decreasing pressure improved AHI

[Elle]

This is probably something really obvious to you cpap gurus but it surprised me. I had been on a pressure range topped at 16 and hovered near that range most of the night. I recently lowered it to 14 to see if ear pressure would decrease. It did somewhat but I saw a new DME who lowered the pressure to 12 and my AHI dropped (already in a good range) and now at a pressure of 11 it is still great (mostly under 1).

It bothers me that I was on such a high pressure for so long if it wasn't necessary and am also curious as to why I would meet the top pressure no matter what it was.

Just ruminating out loud here.

[Wulfman...]

Doesn't surprise me at all.
You didn't say what your minimum pressure is, but that could make some difference in tweaking your therapy.


Den

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[Julie]

Since when do DME's play doctor?

[Elle]

Thanks Den, minimum is 8 and hasn't been changed.

[Elle]

I don't understand your comment in this context Julie. The respiratory technologist was following a suggestion made by me because he agreed it might work to decrease ear pressure. I didn't see him acting doctorish.

[Wulfman...]

Thanks Den, minimum is 8 and hasn't been changed.

OK. I momentarily forgot about your ear issues.
Anyway, glad to hear your numbers have improved.


Den

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[cnaumann]

It is quite possible that the higher pressure was triggering central or complex apneas. With complex apnea, you can have a central apnea with a closed airway. You are basically holding your breath in your sleep. If your machine sees an apnea with a closed airway, it responds by increase pressure. The increased pressure causes more events, and the pressure stays near the maximum all night. Auto CPAP is not for everyone.

[Elle]

Cnaumann, thank you. I really should try to learn this stuff. It bothers me that former dme's missed this.

[Julie]

Oh, ok, I wondered, but wasn't sure.

[Elle]

I am down to a pressure of 10 (which is where I had it set for 5 years using a brick) and AHI was 0.5 last night.

It is puzzling to me that when I got the auto machine and DME kept upping the top pressure when I would hover at the max number most of the night but now am feeling better back at 10 and still have great numbers. I really hope this solves the dizziness.

[Sleeprider]

It is quite possible that the higher pressure was triggering central or complex apneas. With complex apnea, you can have a central apnea with a closed airway. You are basically holding your breath in your sleep. If your machine sees an apnea with a closed airway, it responds by increase pressure. The increased pressure causes more events, and the pressure stays near the maximum all night. Auto CPAP is not for everyone.

The machines do not attempt to increase pressure to clear an apnea. They increase due to flow limitations and snores to prevent H and OA.

[Guest1]

Elle. The CPAP pressure needed to treat OSAHS reduces from the original titration. The following article provides more data on it.

ncbi DOT nlm DOT nih DOT gov/pmc/articles/PMC1765906/pdf/v053p00S49 DOT pdf

It could be that your pressure need has reduced since you started CPAP.

[Elle]

Guest, Thank you for the link. It was interesting....skimmed...will read again and pass to my sister who was only given a cpap machine (data but no auto).

I am pretty sure if I set the machine higher I would still stay at the top number but because of paranoia about ear pressure I don't want to test it. I am thinking I will go to pressure of 9. I was at 10 for years with a non auto/non data machine and was fine. I had lost a ton of weight years ago and pressure needs didn't seem to change. Also, since 5 sibs have OSA and they are not overweight I am thinking there might be a structural reason for the Dx.

The vertigo has been getting worse but may be unrelated to higher pressures. I appreciate the input.