Need help with pressure settings (newbie)

[total_nonsense]

I was diagnosed with moderate OSA with 17 AHI and have been struggling with my CPAP for 2 weeks now.

Original pressure prescribed: 8-13 (no titration study done) resulted in extremely painful aerophagia plus it was very uncomfortable to breathe. Was on it for a week and my AHI varied from 0.0 to 2.4 depending on how well I tolerated the mask that night.


Changed pressure to 4-8, which have helped with the aerophagia considerably. I'm also getting more sleep with my mask on but I don't know how much this is because of the pressure or it's just me getting used to sleeping with a mask. AHI has been in t he 0.33-0.85 range.

Here is my sleepy head data from last night:


Looking at it, I'm pretty sure that I need to increase my max pressure. Any suggestions by how much?

What about min pressure? 4 is probably to low as well but I have no idea by how much to increase it.


Here is an image of the only night I got good sleep with the 8-13 pressure:



To me it does look like 13 was a pretty good guess for an upper limit but I'm afraid to bring the pressure that high again because of aerophagia.
Does gradual increase in pressure help people tolerate it better? As in can I get back to the prescribed 8-13 over the course of a couple months?
Would it even make sense to go back to 8-13 when my current AHI is pretty low.

[LSAT]

Your pressure never got that high....95% of the time your pressure was 10.80 OR LOWER. Your settings are fine.

[esel]

Aerophagia can be quite terrible.

I would suggest to set Pmin to 6 and Pmax to 11. Most important is how you feel after a night of sleep. Reduce Pmax if aerophagia is still a problem. AHI < 5 is considered as normal. No need to absolutely get under 1.

[total_nonsense]

Your pressure never got that high....95% of the time your pressure was 10.80 OR LOWER. Your settings are fine.

I might be wrong here, but my understanding is that when the pressure goes up it is to prevent an obstruction, no? If this is so, wouldn't it mean that I need my max pressure to be 10+ ?

[total_nonsense]

Aerophagia can be quite terrible.

I would suggest to set Pmin to 6 and Pmax to 11. Most important is how you feel after a night of sleep. Reduce Pmax if aerophagia is still a problem. AHI < 5 is considered as normal. No need to absolutely get under 1.

I'll try increasing both min and max tonight and will report back! Thank you for the feedback. So far my sleep has been absolutely terrible because the mask keeps on waking me up. I'm considering getting some medical marijuana to help me stay asleep because right now I'm so much more tired than before CPAP :/

[Julie]

It is the MIN. pressure that goes up in response to events to prevent new ones... you could leave the max at 20 for all it would matter to anything (and very many do). It's only the min. that matters.

[zonker]

I was diagnosed with moderate OSA with 17 AHI and have been struggling with my CPAP for 2 weeks now.

Original pressure prescribed: 8-13 (no titration study done) resulted in extremely painful aerophagia plus it was very uncomfortable to breathe. Was on it for a week and my AHI varied from 0.0 to 2.4 depending on how well I tolerated the mask that night.


Changed pressure to 4-8, which have helped with the aerophagia considerably. I'm also getting more sleep with my mask on but I don't know how much this is because of the pressure or it's just me getting used to sleeping with a mask. AHI has been in t he 0.33-0.85 range.

Here is my sleepy head data from last night:


Looking at it, I'm pretty sure that I need to increase my max pressure. Any suggestions by how much?

What about min pressure? 4 is probably to low as well but I have no idea by how much to increase it.


Here is an image of the only night I got good sleep with the 8-13 pressure:



To me it does look like 13 was a pretty good guess for an upper limit but I'm afraid to bring the pressure that high again because of aerophagia.
Does gradual increase in pressure help people tolerate it better? As in can I get back to the prescribed 8-13 over the course of a couple months?
Would it even make sense to go back to 8-13 when my current AHI is pretty low.

i really don't think there is any reason to change anything. leave your numbers alone for a few days and see how it goes.

most importantly is how is your sleep? are you sleeping well, with minimum wake ups? are you starting to feel better in the morning?

some times it's better to leave things as they are, rather than "chasing zero". it's unlikely you (or anyone) are going to reach it.

many people DO get used to aerophagia, while others of us have to just get used to lower pressures.

good luck!

[total_nonsense]

i really don't think there is any reason to change anything. leave your numbers alone for a few days and see how it goes.

most importantly is how is your sleep? are you sleeping well, with minimum wake ups? are you starting to feel better in the morning?

some times it's better to leave things as they are, rather than "chasing zero". it's unlikely you (or anyone) are going to reach it.

many people DO get used to aerophagia, while others of us have to just get used to lower pressures.

good luck!

I upped Pmin and Pmax by 0.4. I'll leave it like this for a couple of weeks and focus on getting used to the mask. So far my sleep is pretty terrible because I wake up multiple times a night. I fell asleep without my mask the other night and honestly this was the best sleep I've gotten in the past two weeks :/

But at least my aerophagia is so much better at lower pressure. I no longer wake up in pain which is pretty awesome.

A new question:

This happened last night and I'm confused why the machine took so long to react to such a long apnea event. Any idea what was going on?


Also it's scary to see that I was not breathing for a whole minute; my apneas are usually in the 10-20 sec range. I guess that's what I get for having 2 glasses of wine

[Julie]

That'll do it, esp. if they were near bedtime.

[palerider]

. So far my sleep is pretty terrible because I wake up multiple times a night. I fell asleep without my mask the other night and honestly this was the best sleep I've gotten in the past two weeks :/

Don't mistake not remembering you woke up with good sleep.

When you don't have your mask on, your sleep is being interrupted many times an hour, *you just don't remember it*.

Sleeping with the cpap on is something that's not normal to you yet, and so when you're between sleep cycles, you're more aware of the fact that you've waked up briefly.

Waking up between sleep cycles is *completely normal*, however, most of the time, we just turn over and go right back to sleep, and don't remember it in the morning.

This happened last night and I'm confused why the machine took so long to react to such a long apnea event. Any idea what was going on?


Also it's scary to see that I was not breathing for a whole minute; my apneas are usually in the 10-20 sec range.

Expected behavior, No machine increases pressure *during* an apnea, they wait till you're breathing again, for one thing, a little more pressure can't force the airway open, and for another, for some airway blockages, more pressure is like leaning into a door that only opens towards you, it's just forcing it *more* closed.

[Jas_williams]

A new question:

This happened last night and I'm confused why the machine took so long to react to such a long apnea event. Any idea what was going on?


Also it's scary to see that I was not breathing for a whole minute; my apneas are usually in the 10-20 sec range. I guess that's what I get for having 2 glasses of wine

You need to understand how a normal APAP machine works, it does nothing to respond to an apnoea event it just measures it and records it as an Apnoea event when it has finished. Once you have had an Apnoea event the machine then decides what it is going to do to prevent a further apnoea event occuring. In this instance after the OA your machine raised the pressure.

It also looks like the machine turned off shortly after this event 03:32:57 were you awake at this point had you taken the mask off or was something else going on to confuse the machine ?

[zonker]

intellectually, i bow to what palerider says about waking in the night. but I MYSELF am still sort of raging against the machine about this.

i've fought the gas myself. i'm getting comfortable with how i sleep. i'm getting good numbers.

but i STILL have a ways to go before i'll be accepting all those wake ups.

and i concur re: the red wine. this very week, we have out of town family guest. so i'm drinking more wine and eating more food. this is playing havoc with my sleep numbers, not to mention screwing with my quality of sleep.

but i know enough to just let it go and know i'll get back to normal in a couple of days.

anyway, continued good luck to you!

[total_nonsense]

How often do I actually need to change my filter? I was instructed to change it every 2 weeks which I forgot to do. I've used the same one for a month now. Is it time for a change?

[Pugsy]

How often do I actually need to change my filter? I was instructed to change it every 2 weeks which I forgot to do. I've used the same one for a month now. Is it time for a change?

Who told you that? Let me guess...the DME or people who supplied the machine. That way they get to sell you a bunch of filters.

ResMed actually says in their manual.....6 months or sooner if it gets dirty.

Have you looked to see how the filter looks?

How often depends on how quickly it gets dirty.

[total_nonsense]

Who told you that? Let me guess...the DME or people who supplied the machine. That way they get to sell you a bunch of filters.

ResMed actually says in their manual.....6 months or sooner if it gets dirty.

Have you looked to see how the filter looks?

How often depends on how quickly it gets dirty.

Yep, my DME told me that
The filter looks like new. I'll just let it be for now and check on it every now and then. Thank you!