Got my machine today, pressure setting question

Ok, this is my first PAP machine. It is the S9 AutoSet. The DME set the pressure to 5 to 20. That seems like a really wide range to me but do I need to just wait a few days and see what the reports are looking like?

Were you titrated? If so, that might give you some guidance, but if you're not sure, you can leave it at the open setting it's at now and see how you do. Several days worth of data will help you narrow the setting down.

A wide-open setting can disturb your sleep as the machine may have to "chase" the apneas and pressure will go pretty high in doing so. But it will be helpful to look at the data and see where you're starting to need more pressure. So if you can suffer through a few days . . .

Hope for the best, but expect the worst, the first few nights are roughest. Eventually you'll get it all dialed in.

Did you have a sleep titration study where they hooked you up to mask and machine and tried to figure out optimal pressure settings? If so, what did they come up with?

The 5 to 20 range...will work just fine unless you need 10 cm or more...and if that happens you would likely want to increase that 5 cm minimum to give the machine a better head start. How much of a head start depends on where it wants to go but often if the minimum is set optimally then the machine's maximum pressure actually reduces.
The 20 cm...in most cases the machine won't even go there unless it senses the need to go there and it becomes a moot point what that setting is.
If it does want to go there and the changes in pressure disturb your sleep or make leak control difficult then there are some adjustments that can be made to lessen the problems (if they occur)...just because a machine CAN go there doesn't automatically mean it WILL go there.

It's very possible that if your pressure needs are relatively low...say 8 cm....that the machine might never even hit 10 cm and if it never goes up there it doesn't really matter what the top end is set at.

So yes, I would use these settings (assuming that you are okay with the 5 cm starting point as some people feel like they are suffocating at such a low pressure) for the time being and get a few nights of treatment for evaluation.
Remember if using EPR then the machine can't ever go below 4 cm...so that 5 cm pretty much doesn't allow for much EPR use depending on EPR setting (until the machine goes up to 7 or 8 cm and you will/should be asleep when that happens)...if you like EPR you might want to have a 6 or even 7 minimum so you can feel the full benefit that EPR offers.
Some people like EPR and some don't. It's another one of those personal preference things that cpap comes with.

Thank you for the advice! My titration study says my pressure should be at 8. However, at one point the technician did have to turn it up to 9 to prevent apneas so I'm really not sure why they decided my number should be 8.

Janknitz, I am definitely hoping for the best but fully expecting the worst. I had absolutely no issues with the machine and mask during the study. I got the same mask that I used during the study but I will really be shocked if it goes as smoothly in real life as it did during the titration study.

I hope I don't drive everyone crazy with all the questions. This is all new to me and I really do appreciate all of the advice I am getting here.

Sharrykb wrote:Thank you for the advice! My titration study says my pressure should be at 8. However, at one point the technician did have to turn it up to 9 to prevent apneas so I'm really not sure why they decided my number should be 8.

Janknitz, I am definitely hoping for the best but fully expecting the worst. I had absolutely no issues with the machine and mask during the study. I got the same mask that I used during the study but I will really be shocked if it goes as smoothly in real life as it did during the titration study.

I hope I don't drive everyone crazy with all the questions. This is all new to me and I really do appreciate all of the advice I am getting here.

Then, that's where you need to set your machine for the time being to see how well you do with that pressure.
It's a straight pressure so you would need to set your machine to CPAP mode with that pressure.
It's also unlikely that they used an exhale relief (EPR on your machine), so I would turn that OFF, too. An EPR setting will drop your therapy pressure on exhale and may compromise the effectiveness of that pressure setting.


Den

.

Leaving your setting at 5 will frustrate you - it's very difficult to inhale at that number and quite honestly if it were to stop your apneas, you probably wouldn't need it.

If it were me, I would probably set a range of 7 to 12. I would check my results with Sleepyhead and Resscan and after a week evaluate the results to see if further adjustments were needed.
Tense settings bracket the titration and tighten up the range so the machine can't go wild but can make modest adjustments as needed.

Wulfman... wrote:

Sharrykb wrote:Thank you for the advice! My titration study says my pressure should be at 8. However, at one point the technician did have to turn it up to 9 to prevent apneas so I'm really not sure why they decided my number should be 8.

Janknitz, I am definitely hoping for the best but fully expecting the worst. I had absolutely no issues with the machine and mask during the study. I got the same mask that I used during the study but I will really be shocked if it goes as smoothly in real life as it did during the titration study.

I hope I don't drive everyone crazy with all the questions. This is all new to me and I really do appreciate all of the advice I am getting here.

Then, that's where you need to set your machine for the time being to see how well you do with that pressure.
It's a straight pressure so you would need to set your machine to CPAP mode with that pressure.
It's also unlikely that they used an exhale relief (EPR on your machine), so I would turn that OFF, too. An EPR setting will drop your therapy pressure on exhale and may compromise the effectiveness of that pressure setting.


Den

.

I guess I didn't give enough details. The titration study said pressure of 8. I wanted an APAP machine instead of a CPAP machine. My doctor agreed and recommended the range of 5 to 20. I'm inclined to believe that I will end up with a tighter range of something like 7 to 12 but for now I'm just going to keep the 5 to 20 and see what happens.

Sharrykb wrote:

Wulfman... wrote:

Sharrykb wrote:Thank you for the advice! My titration study says my pressure should be at 8. However, at one point the technician did have to turn it up to 9 to prevent apneas so I'm really not sure why they decided my number should be 8.

Janknitz, I am definitely hoping for the best but fully expecting the worst. I had absolutely no issues with the machine and mask during the study. I got the same mask that I used during the study but I will really be shocked if it goes as smoothly in real life as it did during the titration study.

I hope I don't drive everyone crazy with all the questions. This is all new to me and I really do appreciate all of the advice I am getting here.

Then, that's where you need to set your machine for the time being to see how well you do with that pressure.
It's a straight pressure so you would need to set your machine to CPAP mode with that pressure.
It's also unlikely that they used an exhale relief (EPR on your machine), so I would turn that OFF, too. An EPR setting will drop your therapy pressure on exhale and may compromise the effectiveness of that pressure setting.


Den

.

I guess I didn't give enough details. The titration study said pressure of 8. I wanted an APAP machine instead of a CPAP machine. My doctor agreed and recommended the range of 5 to 20. I'm inclined to believe that I will end up with a tighter range of something like 7 to 12 but for now I'm just going to keep the 5 to 20 and see what happens.

You gave enough details. But, an APAP machine can be run in single pressure (CPAP) mode besides a range of pressures.

It's your therapy. But, when you keep waking up feeling like you haven't slept, just remember this suggestion I gave you.
When you keep waking up with your mask leaking because the pressure is beyond what you adjusted your mask for, just remember my suggestion. When you keep waking up frequently during the night because of the pressure bumps, just remember my suggestion.

I've been here and on this therapy for nine years and I've seen (LOTS of) the negative side of using an APAP in a range of pressures. I own four APAPs myself (and other straight pressure machines), so I know from my own experience about the potential for "pressure-disturbed-sleeping".


Den

.

Hi Sharry,

My doctor prescribed the same wide range as yours. In my case, Medicaid would not pay for another sleep study even though mine was seven years ago and this was the doctor's way to figure out what I needed in terms of prescription after not using Cpap for five years.

Not everyone is disturbed by pressure changes. I'm no expert but I personally never wake up due to pressure changes. They won't leave you on that wide a range and the experts here can help you fine tune the settings that will make you feel good which may not agree with your care team (probably won't ). I found that the people here are better at advising on that type of thing more than likely because they know from experience.

Here's wishing you the best and deep sleep without interruptions such as I experience. Try to have a positive attitude and you will achieve the results you need. Good luck!!

Wulfman... wrote:

Sharrykb wrote:

Wulfman... wrote:

Sharrykb wrote:Thank you for the advice! My titration study says my pressure should be at 8. However, at one point the technician did have to turn it up to 9 to prevent apneas so I'm really not sure why they decided my number should be 8.

Janknitz, I am definitely hoping for the best but fully expecting the worst. I had absolutely no issues with the machine and mask during the study. I got the same mask that I used during the study but I will really be shocked if it goes as smoothly in real life as it did during the titration study.

I hope I don't drive everyone crazy with all the questions. This is all new to me and I really do appreciate all of the advice I am getting here.

Then, that's where you need to set your machine for the time being to see how well you do with that pressure.
It's a straight pressure so you would need to set your machine to CPAP mode with that pressure.
It's also unlikely that they used an exhale relief (EPR on your machine), so I would turn that OFF, too. An EPR setting will drop your therapy pressure on exhale and may compromise the effectiveness of that pressure setting.


Den

.

I guess I didn't give enough details. The titration study said pressure of 8. I wanted an APAP machine instead of a CPAP machine. My doctor agreed and recommended the range of 5 to 20. I'm inclined to believe that I will end up with a tighter range of something like 7 to 12 but for now I'm just going to keep the 5 to 20 and see what happens.

You gave enough details. But, an APAP machine can be run in single pressure (CPAP) mode besides a range of pressures.

It's your therapy. But, when you keep waking up feeling like you haven't slept, just remember this suggestion I gave you.
When you keep waking up with your mask leaking because the pressure is beyond what you adjusted your mask for, just remember my suggestion. When you keep waking up frequently during the night because of the pressure bumps, just remember my suggestion.

I've been here and on this therapy for nine years and I've seen (LOTS of) the negative side of using an APAP in a range of pressures. I own four APAPs myself (and other straight pressure machines), so I know from my own experience about the potential for "pressure-disturbed-sleeping".


Den

.

Thank you! One of the things I have learned from this forum is that everyone's experience seems to be different. I'm going to try the AUTO like my doctor instructed but if that doesn't seem to be working I will definitely try the set pressure of 8.