should i change my minimum pressure

i recently switched from cpap mode to apap. in cpap my ahi was all over, from 0.41 to 9.33. since changing to auto(5 days) highest was 1.95. my pressure seems to be all over though, the highest it got one night was 18. i was just currious if i should bump it up on the minimum to 10.0 since it never really is at the 9 where its set. 9 was the pressure i was prescribed. but i do feel a lot better since changing to auto. thanks for any input you have.

i assume the pressure bouncing around is due to leaks? i have a resmed airfit 10 ffm. any tips to get it to fit correctly? if i tighten the straps anymore it hurts.

jt1 wrote:i recently switched from cpap mode to apap. in cpap my ahi was all over, from 0.41 to 9.33. since changing to auto(5 days) highest was 1.95. my pressure seems to be all over though, the highest it got one night was 18. i was just currious if i should bumo it up on the minimum to 10.0 since it never really is at the 9 where its set. 9 was the pressure i was prescribed. but i do feel a lot better since changing to auto. thanks for any input you have.

Yes........10 or even 11 may be appropriate. Give it some nights to see the results.


Den

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jt1 wrote:i assume the pressure bouncing around is due to leaks? i have a resmed airfit 10 ffm. any tips to get it to fit correctly? if i tighten the straps anymore it hurts.

The pressure won't change on leaks. The machine will increase "volume" in order to maintain the last pressure it was at when the leaks started.

Many things can make for problematic mask leaking. Too tight, too loose (for the anticipated higher pressures), incorrect mask adjustments and fitting, wrong size, and finally..........bed pillow. If it's too soft, the head may sink too far into it and push the mask out of alignment.


Den

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Wulfman... wrote:

jt1 wrote:i assume the pressure bouncing around is due to leaks? i have a resmed airfit 10 ffm. any tips to get it to fit correctly? if i tighten the straps anymore it hurts.

The pressure won't change on leaks. The machine will increase "volume" in order to maintain the last pressure it was at when the leaks started.

Many things can make for problematic mask leaking. Too tight, too loose (for the anticipated higher pressures), incorrect mask adjustments and fitting, wrong size, and finally..........bed pillow. If it's too soft, the head may sink too far into it and push the mask out of alignment.


Den

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thanks for the reply. are my leaks acceptable or no? if not, what would be acceptable?

jt1 wrote:

Wulfman... wrote:

jt1 wrote:i assume the pressure bouncing around is due to leaks? i have a resmed airfit 10 ffm. any tips to get it to fit correctly? if i tighten the straps anymore it hurts.

The pressure won't change on leaks. The machine will increase "volume" in order to maintain the last pressure it was at when the leaks started.

Many things can make for problematic mask leaking. Too tight, too loose (for the anticipated higher pressures), incorrect mask adjustments and fitting, wrong size, and finally..........bed pillow. If it's too soft, the head may sink too far into it and push the mask out of alignment.


Den

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thanks for the reply. are my leaks acceptable or no? if not, what would be acceptable?

They're probably OK. See what happens after you get the pressure increased.......it may level out the leaks a bit.
Most pressure increases are caused by Flow Limitations and Snores. You may want to substitute the Flow Limitations report for the Mask Pressure report when you post them.


Den

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Ok thanks. Just curious, what's considered a good ahi ? I've read <5 is considered no sleep apnea, so if I can keep mine under 2 as its been since switching to apap should I start to see some improvement in my fatigue? I'm not even a month into my therapy.

jt1 wrote:Ok thanks. Just curious, what's considered a good ahi ? I've read <5 is considered no sleep apnea, so if I can keep mine under 2 as its been since switching to apap should I start to see some improvement in my fatigue? I'm not even a month into my therapy.

Well, the AHI is part of it, but the other part is the "quality of sleep". Finding the right balance is important.
Many of the forum members give me a bad time because I've been a proponent of straight pressure.......which is BECAUSE I've seen too many "train wrecks" from people trying to use ranges of pressure. I have APAPs, I've used my APAPs in ranges of pressure and found out early on that the changing pressures wreck my sleep. I've seen that in other users who come to the forum complaining that they've been using their therapy for months or even years and they don't feel "rested". Looking at their reports I've seen why........have recommended straight pressures and they have reported better sleep quality.
It's a very individual thing. Some people can tolerate the changing pressures and some can't. The important thing is to be able to recognize what works best for that particular person.


Den

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To address the AHI specifically........

The "less than 5.0" is some sort of compromise between the doctors and insurance companies.
Less than 2.0 is good. Less than that is even better

My monthly and annual averages have (generally) been below 1.0 since I started therapy.
For the last several years it's been around 0.3 or less (annual average).
My Snore Index when I started was in the "hundreds". It gradually dropped as I found different tweaks and pressure adjustments and for quite a few years now has been less than 0.5.
I'm fairly diligent about tracking my leakage numbers, too. I don't get too excited if it gets a little higher, but usually know why and make some tweaks there, too. As long as I don't get too many Large Leaks, I'm not too concerned, but do try to keep the leakage under some sort of control.


Den

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I'd go with 11, as wulfman suggested, looks like when you get much below that, something happens and boosts pressure up, better to head it off in the first place.

investigate mask liners to help with the leaks. under 24 is where you want to be, but that much leaking tends to bother me, mask liners tame the noises and annoyances of leaks for many people.

Ok thanks guy's. I'll bump it up to 11 for a few nights and see what happens.

here's a screenshot with the flow limitations. is it good?

i guess the road to recovery from sleep apnea isn't just getting the study and a machine! sounds like a lot of trial and error!

jt1 wrote:here's a screenshot with the flow limitations. is it good?

Looks OK for now. If you'll notice, the pressure increases as your flow limitations increase.
Study your reports and you'll find out more about how you sleep (and breathe while you're sleeping) and what events occur and when. It appears that your flow limitations don't always precede your apnea events either.......sometimes they occur after the apnea event. Anyway, you'll get to know more as you follow your nightly reports.


Den

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jt1 wrote:i guess the road to recovery from sleep apnea isn't just getting the study and a machine! sounds like a lot of trial and error!

Ooooooooh DEFINITELY!!!
This has been one of our points of anger about the DMEs issuing non-data-capable machines to users over the years. They think that only the "hours used" is all the data a person needs. Nothing could be further from the truth. It would be like a person with diabetes testing his blood sugar with a meter that didn't display what the blood glucose number was. Totally absurd!


Den

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