Question regarding treatment pressure...

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
salinas212
Posts: 123
Joined: Sat Jan 13, 2018 10:22 am
Location: Denver, CO

Question regarding treatment pressure...

Post by salinas212 » Fri Apr 13, 2018 1:25 pm

Between 3 and 4 weeks ago I starrted making a mental note of my daily pressures. While my machine is on autoset, my high/low presets are 16/8 respectively. My question is why has my actual pressure used gradually increased in the past 3-4 weeks? Pressure that started at 8.2 a few weeks ago is now averaging 9.6 per day and seems to have 'plateau'd' there. I understand its a 95 percentile number but can't quite come to grips with why the slow, steady increase then a latent leveling off most recently. TIA!

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Mask: ResMed AirFit F30i Full Face CPAP Mask with Headgear
Additional Comments: ClimateLineAir Oxy Heated Tube & Perfecto2 O2 Concentrator during sleep only at 2.0 L/min w/bubbler
If you're gonna be a dog, why intentionally choose Chihuahua!?!

User avatar
jnk...
Posts: 2988
Joined: Fri Sep 19, 2014 12:36 pm
Location: New York State

Re: Question regarding treatment pressure...

Post by jnk... » Fri Apr 13, 2018 1:29 pm

salinas212 wrote:
Fri Apr 13, 2018 1:25 pm
Between 3 and 4 weeks ago I starrted making a mental note of my daily pressures. While my machine is on autoset, my high/low presets are 16/8 respectively. My question is why has my actual pressure used gradually increased in the past 3-4 weeks? Pressure that started at 8.2 a few weeks is now averaging 9.6 per day and seems to have 'plateau'd' there. I understand its a 95 percentile number but can't quite come to grips with why the slow, steady increase then a latent leveling off most recently. TIA!
It could mean (or not mean) many things. But here is one possibility.

Maybe your sleep was steadily improving as far as your getting good REM and/or good deep-stage sleep, so you were spending more time asleep in the stages that require slightly higher treatment pressures for some (possibly you). So it could, possibly, be a positive indication of your getting better sleep.
-Jeff (AS10/P30i)

Accounts to put on the foe list: Me. I often post misleading, timewasting stuff.

User avatar
LSAT
Posts: 13229
Joined: Sun Nov 16, 2008 10:11 am
Location: SE Wisconsin

Re: Question regarding treatment pressure...

Post by LSAT » Fri Apr 13, 2018 2:21 pm

salinas212 wrote:
Fri Apr 13, 2018 1:25 pm
Between 3 and 4 weeks ago I starrted making a mental note of my daily pressures. While my machine is on autoset, my high/low presets are 16/8 respectively. My question is why has my actual pressure used gradually increased in the past 3-4 weeks? Pressure that started at 8.2 a few weeks ago is now averaging 9.6 per day and seems to have 'plateau'd' there. I understand its a 95 percentile number but can't quite come to grips with why the slow, steady increase then a latent leveling off most recently. TIA!
The 95% number is not an average....It means that 95% of the time you were at that number or below. You might have been at that 95% number for 5 minutes during the night.

_________________
Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier
Mask: Fisher & Paykel Vitera Full Face Mask with Headgear (S, M, or L Cushion)
Additional Comments: Back up is S9 Autoset...... Buckwheat hull pillow

salinas212
Posts: 123
Joined: Sat Jan 13, 2018 10:22 am
Location: Denver, CO

Re: Question regarding treatment pressure...

Post by salinas212 » Fri Apr 13, 2018 2:40 pm

As I said in my original post; "I understand its a 95 percentile number..." What I was hoping to say was my latest daily pressure report is "averaging" closer to 9.6 than the initial 8.2. By that I mean its been 9.2, 9.4, 9.6, 9.6, 9.6, 9.8 (actual) etc.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Mask: ResMed AirFit F30i Full Face CPAP Mask with Headgear
Additional Comments: ClimateLineAir Oxy Heated Tube & Perfecto2 O2 Concentrator during sleep only at 2.0 L/min w/bubbler
Last edited by salinas212 on Fri Apr 13, 2018 2:45 pm, edited 2 times in total.
If you're gonna be a dog, why intentionally choose Chihuahua!?!

User avatar
jnk...
Posts: 2988
Joined: Fri Sep 19, 2014 12:36 pm
Location: New York State

Re: Question regarding treatment pressure...

Post by jnk... » Fri Apr 13, 2018 2:42 pm

I didn't have a problem with the wording of the original post. But I think LSAT may have been addressing the wording of my post more than yours in highlighting what those numbers are, more as a way to illustrate a reason to discount some aspects of the presumed meaning of those particular numbers as a trend. In other words, yes, it is a statistical trend, but the nature of the number may make that particular trend less meaningful than other trends. I personally tend to put some meaningful weight into the 90th and 95th percentile numbers for making some choices, but many here do not. And I highly respect that position. It is similar to the meaning-of-AHI discussions.

And for those who want to go deeper into the math that is at the heart of LSAT's point and want to do so until their heads hurt and explode, RobySue gives all the explanation necessary to accomplish that: http://adventures-in-hosehead-land.blog ... de-to.html

But getting back to the point of the point, LSAT may be indicating that your mean pressure and average pressure may have actually lowered during the time that your reported percentile numbers went higher, which can understandably be counterintuitive even for those very familiar with the nature of the numbers themselves. A quick jump in pressure for a brief time may throw off one number in a way that doesn't especially matter when using our machine-reported numbers to look for trends.

Then again, math ain't my strong suit. Never was.
Last edited by jnk... on Fri Apr 13, 2018 2:59 pm, edited 1 time in total.
-Jeff (AS10/P30i)

Accounts to put on the foe list: Me. I often post misleading, timewasting stuff.

User avatar
Julie
Posts: 19898
Joined: Tue Feb 28, 2006 12:58 pm

Re: Question regarding treatment pressure...

Post by Julie » Fri Apr 13, 2018 2:59 pm

Have you gained even a little weight lately - amazing how much difference it can make.

salinas212
Posts: 123
Joined: Sat Jan 13, 2018 10:22 am
Location: Denver, CO

Re: Question regarding treatment pressure...

Post by salinas212 » Fri Apr 13, 2018 3:12 pm

HAHAHAHA... I was hoping no one would ask but yes, just a lot! Prolly 12-14lbs since Feb 8 (CPAP start date). I'm hungry alla time!!

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Mask: ResMed AirFit F30i Full Face CPAP Mask with Headgear
Additional Comments: ClimateLineAir Oxy Heated Tube & Perfecto2 O2 Concentrator during sleep only at 2.0 L/min w/bubbler
If you're gonna be a dog, why intentionally choose Chihuahua!?!

vinhbao
Posts: 4
Joined: Fri Apr 13, 2018 3:09 pm

Re: Question regarding treatment pressure...

Post by vinhbao » Fri Apr 13, 2018 4:28 pm

Hoping nobody would ask? Does that mean you already suspected that could be it?

I would make a habit of giving all possible info... I've found that when I don't, people (even doctors) make assumptions that are often wrong. Of course that might lead to a pleasant answer, but never really the right answer.

Did you check your leak rates? I wonder if an increase in leak could lead to an increase in pressure.

Personally, I'm not a huge fan of auto. I just recently started it though, but with the minimum at what was my previous steady pressure, so it can give me a boost when needed, but never lower than what I'm used to.

User avatar
Julie
Posts: 19898
Joined: Tue Feb 28, 2006 12:58 pm

Re: Question regarding treatment pressure...

Post by Julie » Fri Apr 13, 2018 4:47 pm

That'll do it... not to get too serious here, but if you're hungry 'all the time', have you had your sugar checked lately?

salinas212
Posts: 123
Joined: Sat Jan 13, 2018 10:22 am
Location: Denver, CO

Re: Question regarding treatment pressure...

Post by salinas212 » Sat Apr 14, 2018 9:34 am

Yes Julie, in fact 4 vials of blood was given just under two weeks ago on April 2nd at the same visit with my VA pulmonologist. Everything was fine. Pulmonologist thought it a very good thing as I'm 5'10" and was only 145lbs pre-cpap. Now I'm closer to a buck sixty, perhaps a pound or two heavier today , feel tons better, have incredible energy level in terms of comparison and food is tasting pretty darn good again! To my benefit in this situation I guess sometimes a cigar is just a cigar.

Oh and leakage has remained constant since therapy began, ie; +/- 1 L/min

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Mask: ResMed AirFit F30i Full Face CPAP Mask with Headgear
Additional Comments: ClimateLineAir Oxy Heated Tube & Perfecto2 O2 Concentrator during sleep only at 2.0 L/min w/bubbler
If you're gonna be a dog, why intentionally choose Chihuahua!?!

User avatar
Pugsy
Posts: 63941
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: Question regarding treatment pressure...

Post by Pugsy » Sat Apr 14, 2018 9:47 am

I would tend to think along the lines of where jnk went.
Maybe just getting more/better sleep so the chances of the OSA events happening increase especially if maybe getting more REM or even maybe ending up on your back more.
If we are sleeping better/longer it increases the chances of the apnea events happening. Without sleep we don't get the chance for the airway to collapse.
Maybe just getting more REM and maybe just need a little more pressure in REM.

I have weeks where my pressures average higher and weeks with it being a lot lower average (and I mean median average because the 95% number doesn't necessarily give an accurate picture) and I don't know that anything has changed.
I do know that we don't sleep the same and I expect things to change and I would be more worried if nothing seemed to change.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
I may have to RISE but I refuse to SHINE.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

D.H.
Posts: 3467
Joined: Sun Sep 04, 2016 7:07 pm

Re: Question regarding treatment pressure...

Post by D.H. » Sat Apr 14, 2018 10:01 am

Has you AHI changed? If not, the higher pressure is not problematic, any more than appropriately increasing the dose of a medicine would be.

_________________
MachineMask
Additional Comments: Auto PAP; 13.5 cmH2O min - 20 cmH2O max

salinas212
Posts: 123
Joined: Sat Jan 13, 2018 10:22 am
Location: Denver, CO

Re: Question regarding treatment pressure...

Post by salinas212 » Sat Apr 14, 2018 10:12 am

Since I began journaling in earnest for the past 6-8 weeks my events have remained at/near .4 or .5. Anything dramatically different would've had me running to you guys in a panic screaming; "whats does this mean?" Not altogether different than my lead post above asking about pressure differentials.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Mask: ResMed AirFit F30i Full Face CPAP Mask with Headgear
Additional Comments: ClimateLineAir Oxy Heated Tube & Perfecto2 O2 Concentrator during sleep only at 2.0 L/min w/bubbler
If you're gonna be a dog, why intentionally choose Chihuahua!?!