Adjusting to higher pressure

[JeffV]

Finally got the results back from my titration study yesterday, and my pressure went from 9-15 to 14-20. I've been on a min pressure of 9 for the last six months, and it was even lower before that (7, I think) so this is a pretty big jump for me. I slept with that pressure last night and didn't really have trouble falling asleep, but I know I was waking up and tossing and turning a lot. Exhaling against that much more pressure was definitely different, and that much pressure in my throat was bugging me. Is this something I'm just going to have to suck up and get used to? Any tips for making the transition? I've already turned up the EPR (A-Flex+) as high as it'll go and I used a 5-minute ramp up from 9 last night.

Thanks!

[popcpoo]

I am running 15 - 20 EPAP and 20 - 15 IPAP. These are my initial settings when I got my machine. It took a few nights to get used to the pressure. Now, when I wake up at night, I often wonder if the machine is working correctly.

[Bill44133]

Hi Jeff! I have a pressure of 23 and it does take some getting used to. I used to say it was a Hurricane going to bed and a tripical breeze by the time I wake up. Believe it or not now some times I wonder if the machine is really giving me 23.

The biggest issue you will have to deal with is leaks. With higher pressure leaks could become a problem. Make sure you are using some type of liner with your mask that holds the leaks down to acceptable levels.


I wish you well....

[Pugsy]

Mainly the difference is going to be the starting minimum pressure...going from 9 to 14 is a big step.
You could just suck it up and you will eventually get used to it but you could also take it in small steps and it won't be so stressful and uncomfortable
Use 10 cm minimum for 3 or 4 nights so you are used to it...then move to 11cm for 3 or 4 nights and so on. Even use 0.5 cm increments if that helps. Go ahead and leave the max at 20 though.

Sometimes I think big jumps like that to the pressures in the mid teens is harder for someone who has been on cpap for a long time because the body gets used to one way of having things done and then we throw it a curve with a big jump. Newbies who have never used a machine who are prescribed those higher pressures never knew a lower pressure so their adjustment is actually a bit easier. Their bodies haven't had months or years at a lower pressure.

Do whatever let's you get to sleep easier and more comfortably.

[JeffV]

Thanks for the advice, Pugsy - I think I'll do exactly that. I set my min to 10 last night and had no trouble at all.

Hi Jeff! I have a pressure of 23 and it does take some getting used to. I used to say it was a Hurricane going to bed and a tripical breeze by the time I wake up. Believe it or not now some times I wonder if the machine is really giving me 23.

The biggest issue you will have to deal with is leaks. With higher pressure leaks could become a problem. Make sure you are using some type of liner with your mask that holds the leaks down to acceptable levels.

I understand about getting used to the pressure, for sure - when I first started I had to ramp up to 7, and now I don't even blink at 10.

As far as liners go - are there liners for pillows? I know about barrel cozies (and I have one) but that's not really there to address leaks... I'll keep an eye on the leak graph and I'm sure I'll be posting some for peer review here, but is there really anything to do if leaks become a problem?

[Pugsy]

As far as liners go - are there liners for pillows? I know about barrel cozies (and I have one) but that's not really there to address leaks

The barrel cozies are pretty much it for something like a liner for nasal pillow masks. Now some people thought the n barrel cozy helped with leak control and some thought it made things worse so that's another one of those YMMV things.
I used a barrel cozy all the time when I was using the Swift FX. Even in the summer and I really didn't need it for rain out control (my primary reason for buying it in the first place) because it just felt so good against my skin. I never could really tell any difference in the leak situation though. No better and no worse but then I always have worn my nasal pillow masks disgustingly loose. I have found that they rarely move even when the straps are barely on my head.
Even now with the P10 I might wake up with that back strap that starts out down at the base of my skull ending up on top of my head and the pillows are still stuck in my nostrils. I am all over the bed too...I toss and turn a lot because I just can't stay in any one position very long due to joint pain.

[JeffV]

Even now with the P10 I might wake up with that back strap that starts out down at the base of my skull ending up on top of my head and the pillows are still stuck in my nostrils. I am all over the bed too...I toss and turn a lot because I just can't stay in any one position very long due to joint pain.

That's how I am with the Nuance... The strap rides up all the time and I only get a very little bit of leak. Of course, that's at 9... I guess I'll just wing it and see what happens! Thanks for the advice.