For pressure being too low, the usual issue is that the AHI is not reduced to levels below 5.0. Although in that case it's not always easy to just fix the problem by increasing pressure.DanOtn wrote:Thanks for the answer!
What kind of issue's would point to a pressure problem?
For pressure being too high? Well, in my case, aerophagia, air getting into my eyes through my tear ducts, and a serious crash and burn in terms of day time functioning due to severe sleep deprivation that STARTED immediately after I started CPAP were among the symptoms that lead my PA to first recommend a week of autotitration that lead to a pressure decrease from straight 9cm to APAP range of 4--8cm. Continued (but reduced aerophagia) and continued crash & burn with sleep deprivation symptoms lead to the recommendation for a bi-level titration and a switch to a BiPAP. Continued aerophagia issues popping up in my insomnia sleep log lead to the recommendation for a second bi-level titration, which lead to the BiPAP levels being reduced from 8/6 to 7/4.
I don't think so. The critical thing that determines the need for CPAP/APAP is the AHI or RDI on the diagnostic sleep study. (Whether it's the AHI or RDI depends on how the lab scores certain things.) It might be unusual, but it is possible for a person who has really severe OSA (diagnostic AHI well above 30) to only need a minimum pressure of 4 or 5 cm to bring that AHI down to less than 5. It's also possible (and not that unusual) for a person with fairly mild OSA (diagnostic AHI between 5 and 15) to need a pretty high pressure setting---say above 12---to properly splint their airway open. The amount of pressure you need is more determined by the structures in your throat and how they react to the pressurized air being blown down your throat rather than the overall severity of your OSA.And... is there a minimum pressure... where the insurance might say "this person doesn't need CPAP/APAP"?