Can higher than needed pressure cause Hypopnea Apena

As I've understood Hypopnea's they occur when the airway partially collapses so an increase in pressure would be needed.

Is it possible that higher than needed pressure can cause a Hypopnea Apnea? I would thank not but wanted to ask.

Example: If you normally have EPR on at a 1 and then go to 0.

No but higher pressures can cause central apnea in some people.

fdw wrote:As I've understood Hypopnea's they occur when the airway partially collapses so an increase in pressure would be needed.

Is it possible that higher than needed pressure can cause a Hypopnea Apnea? I would thank not but wanted to ask.

Example: If you normally have EPR on at a 1 and then go to 0.

I'm not sure if I follow that, but.......
With regard to EPR, it's been often discussed on the forum that IF the point of the end of exhale and beginning of inhale is a source for apneas, then the EPR setting CAN affect the effectiveness of the pressure setting. Or, said another way, if you NEED a pressure of 10 cm. to keep your airway open and your pressure is 12 and your EPR setting is "3", your pressure will fall below the needed pressure at the point of exhale.......and you COULD experience apneas at that point.
So, the general advice has been to either increase the pressure setting or reduce the EPR setting.

With regard to whether higher (than needed) pressures can cause events........"Maybe", but more than likely, "probably not".
Same answer for "pressure induced Centrals". Supposedly, only about 15% of the users are actually susceptible to those.

I believe that with most clinical titrations, they try to find the "sweet spot" where the majority of the events are eliminated with the minimum amount of pressure. Why would anyone want to experience an excessive amount of pressure if you don't actually need it?


Den

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fdw wrote:Is it possible that higher than needed pressure can cause a Hypopnea Apnea? I would thank not but wanted to ask.

Example: If you normally have EPR on at a 1 and then go to 0.

that would make hypops or obstructives LESS likely.

also, hypopneas and apneas are different things.

Wulfman... wrote:

fdw wrote:As I've understood Hypopnea's they occur when the airway partially collapses so an increase in pressure would be needed.

Is it possible that higher than needed pressure can cause a Hypopnea Apnea? I would thank not but wanted to ask.

Example: If you normally have EPR on at a 1 and then go to 0.

I'm not sure if I follow that, but.......
With regard to EPR, it's been often discussed on the forum that IF the point of the end of exhale and beginning of inhale is a source for apneas, then the EPR setting CAN affect the effectiveness of the pressure setting. Or, said another way, if you NEED a pressure of 10 cm. to keep your airway open and your pressure is 12 and your EPR setting is "3", your pressure will fall below the needed pressure at the point of exhale.......and you COULD experience apneas at that point.
So, the general advice has been to either increase the pressure setting or reduce the EPR setting.

With regard to whether higher (than needed) pressures can cause events........"Maybe", but more than likely, "probably not".
Same answer for "pressure induced Centrals". Supposedly, only about 15% of the users are actually susceptible to those.

I believe that with most clinical titrations, they try to find the "sweet spot" where the majority of the events are eliminated with the minimum amount of pressure. Why would anyone want to experience an excessive amount of pressure if you don't actually need it?

Den

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So in my case. I'm on straight CPAP 13.6 with EPR 1, last official titration 13.0 (8 years ago). If I turn off EPR should I just leave my pressure alone? The reason I'm asking is because my AHI numbers look great. However sometime I'll have Hypopnena lasting up to 30 plus seconds long......like AHI of 0.60 but time in Apena 2 plus minutes.

[/quote]So in my case. I'm on straight CPAP 13.6 with EPR 1, last official titration 13.0 (8 years ago). If I turn off EPR should I just leave my pressure alone? The reason I'm asking is because my AHI numbers look great. However sometime I'll have Hypopnena lasting up to 30 plus seconds long......like AHI of 0.60 but time in Apena 2 plus minutes.[/quote]

Personally I would not change a thing....a 30 second hypopnea is no big deal

fdw wrote:So in my case. I'm on straight CPAP 13.6 with EPR 1, last official titration 13.0 (8 years ago). If I turn off EPR should I just leave my pressure alone? The reason I'm asking is because my AHI numbers look great. However sometime I'll have Hypopnena lasting up to 30 plus seconds long......like AHI of 0.60 but time in Apena 2 plus minutes.

Theoretically, yes.
However, that may or may not account for or prevent "positional" events. (sleeping supine, chin tucked down to the chest, and any number of other possibilities)
If turning off EPR doesn't fix it, bumping up one (or more) centimeter(s) might be in order.

Den

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Wulfman... wrote:

fdw wrote:So in my case. I'm on straight CPAP 13.6 with EPR 1, last official titration 13.0 (8 years ago). If I turn off EPR should I just leave my pressure alone? The reason I'm asking is because my AHI numbers look great. However sometime I'll have Hypopnena lasting up to 30 plus seconds long......like AHI of 0.60 but time in Apena 2 plus minutes.

Theoretically, yes.
However, that may or may not account for or prevent "positional" events. (sleeping supine, chin tucked down to the chest, and any number of other possibilities)
If turning off EPR doesn't fix it, bumping up one (or more) centimeter(s) might be in order.

Den

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Great....I think I'll try it for a few night just to see how i feel.

fdw wrote:

Wulfman... wrote:

fdw wrote:So in my case. I'm on straight CPAP 13.6 with EPR 1, last official titration 13.0 (8 years ago). If I turn off EPR should I just leave my pressure alone? The reason I'm asking is because my AHI numbers look great. However sometime I'll have Hypopnena lasting up to 30 plus seconds long......like AHI of 0.60 but time in Apena 2 plus minutes.

Theoretically, yes.
However, that may or may not account for or prevent "positional" events. (sleeping supine, chin tucked down to the chest, and any number of other possibilities)
If turning off EPR doesn't fix it, bumping up one (or more) centimeter(s) might be in order.

Den

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Great....I think I'll try it for a few night just to see how i feel.

I've been using straight 12 and 13 for the last couple of years with no exhale relief. I used a C-Flex setting of "2" for years and then turned it off after a few nap "trials" and found out I didn't really need it.......and wondered why I waited so long to turn it off.

Good luck with your experiment.


Den

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Theoretically, yes.
If turning off EPR doesn't fix it, bumping up one (or more) centimeter(s) might be in order.

Den

Great....I think I'll try it for a few night just to see how i feel.

I've been using straight 12 and 13 for the last couple of years with no exhale relief. I used a C-Flex setting of "2" for years and then turned it off after a few nap "trials" and found out I didn't really need it.......and wondered why I waited so long to turn it off.

Good luck with your experiment.

Den

Den, So you change your pressure from 12 to 13 (back and forth), how do you know when it's time to change?

Last night. Not what I was hoping to see on my report this morning. Looks like the Hypopnea's nearly doubled with the longest at 44 seconds and shortest 18 seconds. Flow Limitations also doubled from previous nights. And finally Time in Apnea was nearly 4 minutes. I feel fine, but will see as the day goes on.

Den, You think I Should wait a few more days before increasing the pressure?

You feel good, your AHI's under 1, stop looking at every number and wait for a weekly wrap-up. Don't get obsessed with every little change overnight on every graph.

Julie wrote:You feel good, your AHI's under 1, stop looking at every number and wait for a weekly wrap-up. Don't get obsessed with every little change overnight on every graph.

Im sorry Julie....I don't want to come off as rude, a know it all, or un-apprecitave. But my question was directed to Den. I certinally value others (yours) opinions and recommendations.

Please forgive me Julie if Im out of line!

Julie wrote:You feel good, your AHI's under 1, stop looking at every number and wait for a weekly wrap-up. Don't get obsessed with every little change overnight on every graph.

ah, the obsessive quest for perfect and it's attendant spiral into madness.

Not out of line - you have a right to talk to anyone - good luck with all.

fdw wrote:

Theoretically, yes.
If turning off EPR doesn't fix it, bumping up one (or more) centimeter(s) might be in order.

Den

Great....I think I'll try it for a few night just to see how i feel.

I've been using straight 12 and 13 for the last couple of years with no exhale relief. I used a C-Flex setting of "2" for years and then turned it off after a few nap "trials" and found out I didn't really need it.......and wondered why I waited so long to turn it off.

Good luck with your experiment.

Den

Den, So you change your pressure from 12 to 13 (back and forth), how do you know when it's time to change?

Last night. Not what I was hoping to see on my report this morning. Looks like the Hypopnea's nearly doubled with the longest at 44 seconds and shortest 18 seconds. Flow Limitations also doubled from previous nights. And finally Time in Apnea was nearly 4 minutes. I feel fine, but will see as the day goes on.

Den, You think I Should wait a few more days before increasing the pressure?

Looks really good to me. I'd let it ride for awhile. You're very close to "perfection". The numbers and types of events can vary from night to night and you can choose to watch those for any trends........and then you can decide whether to tweak them or not. I know, for me, at this time of the year my AHI numbers can be just a bit higher for some reason.

This is a little complicated, but........ With regard to my pressures, I typically use a setting of 12 cm. and have since late 2012. However, in early 2011, I acquired two "cheap" ( $15.00 each ) machines from a source who used to sell on the CPAPAuction.com site. Later in 2011, I acquired a gauge manometer from CPAP.COM to check all my machines. I discovered that one of those "cheapies" was putting out 13 cm. at a setting of 12 cm., and the original Auto I bought (second-hand) in 2006 was putting out nearly 15 cm. at a setting of 12 cm. Well, that "cheapie" I use for naps (it lost its data-recording capabilities before I got it and that's probably why it was so cheap), but, it does blow air and that's why I use it for naps and don't have to download the nap data. With the Auto, I decided to use it this year (except for a few years, I've rotated my machines in some manner.....yearly, monthly, etc.) and in order to get close to 12 cm., using my manometer, I set it to 10 cm., which essentially gives me straight 13 cm. So, this will be the first YEAR I've used straight 13 cm., so I'll see how that works. In the past years when I used that Auto, I had it set to straight 12 and it was actually delivering about 15, so I was actually using a higher pressure than I thought I was using. I actually contemplated sending that Auto machine to one of the places that does repairs and have them recalibrate it, but decided it would be cheaper if I just set the pressure according to the manometer.......which was the way they set the machines years ago. Anyway, so far, so good.

As far as changing MY settings (or machines or whatever), over the years it's become longer and longer trial periods. What used to be "a week or more", became "a month or more" and is now "a year or more". I find it interesting to watch the trends throughout a year or even years. And, that's another reason I use straight pressure. It's a "constant" and other things/factors become the "variables".......instead of the pressure.


Den

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