Need some help with pressure settings

[vincec2019]

Hi All. I was diagnosed with severe sleep apnea at 36 per hour on my sleep test. The good news is I've been sleeping with the machine with pretty good success for a year. I still think my numbers could be better. I also have OCD, and when I have my meds adjusted it messes with the AHI. However, if someone could take a look at my pics, and give me some feedback relating to the pressure, or anything else of note it would be greatly appreciated. And to those just starting out, stick with it, it's well worth it! -Vinny p.s. the big gaps in the data are from my daily nap

[LSAT]

Increase your pressure from 14 to 15 and see if there is improvement. If there is..try 16.

[vincec2019]

Thank you. How did you come up with that? Is it because the max pressure is maxing out?

[palerider]

Thank you. How did you come up with that? Is it because the max pressure is maxing out?

Um, you don't *have* a 'max pressure', you have a set pressure, it doesn't change based on your needs, it can't, in an Elite model.

He's just saying that it needs to be raised, because you're not being effectively treated with your current pressures, and the normal answer to obstructive events (OA and H) is 'more pressure'.

[vincec2019]

Awesome. Thanks for clearing that up. So what’s the reasoning for changing the minimum pressure as opposed to the max setting?

[palerider]

Awesome. Thanks for clearing that up. So what’s the reasoning for changing the minimum pressure as opposed to the max setting?

Note that none of this is applicable to your machine, since it only has a single pressure, no min or max pressure settings.

For people that have an auto machine, the idea is to get the min pressure high enough to take care of most things and let the machine handle any exceptions... it's very very rare that setting the max pressure to anything below the max possible has any benefit, and often has a detriment.

[Miss Emerita]

I think the Air Sense Elite offers fixed pressure only, so the machine doesn’t max out; it just goes to wherever it’s set and stays there. EPR can lower the EPAP, but that will be fixed too. So with your current settings, your IPAP is fixed at 14 and your EPAP is fixed at 11.

I don’t have any expertise about advisable pressures, so I won’t venture there. I do see that you may have some issues with flow limitations. It might help the experts to see your FL graph, if you can provide it. (Not sure if SH will do that for your particular machine.)

It’s great that you’ve adapted so well to treatment. How are you sleeping? And how rested do you feel during the day?

[vincec2019]

Thanks Pale for letting me know. I’m still a noobie when it comes to knowledge about my machine. Thank you for taking the time to fill me in.

And thanks to Miss Emerita as well. I feel like a have a good amount of energy during the day. It’s just when I initially wake up I feel tired by my eyes, and unfortunately the ssri’s contributes to the sleepiness.

From what I’ve been reading people set the min a little higher so they can breath in the mask, but since I have auto I don’t need to worry about that. I’m still afraid that if I up the max setting it will wake me up, but again I guess the auto will sort all of that out? When you have ocd and teach in a middle school you can’t mess with your sleep. Thanks all and sleep well

[vincec2019]

and here's what I could find on my flow. Not sure if this helps.

[palerider]

From what I’ve been reading people set the min a little higher so they can breath in the mask, but since I have auto I don’t need to worry about that. I’m still afraid that if I up the max setting it will wake me up, but again I guess the auto will sort all of that out? When you have ocd and teach in a middle school you can’t mess with your sleep. Thanks all and sleep well

I'll say this one more time, and then give up.

According to the data in the screenshots you posted,

You DO NOT HAVE a 'min' setting, you DO NOT HAVE a 'max' setting, you DO NOT HAVE an auto machine.

What does it say on the lower right corner of the machine?

[vincec2019]

Yes, it has a set pressure of 14, with and epr of 3 which brings the EPAP to 11. So if I switch the set pressure to 20 will the air pressure be 17? That’s where I’m lost.

[vincec2019]

It says airsense 10 elite

[vincec2019]

Ahh, now it’s making sense. It’s a set pressure. And to try to reduce the apneas, increase the pressure.

[palerider]

Yes, it has a set pressure of 14, with and epr of 3 which brings the EPAP to 11. So if I switch the set pressure to 20 will the air pressure be 17? That’s where I’m lost.

EPR 3 drops the set pressure by 3, when you're not inhaling.

So, yes, pressure of 20, with EPR 3 gives you an inhale pressure of 20, and a exhale pressure of 17, with no automatic adjustment throughout the night.

I would suggest raising the set pressure by ONE, and see what happens over a few days, then repeat, until you have better results.

[zoocrewphoto]

t I believe part of your confusion is that there are two pressure lines on your graph. One is your set pressure of 14. The other is the exhale pressure which is 3 lower. As the others stated, this is not auto. This is simply one set pressure with a reduction when you exhale. An auto machine can still do the reduction during exhale, but can go up when it senses flow limitations.

Now, looking at your graphs, you have success most of the time at 14, but then you have clusters of events. You are probably either sleeping on your back during those times and/or having REM sleep. A lot of people need a bit more pressure during those times. By raising your pressure to 15 or 16, you may be able to eliminate those.

Considering that most people really should have a backup machine in case of problems, you might start looking for a cheap auto machine, either an S9 autoset, or an Airsense 10 autoset. You could then use the auto with a minimum 14 and let the machine go up to prevent those clusters. Then use the elite as your backup machine.

Since you aren't in a hurry, you could keep an eye on craigslist ads until a good deal comes along.