Too much pressure?

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alpha752
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Too much pressure?

Post by alpha752 » Sat Nov 28, 2015 1:04 pm

Is there such a thing as too much pressure? Instead of trying to find the just right lowest pressure, can you (provided you can tolerate it) just set the machine to 20 and be good?

What could too much pressure do?

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kaiasgram
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Re: Too much pressure?

Post by kaiasgram » Sat Nov 28, 2015 1:16 pm

For some people too much pressure could trigger central apneas. Too much pressure could also cause problems for people with additional respiratory and other medical conditions.

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Julie
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Re: Too much pressure?

Post by Julie » Sat Nov 28, 2015 1:48 pm

However, just putting the machine on a high setting doesn't mean much because it doesn't raise your pressure to meet that setting - your pressure will only go up to any setting in response to an apnea, or in anticipation of one, so don't be afraid of centrals on that account - lots of people leave their high setting on 20. It's the low setting that can be problematic, but again only if it's high, and only if you're susceptible... centrals aren't automatic or anything close just because you have a high setting.

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BlackSpinner
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Re: Too much pressure?

Post by BlackSpinner » Sat Nov 28, 2015 1:56 pm

Just check the data on your machine to see what you need.

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OkyDoky
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Re: Too much pressure?

Post by OkyDoky » Sat Nov 28, 2015 2:05 pm

Julie wrote:However, just putting the machine on a high setting doesn't mean much because it doesn't raise your pressure to meet that setting - your pressure will only go up to any setting in response to an apnea, or in anticipation of one, so don't be afraid of centrals on that account - lots of people leave their high setting on 20. It's the low setting that can be problematic, but again only if it's high, and only if you're susceptible... centrals aren't automatic or anything close just because you have a high setting.
He doesn't state if he means an APAP setting or straight CPAP.
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kaiasgram
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Re: Too much pressure?

Post by kaiasgram » Sat Nov 28, 2015 2:23 pm

OkyDoky wrote:
Julie wrote:However, just putting the machine on a high setting doesn't mean much because it doesn't raise your pressure to meet that setting - your pressure will only go up to any setting in response to an apnea, or in anticipation of one, so don't be afraid of centrals on that account - lots of people leave their high setting on 20. It's the low setting that can be problematic, but again only if it's high, and only if you're susceptible... centrals aren't automatic or anything close just because you have a high setting.
He doesn't state if he means an APAP setting or straight CPAP.
He said "can you...just set the machine to 20 and be good?" He can come back and clarify if he actually meant set the max pressure to 20.

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Last edited by kaiasgram on Sat Nov 28, 2015 2:50 pm, edited 1 time in total.

alpha752
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Re: Too much pressure?

Post by alpha752 » Sat Nov 28, 2015 2:42 pm

I mean cpap. My machine doesn't have full data, it just does AHI and hours used. My question was more along the lines of, if a pressure of 14 is good, would 18 be better? Or at least not harmful? With out seeing full data, I can't be sure if my therapy is optimal, and I don't necessarily trust the AHI reading. So my thought process was that, if there were no consequences, wouldn't it make sense just to use the maximum tolerable pressure?

This question comes from straight ignorance, so please forgive me.

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kaiasgram
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Re: Too much pressure?

Post by kaiasgram » Sat Nov 28, 2015 2:48 pm

alpha752 wrote:I mean cpap. My machine doesn't have full data, it just does AHI and hours used. My question was more along the lines of, if a pressure of 14 is good, would 18 be better? Or at least not harmful? With out seeing full data, I can't be sure if my therapy is optimal, and I don't necessarily trust the AHI reading. So my thought process was that, if there were no consequences, wouldn't it make sense just to use the maximum tolerable pressure?

This question comes from straight ignorance, so please forgive me.
No apology needed.

So if 14 is good, it does not necessarily follow that 18 would be better or not harmful. It depends on a lot of factors.

I'm not familiar with your history -- how long have you been using your machine and what is your typical AHI? What is the make and model of your machine?

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alpha752
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Re: Too much pressure?

Post by alpha752 » Sat Nov 28, 2015 2:57 pm

I've had OSA for almost 10 years. Was noncompliment for a long time. Been back on the mask for about a year. Machine is an Airsense 10. Before that I had a Remstar (don't know the model, but it had full data). AHI is typically below 2, but with the old machine I would see a lot of hypopneas and snore events that didn't register in the AHI. Now I can't see that stuff, so it makes me wonder.

I just want to make sure I'm getting the best therapy I can, and the pressure at 14 doesn't bother me, so I wasn't sure if going up would do more harm or good.

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kaiasgram
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Re: Too much pressure?

Post by kaiasgram » Sat Nov 28, 2015 2:59 pm

alpha752 wrote:I've had OSA for almost 10 years. Was noncompliment for a long time. Been back on the mask for about a year. Machine is an Airsense 10. Before that I had a Remstar (don't know the model, but it had full data). AHI is typically below 2, but with the old machine I would see a lot of hypopneas and snore events that didn't register in the AHI. Now I can't see that stuff, so it makes me wonder.

I just want to make sure I'm getting the best therapy I can, and the pressure at 14 doesn't bother me, so I wasn't sure if going up would do more harm or good.
Well there might be room for more pressure, but first: which AirSense 10 model do you have? The name should be on the front, lower right and would be either CPAP, Elite, or Autoset...

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alpha752
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Re: Too much pressure?

Post by alpha752 » Sat Nov 28, 2015 3:24 pm

CPAP. I asked for an Elite, but my DME gave me the brick.

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kaiasgram
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Re: Too much pressure?

Post by kaiasgram » Sat Nov 28, 2015 3:40 pm

alpha752 wrote:CPAP. I asked for an Elite, but my DME gave me the brick.
A frustrating and common story.

With your AHI already below 2, just be careful and go slow (and small) with any pressure increases you try. Give any adjustment you make a good week or more before evaluating and making another adjustment. If your AHI goes down a little more, great. If the AHI starts to climb up, then bring the pressure back down because that might be centrals popping up and causing the AHI to go higher.

To a comment you made earlier -- snores do not factor into the AHI, but hypopneas always do. The other variable that does not factor into AHI but can definitely affect sleep quality is flow limitation (read: limited air flow), a partial compromise of the airway which can be a precursor to an apnea or hypopnea, but can also just stay flow-limited breathing without turning into an event. Increasing the pressure could help if you have a lot of flow limitations and snores, and perhaps could also bring your AHI down a little more too, but as I said just go slow and gentle with it.

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alpha752
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Re: Too much pressure?

Post by alpha752 » Sat Nov 28, 2015 4:23 pm

Thanks so much for the information and help!

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kaiasgram
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Re: Too much pressure?

Post by kaiasgram » Sat Nov 28, 2015 5:23 pm

alpha752 wrote:Thanks so much for the information and help!
Very welcome

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fbecke
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Re: Too much pressure?

Post by fbecke » Sun Nov 29, 2015 8:03 am

i have been using this therapy since 1999. my pressure was set at 7. After losing the machine via Hurricane Katrina, i had my new PCP physician write me a script for 9. i cant imagine setting my AirSense 10 at 20. Wow, that's high! My question focuses on what is the ideal setting..