Air Pressure and Hypopnea please

[jefe2018]

Hi all, This site has already been super helpful in educating me.

ON RESMED airsense 10 for 8 weeks now. The first two weeks destroyed my sleep. The high pressure had my cheeks popping, which woke me up over and over, and my stomach ached in the Morning from gulping air. Upper pressure had been 15 for all this. Then, a friend with same device showed me how to reduce pressure, so I changed to 9. I immediately started to get good sleep, and AHI's went quickly to 1.2 to 2.8 pretty consistently.

I got onto Sleep Head three days ago. WOW. I can see I have been butting up against the upper limit of 9 and holding there for most of the night, so I increased to 10 for two nights and will increase again to 11 tonight to see if I can start to get ahead of the auto seting's desire to move higher. I know I need to get some consistency to really get the sensitivity adjusted, but it clearly wants to be higher. During the last three days, while I've done this, my AHI went up a bit to around 3.2 each night.

Most of my AHI comes from hypopnea. Will higher pressures deal with this effectively, or am I chasing a problem I can't help with higher upper limit? Since I increased the pressure three days ago, my AHI has gone up above the 1.2 to 2.8 I had experienced for the two weeks prior; all with 9 being upper limit. I know I'm dealing with a short period of change, and the change is small, but there it is.

Any thoughts on my process and on higher pressure impact on Hyopnea? THANKS!!!

I'm using the ResMed Airsense 10 AutoSet
Ramp time is set on AUTO
Mode is Auto Set
Minimum Pressure was originally 4, but I moved it up to 6, because it just felt more comfortable
Maximum Pressure was 10 until 3 days ago, changed to 11 for two days and plan to move to 12 tonight.
EPR is OFF (that's the original setting)

my doc had 4 as lower and 15 as upper originally. 15 blew me out.

I am trying to sort out the save screen function........

[Pugsy]

Exactly which model AirSense 10 machine are you using?
Exactly what are all the settings you are using.....exhale relief (EPR)...ramp...is your pressure of 9 or 10 or whatever a fixed pressure or auto adjusting pressure and if it is..is that the minimum or maximum? Sounds like it might be the max...if so, what is your minimum starting pressure?

Yes..more pressure will usually deal with hyponeas but for someone with the aerophagia issues at the higher pressures sometimes the belly issues are worse than what and AHI of 2 represents.

Sometimes when using auto adjusting pressures we can better deal with the hyponeas by increasing the minimum pressure instead of letting the machine go higher.

Can you post an image of the detailed report from a recent night? It helps us help you if we can see what you are seeing.

new screen shot thread that is better with Imgur stuff viewtopic/t103468/Need-help-with-screen-shots.html
https://sleep.tnet.com/reference/tips/imgur

Do NOT do the full screen toggle thing that is mentioned in these instructions. There's a bug in SleepyHead where if you do full screen toggle you can't easily get out of it.

orginization of images https://sleep.tnet.com/resources/sleepyhead/shorganize

[Okie bipap]

The object of your treatment is to improve your sleep. If that means getting the lowest AH I you can, then that should be your goal. However, if the higher pressure causes problems with how well you sleep, lower the pressure slightly. You make adjustments to give yourself the best sleep you can

[jefe2018]

I'm using the ResMed Airsense 10 AutoSet
Ramp time is set on AUTO
Mode is Auto Set
Minimum Pressure was originally 4, but I moved it up to 6, because it just felt more comfortable
Maximum Pressure was 10 until 3 days ago, changed to 11 for two days and plan to move to 12 tonight.
EPR is OFF (that's the original setting)

my doc had 4 as lower and 15 as upper originally. 15 blew me out.

I am trying to sort out the save screen function........

[Setj]

Do you know how to make a screenshot and save it?

[jefe2018]

I've saved the screen shot, but don't know how to copy or export it to a post. How?

[TedVPAP]

I've saved the screen shot, but don't know how to copy or export it to a post. How?

The three links below should address your questions.

[ChicagoGranny]

I've saved the screen shot, but don't know how to copy or export it to a post. How?

Set up a free account at imgur.com. Post it there, then post the link in this thread.

[jefe2018]

[TedVPAP]

Edit your post and change to large thumbnail and use "Linked BBCode"

[ajack]

I would have min 10 It is a bit under your median pressure.
max 15 the machine is being stopped to go higher 95% am chart max is the same number.
That should get you in range and then perhaps a tweak.

[Pugsy]

I would for sure increase the minimum...maybe 8 or 9 ish...go slow if it isn't comfortable.
Probably need more maximum but you have already found out that around 15 and your aerophagia issues get worse.
You might try a little more maximum with a little more minimum and see if the report cleans up a bit (it's showing sub optimal therapy right now but not horrible...the RERAs especially which aren't part of the AHI).
Sometimes when people use more minimum or more optimal minimum the machine doesn't end up needing to go so high.

I would start with the increase in minimum and maybe try 12 max...see if you can figure out where the line is for the aerophagia trigger and see if you can stay below it. The line might be 12 or it might be 14.5...you already know what happens when you spend much time at 15.

Sometimes adding EPR (exhale relief) will keep the aerophagia monster away when we have to use those higher pressures for the apnea prevention and the higher pressures cause belly issues...So that's also something to consider adding to your therapy if you get to where the aerophagia monster wants to return. Using EPR will create a bilevel situation and bilevel is usually the first thing that is done when a person has really bad aerophagia and the pressures needed can't be lowered because of apnea control.
See this.
wiki/index.php/Aerophagia

[ajack]

I had gas when I first started too, I found it did settle down, you do need more pressure than you have now, It is up to you how you raise it. I would definitely raise my min to 10 asap. they raise the max as you progress and your body adjusts to cpap. I don't know what the pressure range is going to end up at. On this chart, your median is 10.7 and 95% and max is 11, the machine is being choked. that's fine for now and raise it as you go. , but I would have the min pressure on 10, to try and treat the apnea better. You are sitting at 11 for most of the night so you probably won't nice the move to 10. but it will give you a solid base to work from.
as pugsy said, EPR will help your comfort.

[Hang Fire]

Edit your post and change to large thumbnail and use "Linked BBCode"

No need to do that. Just right click and open the image in a new tab. It's easily viewable.

[TedVPAP]

Edit your post and change to large thumbnail and use "Linked BBCode"

No need to do that. Just right click and open the image in a new tab. It's easily viewable.

Thanks for the tip.