What about a person drives pressure level?

I assume it is a number of factors, but I am curious if there is any research on what physical characteristics of a person drive required pressure for proper CPAP therapy... ie. I am guessing that two different people having severe apneas may need very different pressure stetings to get to <1 AHI... is it related to airway size... throat structure.... muscle tone... nasal/sinuses... sleep positions... jaw... weight...?

I am guessing some of all that and more... but just curious if there is any known research or papers written on the subject.

Thanks!

ignore that note... but you're right, it could be any or all of what you listed except for centrals, which are another story altogether.

Who would pay for the research, as long as the treatment is the same?
Money is rarely spent without the anticipation of more money.

chunkyfrog wrote:Who would pay for the research, as long as the treatment is the same?
Money is rarely spent without the anticipation of more money.

Our government, they would pay for both sides of any issue, even when they are written by by the same researcher with there hand out. Jim

Apnea home test kits request the customer's neck size to help set the initial AutoPAP pressure.

TedVPAP wrote:Apnea home test kits request the customer's neck size to help set the initial AutoPAP pressure.

Please cite your references... since neck size doesn't determine pressure.

palerider wrote:

TedVPAP wrote:Apnea home test kits request the customer's neck size to help set the initial AutoPAP pressure.

Please cite your references... since neck size doesn't determine pressure.

I don't remember exactly where I read it but it was in regards to a home test kit.
Regardless, the correlations exist http://www.sciencedirect.com/science/ar ... 3816302448

Ref10 of the above states that their prediction was within +/-1cm for 20 of the 26 patients.
http://www.atsjournals.org/doi/abs/10.1 ... .2.8049834

TedVPAP wrote:

palerider wrote:

TedVPAP wrote:Apnea home test kits request the customer's neck size to help set the initial AutoPAP pressure.

Please cite your references... since neck size doesn't determine pressure.

I don't remember exactly where I read it but it was in regards to a home test kit.
Regardless, the correlations exist http://www.sciencedirect.com/science/ar ... 3816302448

Ref10 of the above states that their prediction was within +/-1cm for 20 of the 26 patients.
http://www.atsjournals.org/doi/abs/10.1 ... .2.8049834

Don't let that little devil troll push you around.

Neck size was what my primary care doc used to send me for a sleep study over a decade ago.

xxyzx wrote:

DreamStalker wrote:

TedVPAP wrote:

palerider wrote:

TedVPAP wrote:Apnea home test kits request the customer's neck size to help set the initial AutoPAP pressure.

Please cite your references... since neck size doesn't determine pressure.

I don't remember exactly where I read it but it was in regards to a home test kit.
Regardless, the correlations exist http://www.sciencedirect.com/science/ar ... 3816302448

Ref10 of the above states that their prediction was within +/-1cm for 20 of the 26 patients.
http://www.atsjournals.org/doi/abs/10.1 ... .2.8049834

Don't let that little devil troll push you around.

Neck size was what my primary care doc used to send me for a sleep study over a decade ago.

========

neck size 17+ is one of the signs of possible apnea that doctors use to decide on tests
it has nothing to do with the pressure needed

Perhaps.

But the references he cited refer to several variables such as neck circumference, neck-to-height ratio, BMI, etc. which were all used to statistically develop formulas for estimating starting pressures to be used for quicker APAP titrations. There may or may not be an exact known deterministic relationship between neck size and needed pressure ... but there are many phenomena in the world of science that may be too complex for deterministic methods but where statistical methods get us close enough ... like weather forecasting.

Oh yes ... plus I had an opportunity to stick one into the little red devil troll.

TedVPAP wrote:

palerider wrote:

TedVPAP wrote:Apnea home test kits request the customer's neck size to help set the initial AutoPAP pressure.

Please cite your references... since neck size doesn't determine pressure.

I don't remember exactly where I read it but it was in regards to a home test kit.
Regardless, the correlations exist http://www.sciencedirect.com/science/ar ... 3816302448

Ref10 of the above states that their prediction was within +/-1cm for 20 of the 26 patients.
http://www.atsjournals.org/doi/abs/10.1 ... .2.8049834

Oh well then, I guess that titration studies are unnecessary and will be stopped after 1994... on the other hand...

The pressure calculated by Hoffstein et al. equation was significantly lower than autoCPAP P90%. ... Predictive formulas might be useful as an alternative to autoCPAP. The model of predictive formula derived from the present small sample of Egyptian patients with OSAHS should be validated on a larger sample size.

Apnea home test kits don't recommend pressure.

palerider wrote:

TedVPAP wrote:

palerider wrote:

TedVPAP wrote:Apnea home test kits request the customer's neck size to help set the initial AutoPAP pressure.

Please cite your references... since neck size doesn't determine pressure.

I don't remember exactly where I read it but it was in regards to a home test kit.
Regardless, the correlations exist http://www.sciencedirect.com/science/ar ... 3816302448

Ref10 of the above states that their prediction was within +/-1cm for 20 of the 26 patients.
http://www.atsjournals.org/doi/abs/10.1 ... .2.8049834

Oh well then, I guess that titration studies are unnecessary and will be stopped after 1994... on the other hand...

The pressure calculated by Hoffstein et al. equation was significantly lower than autoCPAP P90%. ... Predictive formulas might be useful as an alternative to autoCPAP. The model of predictive formula derived from the present small sample of Egyptian patients with OSAHS should be validated on a larger sample size.

Apnea home test kits don't recommend pressure.

Nobody (except you) ever said that titration studies are unnecessary or that they would be stopped or any other stupid thing like that you devil troll.

And your "recommended pressure" does not equal ... "helping to set an initial pressure" either.

palerider wrote:

TedVPAP wrote:

palerider wrote:

TedVPAP wrote:Apnea home test kits request the customer's neck size to help set the initial AutoPAP pressure.

Please cite your references... since neck size doesn't determine pressure.

I don't remember exactly where I read it but it was in regards to a home test kit.
Regardless, the correlations exist http://www.sciencedirect.com/science/ar ... 3816302448

Ref10 of the above states that their prediction was within +/-1cm for 20 of the 26 patients.
http://www.atsjournals.org/doi/abs/10.1 ... .2.8049834

Oh well then, I guess that titration studies are unnecessary and will be stopped after 1994... on the other hand...

The pressure calculated by Hoffstein et al. equation was significantly lower than autoCPAP P90%. ... Predictive formulas might be useful as an alternative to autoCPAP. The model of predictive formula derived from the present small sample of Egyptian patients with OSAHS should be validated on a larger sample size.

Apnea home test kits don't recommend pressure.

Most others would simply respond with a thank you for providing useful references. Oh well.

xxyzx wrote:===========
neck size 17+ is one of the signs of possible apnea that doctors use to decide on tests
it has nothing to do with the pressure needed

Dreamstalker wrote:Perhaps.

But the references he cited refer to several variables such as neck circumference, neck-to-height ratio, BMI, etc. which were all used to statistically develop formulas for estimating starting pressures to be used for quicker APAP titrations. There may or may not be an exact known deterministic relationship between neck size and needed pressure ... but there are many phenomena in the world of science that may be too complex for deterministic methods but where statistical methods get us close enough ... like weather forecasting.

Oh yes ... plus I had an opportunity to stick one into the little red devil troll.

~~~~~~~~~~~~

neck size was alleged to be part of an IHT so they could set the pressure

that is a total crock

whether you can measure all the attributes of a person and guess a pressure is questionable
far easier better faster to titrate it at home and get the right pressure then let the auto function handle variations

I think you're still misinterpreting a "guessed therapeutic pressure" for what was actually stated ... an "estimated initial pressure" to start with for a home APAP titration. Some may feel that statistical estimates/guesses, like weather forecasting, are a crock ... but that is just an opinion because those who dislike the use of statistics do not have any better justifiable methods. Statistics is not "perfect" but neither is life ... but still better than throwing a dart at a wall with a bunch of numbers.

xxyzx wrote:

DreamStalker wrote:

xxyzx wrote:===========
neck size 17+ is one of the signs of possible apnea that doctors use to decide on tests
it has nothing to do with the pressure needed

Dreamstalker wrote:Perhaps.

But the references he cited refer to several variables such as neck circumference, neck-to-height ratio, BMI, etc. which were all used to statistically develop formulas for estimating starting pressures to be used for quicker APAP titrations. There may or may not be an exact known deterministic relationship between neck size and needed pressure ... but there are many phenomena in the world of science that may be too complex for deterministic methods but where statistical methods get us close enough ... like weather forecasting.

Oh yes ... plus I had an opportunity to stick one into the little red devil troll.

~~~~~~~~~~~~

neck size was alleged to be part of an IHT so they could set the pressure

that is a total crock

whether you can measure all the attributes of a person and guess a pressure is questionable
far easier better faster to titrate it at home and get the right pressure then let the auto function handle variations

I think you're still misinterpreting a "guessed therapeutic pressure" for what was actually stated ... an "estimated initial pressure" to start with for a home APAP titration. Some may feel that statistical estimates/guesses, like weather forecasting, are a crock ... but that is just an opinion because those who dislike the use of statistics do not have any better justifiable methods. Statistics is not "perfect" but neither is life ... but still better than throwing a dart at a wall with a bunch of numbers.

============

measurment beats guesses

just titrate it until you find the sweetspot to start
and let the auto handle the changes we all have by sleep position, sleep stage, congestions, etc

Of course measurement beats guesses ... but you still have to start measuring/titrating somewhere. Do you start minimum pressure at 4 or 14?

The study(s) proposed measuring certain human parameters frequently correlated with OSA ... like neck size, BMI, etc. ... and then titrating the subjects to find other statistical correlations between those same measurements and minimum starting pressure to begin a home titration and thereby shortening the time needed to find the "sweet spot". That's all.

As for APAP handling nightly variabilities accosiated with sleep position, sleep stage, congestions, etc, .... nobody is arguing that. That was never the issue in these studies.

TedVPAP wrote:Most others would simply respond with a thank you for providing useful references. Oh well.

Had you done so, I would have.

But what you've offered is hearsay. Not fact, and one of the papers you cited was refuted in the second, which said that more study is needed.