Jan 05, 2018 5:17 pm

Sorry, I put in a link.

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freetimecreations
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Re: Anyone do better with lower pressure?

Post by freetimecreations » Fri Jan 05, 2018 10:32 pm

Just to be clear, the graphs I linked to belong to Rainmom17. Thank You for your explanations. To the OP, Keep up being involved in your lifelong treatment.

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Mask: AirFit™ F20 Full Face CPAP Mask with Headgear
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TedVPAP
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Re: Anyone do better with lower pressure?

Post by TedVPAP » Fri Jan 05, 2018 10:36 pm

freetimecreations wrote:Will someone explain why this user's CPAP machine is not raising max pressure above 11? Viewing the SleepyHead screen shot https://imgur.com/uM5evxG it peaks at 11cm but the Max Pressure is set to 14.5.
Thank You
It is very important to understand that the auto algorithm is not perfect. Algorithms operate on the settings (max, min) and various responses (VS, FL, H, OA). If perfect, the pressure range would be open (4-20) and treatment would be perfect. Until auto has been perfected, setting the minimum will impact treatment.

The direct answer to you question is that the need for more pressure surpassed.

In my opinion, the minimum pressure needs to be high enough so that small changes in pressure called by the auto-algorithm are sufficient to minimize most OSA events. Instead of reacting to the fire, instead try to avoid it.

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Machine: DreamStation Auto CPAP Machine
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Humidifier: DreamStation Heated Humidifier
Additional Comments: AutoPAP 16-20, Ultimate Chin Strap http://sleepapneasolutionsinc.com/
Use data to optimize your xPAP treatment:
how to see your data https://sleep.tnet.com/resources/sleepyhead
how to present your data https://sleep.tnet.com/resources/sleepyhead/shorganize
how to post your data https://sleep.tnet.com/reference/tips/imgur

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ChicagoGranny
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Re: Anyone do better with lower pressure?

Post by ChicagoGranny » Sat Jan 06, 2018 11:12 am

TedVPAP wrote:It is very important to understand that the auto algorithm is not perfect. Algorithms operate on the settings (max, min) and various responses (VS, FL, H, OA). If perfect, the pressure range would be open (4-20) and treatment would be perfect. Until auto has been perfected, setting the minimum will impact treatment.
This statement smacks of a failure to consider design limitations.

TedVPAP
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Re: Anyone do better with lower pressure?

Post by TedVPAP » Sat Jan 06, 2018 7:28 pm

ChicagoGranny wrote:
TedVPAP wrote:It is very important to understand that the auto algorithm is not perfect. Algorithms operate on the settings (max, min) and various responses (VS, FL, H, OA). If perfect, the pressure range would be open (4-20) and treatment would be perfect. Until auto has been perfected, setting the minimum will impact treatment.
This statement smacks of a failure to consider design limitations.
I don't understand what you are saying. Please explain.

_________________
Machine: DreamStation Auto CPAP Machine
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Humidifier: DreamStation Heated Humidifier
Additional Comments: AutoPAP 16-20, Ultimate Chin Strap http://sleepapneasolutionsinc.com/
Use data to optimize your xPAP treatment:
how to see your data https://sleep.tnet.com/resources/sleepyhead
how to present your data https://sleep.tnet.com/resources/sleepyhead/shorganize
how to post your data https://sleep.tnet.com/reference/tips/imgur

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ChicagoGranny
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Re: Anyone do better with lower pressure?

Post by ChicagoGranny » Sun Jan 07, 2018 1:31 pm

TedVPAP wrote:I don't understand what you are saying. Please explain.
Ted, You should explain what you mean by a "perfect" algorithm and how "perfect" would work. This might be an interesting discussion. Otherwise, "perfect" just means "magic".