Need help with pressure settings

I want to optimize my therapy, but don't know what my pressure range should be. My doctor set the pressure at 4-12. I very quickly took the advice I got here and raised the minimum to 6. I recently bumped it up to 7. I look at my Sleepyhead data every few days and have found that my pressures are all over the place. Some nights the pressure will stay close to 6.5 all night. Some nights it will hover at around 10. Other nights it will go up and down all night. Some days I feel pretty good, but most of the time I start to fade in the afternoon and some days I can barely function. There is no pattern with high or low pressure and how I feel.

I have UARS, so I can't rely on AHI to tell me what's working, as it is usually 0.2. The one issue I definitely have is a problem with large leaks, so I'm going to try a FFM tonight.

I also have PLMD, so I guess it's possible that an improvement in UARS is allowing the PLMD to become worse.

Any suggestions? I wear my mask all night, every night, work out five times per week and practice good sleep hygiene. I just want to feel better.

Thanks very much for your help!!!

UARS makes it difficult to use the usual data points for therapy evaluation.

It's possible that the pressure changes themselves are affecting your sleep quality...meaning that if they go bouncing around a lot during the night then the changing pressures themselves could maybe be causing arousals (which you already are probably sensitive to because it seems like UARS patients tend to be highly sensitive).

Maybe tried a fixed cpap pressure or if you want or need the variability of apap because maybe pressure needs change during the night due to sleeping position or REM stage sleep (both are common causes for those variations you are seeing) use a small tight range in apap mode....like maybe 8 or 9 cm fixed or 8 to 10 apap range.

Gotta deal with the mask issues too...using a fixed or very limited apap range could help keep leaks better managed since the pressure changing wildly won't be as likely to disrupt the seal.

Which APAP mode are you using...the regular or the for Her mode?

Since you have an A10 Autoset for Her model, switch on the mode where you can also track RERAs. View your RDI in Sleepyhead s/w. RDI = AHI + RERAs so it will be a better proxy for your UARS treatment effectiveness. After RDI is under control, you can see how you feel and then if needed, tweak more to chase out FLs too from your daily reports.

Thanks very much for the help. I'm using the Auto for Her mode. I just adjusted the pressure range to 8-10. I think you may be right that the wider pressure range is disturbing my sleep. I'm also seeing a lot of RERAs and FLs, so hopefully a higher minimum pressure will help those.

I'm also going to try the Simplus FFM tonight because of the leak issue. I'm pretty sure that jaw dropping is the problem.

Thanks again for the help!

A higher minimum pressure should help with the RERAs and FLs.
You are the first real known UARS person that I know of using this new algorithm. I am really interested in what happens with you so please keep me in the loop if you can.
If the changing pressures are too much of a problem I bet we can set the minimum to equal he maximum or use a tinier range and lessen the pressure changes without having to give up the algorithm..

Minky:

Please keep us informed of your progress with this new machine of yours. I suspect many people like myself are interested in how you mitigate the problem.

I slept last night with a range of 8-10 and my data today showed a DRAMATIC reduction in both the number and intensity of flow limitations, so thank you very much for the advice. The sleep lab told me that I would need very low pressure, but that's not the case. My FLs are still not perfect, so little by little I'm going to raise the pressure range, but I'm still going to keep the tight range because the lack of big pressure changes made for a much better night's sleep.

I'm sad to say that I have to wear a FFM going forward . I went to bed at 10 wearing the Simplus and fell asleep easily. I woke up at 1:00am because the mask was bothering me. I took it off while half asleep, woke up a half hour later, put on my P10 and went back to sleep until morning. Sleepyhead showed no large leaks, RERAs or hypopneas and very few FLs during the first half of the night while I was wearing the Simplus, but during the time I was wearing the P10 I had tons of large leaks and other events, so I guess my collection of nasal and pillow masks will be going in the drawer .

Thanks again! I'd be lost without this forum!

Quote : Thanks again! I'd be lost without this forum!

+100

Many of would be lost or have given up without this forum

grayghost4 wrote:Quote : Thanks again! I'd be lost without this forum!

+100

Many of would be lost or have given up without this forum

amen!

Minky wrote:The sleep lab told me that I would need very low pressure, but that's not the case. My FLs are still not perfect, so little by little I'm going to raise the pressure range,

sleep labs see you for a few hours, in unusual settings... it shouldn't be any surprise that they often get things wrong.

probably more of a surprise when they do get them right.

Minky wrote:I want to optimize my therapy, but don't know what my pressure range should be. My doctor set the pressure at 4-12. I very quickly took the advice I got here and raised the minimum to 6. I recently bumped it up to 7. I look at my Sleepyhead data every few days and have found that my pressures are all over the place. Some nights the pressure will stay close to 6.5 all night. Some nights it will hover at around 10. Other nights it will go up and down all night. Some days I feel pretty good, but most of the time I start to fade in the afternoon and some days I can barely function. There is no pattern with high or low pressure and how I feel.

How does you FL chart look like?

My FL chart looks terrible. I turned my settings to 8-10 on Saturday night and yesterday they looked better than they ever had, but still not great. Last night I turned the settings to 8.6-10.6 hoping for even more improvement and the FL chart looked worse this morning, so I'm thinking I should turn the settings back to 8-10.

Does that sound like a good idea? Any other suggestions? I'm still really new to this, only two months in, and am determined to have the therapy be effective.

Thanks so much for everyone's help!

Minky wrote:My FL chart looks terrible. I turned my settings to 8-10 on Saturday night and yesterday they looked better than they ever had, but still not great. Last night I turned the settings to 8.6-10.6 hoping for even more improvement and the FL chart looked worse this morning, so I'm thinking I should turn the settings back to 8-10.

Does that sound like a good idea? Any other suggestions?

no.

give it some more time, you'll have better and worser nights, they're not all the same... so you might even try 9-11.