Dealing with high pressures

By Bearcat42

Obstructive Sleep Apnea,or OSA,is a condition where the airway closes during sleep effectively causing some people to stop breathing for a short period of time in their sleep. While some suffer from OSA others may have Severe Obstructive Sleep Apnea. For those who have been diagnosed with OSA or SOSA the most popular treatment option is to use a Continuous Positive Airway Pressure machine,or CPAP. A Cpap machine offers treatment to the individual by providing a constant airflow during sleep in order to hold the airway open thus reducing episodes of breathing difficulties.

A persons treatment is based on how much air pressure it takes to maintain an open airway during sleep. This pressure setting is determined during a Polysomnogram(PSG),more commonly known as a sleep study. During a sleep study the sleep tech may put you on a CPAP machine halfway through the test to determine if CPAP therapy will be beneficial to the patient. It is during this portion of the test that the most suitable air pressure for treatment is found.

For those who have Severe Obstructive Sleep Apnea the chances are good that they will need higher air pressures for treatment. I say pressures because there is of course an inhalation pressure setting but some people will need an exhalation pressure as well. During a PSG the sleep tech may have to set an exhalation pressure to help maintain the airway during sleep. Personally I have 2 air pressure settings on my machine of 21/17. That is an inhalation setting of 21 and an exhalation pressure of 17. That is high.

When dealing with high pressures every night,or day if you work the night shift,things work somewhat differently than for those with lower pressures. For example you may not be able to use nasal pillows because of the pressures involved so you might have to use a Full Face Mask,or FFM,and maybe even a nasal mask. You will find that personal preference plays a big part in CPAP treatment. High pressures cause the user more problems with mask leaks than anything else. Some people prefer using a FFM over a nasal mask and vice versa. Each has its own pros and cons but it depends on which one works for you. I have found a nasal mask is easier for me to keep sealed than a FFM.

Air escaping from your mask is air that is not used for treatment,period. Every mask has a certain Leak Rate which is supplied by the manufacturer in the user manual and thus cannot be counted toward treatment. Air can also escape from your mouth and is an issue for those not using a FFM. Some find that using a chinstrap works best while others use tape or denture adhesive to seal their lips each night. Again,this depends on what works best for the individual but for those who deal with the higher pressures of CPAP therapy all of these things become very important to achieve the best treatment possible.

Something else that can help to make high pressures more tolerable is Exhalation Pressure Relief(EPR)which is basically a setting on your machine,if equipped,that relieves or softens the air pressure at the beginning of exhalation. Here is a thread explaining some CPAP machines and their correlation to EPR. [[1]]

With higher pressure settings you may have more to deal with so always make it a point to make only one change to your therapy at a time. By using this method of troubleshooting you will more quickly find what works the best for you.