question for Rested Gal or anyone??????

Hi Guys,
I'm desperate for some advice. I have been tinkering with my pressures on my Resmed Auto Spirit and these are my results.

Straight cpap set at 14 Ahi 5.7
Hi 5.4
Ai .3

since this gave me not a bad result I set my machine to Auto with a min pressure 13 and a maximin pressure on 16. The next morning my results were:
Ahi 11.2
Hi 1.2
Ai 10.0
My median pressure was the full 16 so I was advised to raise the lower pressure to 16 and the max pressure to 20. My Ahi is still 7.8 with a Hi of 7.2 and Ai of .6.
Leakage has never been a problem with leak rates sitting at 0.20 or less. My median pressure has got as high as 16.8.
Would you advise to raise my lower pressure to 17 or should I just try Straight cpap

Any advice will be appreciated as I have to commit to buying a machine soon

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Here are my numbers with the same machine at 14.6 cm

I went from Leak - 1.04
AHI - 14.4
Ai - 1.8
HI - 12.6

To: Leak - .06
AHI - 6.8
AI - .9
HI - 5.9

The second set is after I made an oral appliance which holds my toungue back and prevents me from mouthbreathing while I'm sleeping.

Are you waking up with a dry mouth? If so, you are mouth breathing and that will mess up your therapy. Here's a link to the site that tells how to make one if that is the problem. Mine works great!

http://www.talkaboutsleep.com/message-b ... php?t=4750

Try 8 to 16 that is the setting I use on my ResMed Spirit. I never had my machine run away and the max is between 11 and 12. If you set your low limit too high the AHI can increase. Did you ever had a sleep study to determine the pressure? If you feel air hungry raise the low to 8 then. If the machine then pegs to the high limit it may be a indication that with that auto CPAP the straight CPAP mode is better. In my option you are setting the low end way too high.

Anonymous wrote:Hi Guys,
I'm desperate for some advice. I have been tinkering with my pressures on my Resmed Auto Spirit and these are my results.

Straight cpap set at 14 Ahi 5.7
Hi 5.4
Ai .3

since this gave me not a bad result I set my machine to Auto with a min pressure 13 and a maximin pressure on 16. The next morning my results were:
Ahi 11.2
Hi 1.2
Ai 10.0
My median pressure was the full 16 so I was advised to raise the lower pressure to 16 and the max pressure to 20. My Ahi is still 7.8 with a Hi of 7.2 and Ai of .6. ]

I'm wondering why a change is needed from a straight pressure of 14 since those first results are ENVIABLE!!! I WISH my #'s were like that Normal people withOUT apnea can have those numbers is what I've been told...

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CPAPopedia Keywords Contained In This Post (Click For Definition): resmed, CPAP, AHI, auto

What mask are you using? I am finding significant different in pressure results depending on my mask. I use a PB420E and have used the Activa, Swift, and Comfort Gel with it. My settings are 8 to 16 pressure across the board. I've not changed the machine settings and then used each mask for at least two nights. Here are my typicals:

Activa
AHI = 2.7
AV = 3.3
Leakage = .65
Pressure = 15

Swift
AHI = 15
AV = 4.0
Leakage = 1.0
Pressure = 16 solidly

Comfort Gel
AHI = 1.8
AV = 13.4
Leakage = .4
Pressure = 11

I wonder if the pressure sensing line being further away from the mask in the Activa and Swift plays any part. Both of these masks have a "leader tube" where the Comfort Gel does not. My leakage is probably higher with the Activa and Swift because of the much higher pressure. Now if I could figure out why those two yield higher pressures.

From a personal feel perspective - the Swift is much leakier, the Activa and COmfort Gel are about equal. Even though the stats say I ought to feel best with the Comfort Gel, I feel physically best after a night on the Activa. I feel physically the same whether I wear the Swift or COmfort Gel though. Go figure.

Sorry for the double post here, the other interesting number I was just looking at is runs:

Activa
Average is 25

Swift
Average is 20

Comfort Gel
Average is 12

Per other post, at least 2 day average with PB 420E at 8-16 unchanged between days/masks.

The first thing to realize is that everybody is different. In my case the AI rises significantly at pressures above 10 cm (based on three months of recorded data), and APAP at a wide range of settings gave me worse treatment than keeping the max. pressure lower. (On a Respironics Auto). I have given up on the auto and am using straight cpap at 10 cm, with an average AHI of 0.6.
You may be in a similar situation... You might want to try cpap at a lower pressure than you had before and experiment 'til you find the optimum.

Higher pressures can cause central apneas...

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CPAPopedia Keywords Contained In This Post (Click For Definition): respironics, CPAP, AHI, auto, APAP

Barb is correct. In fact the Respironics patent states that they modify the control strategies above 10 cm because of this.

The other word of caution I meant to make in my post above is that you should be careful about drawing conclusions from a single night's data. Before making changes you should take the average of several nights. You will get significant variation in your nightly data - at 10 cm my AHI has gone from 0 to 2.7 with an average of 0.6.

Anonymous wrote:Hi Guys,
I'm desperate for some advice. I have been tinkering with my pressures on my Resmed Auto Spirit and these are my results.

Straight cpap set at 14 Ahi 5.7
Hi 5.4
Ai .3

since this gave me not a bad result I set my machine to Auto with a min pressure 13 and a maximin pressure on 16. The next morning my results were:
Ahi 11.2
Hi 1.2
Ai 10.0
My median pressure was the full 16 so I was advised to raise the lower pressure to 16 and the max pressure to 20. My Ahi is still 7.8 with a Hi of 7.2 and Ai of .6.
Leakage has never been a problem with leak rates sitting at 0.20 or less. My median pressure has got as high as 16.8.
Would you advise to raise my lower pressure to 17 or should I just try Straight cpap

Any advice will be appreciated as I have to commit to buying a machine soon

Back to top

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One thing I think you really need to think about is that other factors seem to make a HUGE difference on the AHI rate. One thing for me that seems to make a difference is hormones. My doc changed my hormone rx, and my AHI was high. (This makes sense to me as that when you first fall asleep you are more at risk for problems, and with hormone change I couldn't fall asleep very well.) Also, how tired I am affects my AHI. If I am over tired my AHI goes way up. And it goes down slowly with good treatment.

I also require a very high pressure, so this topic is very interesting to me. I spend most of my time at 16, and my last tiration done very recently was 13.