Can someone explain 90% pressure?

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hegel
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Can someone explain 90% pressure?

Post by hegel » Fri Jul 24, 2015 8:49 pm

I thought that it meant that 90% of the time I was at a certain pressure; the Kaiser sleep adviser said that it meant something else, but I couldn't quite follow her--we were discussing other things.

Mine typically comes in at around 9.0 to 9.5--whatever it means!

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BleepingBeauty
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Re: Can someone explain 90% pressure?

Post by BleepingBeauty » Fri Jul 24, 2015 8:54 pm

hegel wrote:I thought that it meant that 90% of the time I was at a certain pressure; the Kaiser sleep adviser said that it meant something else, but I couldn't quite follow her--we were discussing other things.

Mine typically comes in at around 9.0 to 9.5--whatever it means!
Everybody thinks it means that your pressure was at that level for 90% of the time. What it really means is that your pressure was AT OR BELOW that number for 90% of the time. So if you're running a range of 10-15, let's say, and you spend most of the night at 12 but your pressure spikes briefly to 15, your reported 90% figure will be 15, when you actually spent most of your night at a pressure lower than that.

I wish they'd stop using the 90% figure (or 95% in some cases), as it's confusing to everyone.

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Pugsy
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Re: Can someone explain 90% pressure?

Post by Pugsy » Fri Jul 24, 2015 8:59 pm

90/95% numbers either pressure or leak mean at OR BELOW that number for 90/95% of the night.
They tend to forget the "or Below" part of the definition,

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Wulfman...
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Re: Can someone explain 90% pressure?

Post by Wulfman... » Fri Jul 24, 2015 9:08 pm

What is your pressure range?
If your minimum pressure is pretty low, and you raise the minimum pressure, the 90% (or 95% with ResMed machines) may also increase. In other words, it can be a "moving target". It all depends on your breathing characteristics and your events (like snores and flow limitations) which the machine uses to trigger pressure increases.

It can take some time for the pressure to increase to where it needs to be, so again, if your minimum pressure is too low, it may not be getting to the needed pressure......the events occur......and the pressure falls back down again. And, this repeats through the night.

So, if your AHI and other indexes are still higher than desired, that may also indicate that your minimum pressure is too low and the events aren't being treated (or prevented).


Den

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palerider
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Re: Can someone explain 90% pressure?

Post by palerider » Fri Jul 24, 2015 9:32 pm

hegel wrote:I thought that it meant that 90% of the time I was at a certain pressure; the Kaiser sleep adviser said that it meant something else, but I couldn't quite follow her--we were discussing other things.

Mine typically comes in at around 9.0 to 9.5--whatever it means!
here's what it means: (as explained very nicely by a math professor)
http://adventures-in-hosehead-land.blog ... de-to.html

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hegel
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Re: Can someone explain 90% pressure?

Post by hegel » Fri Jul 24, 2015 10:45 pm

Thanks everyone. However, I don't see that the pressure number tells me much--other than that I don't need a lot of pressure,which is great. I would need to download my card to look more closely at how the night went if I wanted to dig down--correct? ( I don't have a way to download the card on my new machine yet--I did on my old machine.)

In fact I had my new machine set at a minimum pressure of 8, which was fine for me and worked great. The Kaiser sleep consultant--I really don't know the exact designation of the people that you see for machine issues etc.--simply set my low pressure at 6, with a ramp to 8 over a half hour. she did this after reviewing my downloaded information. She insisted that if I fell asleep in ten minutes my machine would increase pressure as needed. I'm sure that this is correct. She also set my pressure relief at 2, which is fine, I've never had this feature and wanted to try it.

So is my lowest pressure 6 or 8?

My AHI is great with this new machine and I'm definitely sleeping better and feeling more rested--very pleased.

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RogerSC
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Re: Can someone explain 90% pressure?

Post by RogerSC » Sat Jul 25, 2015 2:01 am

hegel wrote:Thanks everyone. However, I don't see that the pressure number tells me much--other than that I don't need a lot of pressure,which is great. I would need to download my card to look more closely at how the night went if I wanted to dig down--correct? ( I don't have a way to download the card on my new machine yet--I did on my old machine.)
You're right, if you really want to understand what your pressure or leaks did for a particular night, you need to look at the graph of your pressure or leaks for the night. The 95% number doesn't give one insight into spikes or whether you're mouth breathing per-se, or how your pressure or leak variations might correlate with events.

I do look at my sleep report each morning, and the most significant numbers there for me are the 95% leak number, the AHI and it's breakdown into CA's and OA's, and usage time. I'm simply watching for a larger than normal leak or AHI numbers, and if I see that, I'll download my data and take a look. These days, that hardly ever happens, but I make sure to download and look at my data at least once a week so I don't lose the detailed information. I look at the usage number just to verify that I had my mask on all night (or at least as long as I thought I did *smile*).

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Sheriff Buford
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Re: Can someone explain 90% pressure?

Post by Sheriff Buford » Sat Jul 25, 2015 4:22 am

Den: is this where we recogmend straight cpap mode? If not, let me know. I always recogmend folks to switch to the "other" mode once or twice a year. Just to see if they feel better.

I'm waiting in the wings... just let me know!

Sheriff

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ChicagoGranny
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Re: Can someone explain 90% pressure?

Post by ChicagoGranny » Sat Jul 25, 2015 5:26 am

Before I comment, let me say YMMV.
hegel wrote:-simply set my low pressure at 6, with a ramp to 8 over a half hour.
This seems silly to me. 8 is a low pressure. Do you really need it at 6 when you first get into bed?

I never liked ramp. I want to feel that minimum pressure while I am awake and can check for leaks.

If you are having any problems at all, get that software so you can see exactly what is happening while you sleep. Learn how to control the machine pressure so you don't have to depend on "the Kaiser sleep consultant" to change things on your machine. (I don't let any damn one touch my machine.)

If you sleep well and are energetic during the day, and the machine display shows a low AHI and a low leak rate, then just keep on enjoying life. The software is not mandatory.

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Pugsy
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Re: Can someone explain 90% pressure?

Post by Pugsy » Sat Jul 25, 2015 7:36 am

Sheriff Buford wrote: is this where we recogmend straight cpap mode? If not, let me know. I always recogmend folks to switch to the "other" mode once or twice a year. Just to see if they feel better.
It isn't always the "best" cpap mode number....it can be spot on and it can be way off depending on several factors. It is easily skewed so that makes it unreliable in some situations.
When I was using APAP I saw 90% pressures of 18 and the next night maybe 12. Not related to leaks either but instead related to probably REM stage sleep where my pressure needs seem to vary quite a bit.

The 90/95% numbers are just numbers that may or may not be useful depending on what a person wants to do and how stable they are.
Long term is the best way to look at 90/95% numbers and that is months not days.

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Wulfman...
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Re: Can someone explain 90% pressure?

Post by Wulfman... » Sat Jul 25, 2015 12:53 pm

Sheriff Buford wrote:Den: is this where we recogmend straight cpap mode? If not, let me know. I always recogmend folks to switch to the "other" mode once or twice a year. Just to see if they feel better.

I'm waiting in the wings... just let me know!

Sheriff
Hi Sheriff.

With the OP, it's not entirely clear which machine is being used. Profile states M Series Auto, but a "new machine" is mentioned, so that's why I hadn't made a recommendation.
As Pugsy has mentioned, the percentage numbers in a range of pressures may not be reliable for going to a straight pressure, but they could be reasonably close as a starting point. But, certain factors can make those percentage numbers either too high or too low. Without software and looking at reports, it can be kind of a "crap shoot".
The OP ("hegel") hasn't told us much about any numbers other than what the minimum pressure MAY be set to and the exhale relief setting. If the AHI is still too high, the range may not be adequately responding to or treating the events.

It would be simple enough to set the machine to CPAP mode (or same pressure for min and max) to some pressure and see what the numbers look like. But.......what the Hell do I know........?


Den

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Pugsy
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Re: Can someone explain 90% pressure?

Post by Pugsy » Sat Jul 25, 2015 1:19 pm

OP had been using a M series APAP and just got a "new" gently used PR S1 model 560 and using SleepyHead.
I assume using the settings that had been used on the M Series and is now learning about the data that is available via SleepyHead.

To OP...when you get a chance you might want to update your profile to your new machine.
PR System One 60 Series Auto CPAP machine
PR System One 60 Series Heated tube humidifier with heated tube (even if you aren't using the optional heated hose at this time because this choice is the only one that works with the 560)

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Wulfman...
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Re: Can someone explain 90% pressure?

Post by Wulfman... » Sat Jul 25, 2015 1:23 pm

Pugsy wrote:OP had been using a M series APAP and just got a "new" gently used PR S1 model 560 and using SleepyHead.
I assume using the settings that had been used on the M Series and is now learning about the data that is available via SleepyHead.

To OP...when you get a chance you might want to update your profile to your new machine.
PR System One 60 Series Auto CPAP machine
PR System One 60 Series Heated tube humidifier with heated tube (even if you aren't using the optional heated hose at this time because this choice is the only one that works with the 560)
Thanks for the info.

Den

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(5) REMstar Autos w/C-Flex & (6) REMstar Pro 2 CPAPs w/C-Flex - Pressure Setting = 14 cm.
"Passover" Humidification - ResMed Ultra Mirage FF - Encore Pro w/Card Reader & MyEncore software - Chiroflow pillow
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hegel
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Re: Can someone explain 90% pressure?

Post by hegel » Sat Jul 25, 2015 4:17 pm

oops sorry, I thought that I updated about two weeks ago. should be fine now.

I'm getting great numbers overall, esp. AHI and leaks; most importantly, I feel more rested with this machine. In a month I'll go back to Kaiser and my numbers will be analyzed.

Again, I'm in agreement with Chicago Granny--I was perfectly happy with 8 as my starting pressure and didn't want it changed, but this particular person is pretty take charge (i.e. she needs to be the expert). I will change things back myself if I want or insist that it be done in a month, but actually this set up is working. I thought that I'd give it a try.

I'm still interested in how lowering the initial setting may affect my overall pressure, if at all. I did raise the pressure on my old machine myself and was glad that I did. But my current machine seems to be responding to my events successfully so far.

I'm curious as to why machines aren't designed to respond with appropriate pressure period. Just a flat minimum setting, then bring on the needed pressure as high as it may take. Done.

I'll eventually download sleepyhead and get a reader for the new machine's card; it's just that I'm terrible at downloading stuff--what can go wrong will. Downloding encore took hours. Plus it makes me anxious.

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ChicagoGranny
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Re: Can someone explain 90% pressure?

Post by ChicagoGranny » Sat Jul 25, 2015 4:54 pm

hegel wrote:I'm curious as to why machines aren't designed to respond with appropriate pressure period. Just a flat minimum setting, then bring on the needed pressure as high as it may take. Done.
You could argue they do exactly that. Unless you mean just blow through and don't worry about the side effects of high pressure such as induced central apneas, disturbed sleep, uncomfortableness, gastric insufflation, more difficulty controlling mask leaks and noises, ...

Put your minimum at 20 cm and get a feel for it.