Pressure adjustment?

MarkM · Post by **MarkM** » Fri Jan 19, 2007 7:39 pm

My titration study showed a pressure of 14. I have my APAP set at 4-20. After 3 nights my max pressure has been 10. If this trend continues, should I lower the upper pressure setting? If yes, why?

My only problem (other than mask tweaking, etc.) so far has been this: I have awakened once or twice each night and the machine is blowing so hard that I cannot go back to sleep. If I reset the macine and let it "ramp up" again, I can return to sleep just fine. Is this OK?

Thanks,

Mark

bdp522 · Post by **bdp522** » Fri Jan 19, 2007 8:05 pm

I don't think 3 nights is enough time to decide on a pressure change. Give it at least a week to see what's going on. It can take weeks or even months to get used to this.
When you use ramp, you're not being treated. The machine doesn't start treating until the ramp has met the set pressure. I don't use the ramp. It only takes me a few minutes to get used to the pressure. I think you should use ramp as little as possible. What made the machine blow so hard? was it an event or a leak? If it was an event you may need the higher pressure, if it was a leak you need to fix it.

Brenda

MarkM · Post by **MarkM** » Fri Jan 19, 2007 8:08 pm

Thanks Brenda. I will look at the data to see if there are high pressures coniciding with leak events. I have been working on adjusting my mask and my leaks have been decreasing every night.

Rabid1 · Post by **Rabid1** » Fri Jan 19, 2007 8:33 pm

Mark,

First, your pressure range is too broad. You want to narrow it considerably. If your titrated pressure is 14, I'd set your range from 12 to 16 initially.

Since there is no ramp feature available when you're using your machine in auto mode, what is happening, is when you restart your machine it automatically starts at the lowest pressure. Rather than ramp up to your titrated pressure, the machine reacts to your events rather quickly, so your pressure may go from 4 to 14 in a very short time, and this will probably be enough to wake you.

One more tip: be sure to adjust your mask at your anticipated highest pressure.

Do you have the software & card reader so you can monitor your results?

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): Ramp, auto

snoregirl · Post by **snoregirl** » Fri Jan 19, 2007 8:34 pm

If your titrated pressure is 14 I would not make my range start at 4. I would try something like 11 - 15 or 10 - 15 if you think you don't need as much all the time.

xzombie · Post by **xzombie** » Sat Jan 20, 2007 1:57 am

Similar experiance. Titrated at 13. Had my Auto for about 2 weeks now. Set it at 8-13. My 7 day avg 90% is 9.6! AHI is .6! I'm guessing I could go even lower and still have an acceptable AHI.

I'm waiting for my card reader so I can look at more detail but I'm just shocked that the pressure is so much lower than my Rx. I don't need to ramp because the starting pressure is so much lower than what I'm used to anyway.

Does this seem strange to anyone?

Guest · Post by **Guest** » Sat Jan 20, 2007 2:06 am

xzombie wrote:Similar experiance. Titrated at 13. Had my Auto for about 2 weeks now. Set it at 8-13. My 7 day avg 90% is 9.6! AHI is .6! I'm guessing I could go even lower and still have an acceptable AHI.

I'm waiting for my card reader so I can look at more detail but I'm just shocked that the pressure is so much lower than my Rx. I don't need to ramp because the starting pressure is so much lower than what I'm used to anyway.

Does this seem strange to anyone?

Not at all, remember the cpap pressure given to you by the sleep lab is the pressure that treats the worst case scenario of events seen during the night. So if you set your Autopap maximum to that value it should treat everything seen at a lower pressure which is what an autopap is designed to do. You could also put the Minimum pressure to 13cm and it would then treat the same as cpap but you are defeating the purpose of having the autopap which is lower pressure and more comfort and less machine and mask noise.

if you only need that 13cm pressure for 2 minutes the whole night, why tolerate it for 7hrs or more when you don't. Once you get the reporting software it will become clear.

pedroski · Post by **pedroski** » Sun Jan 21, 2007 2:45 am

MarkM wrote:My titration study showed a pressure of 14. I have my APAP set at 4-20. After 3 nights my max pressure has been 10. If this trend continues, should I lower the upper pressure setting? If yes, why?

My only problem (other than mask tweaking, etc.) so far has been this: I have awakened once or twice each night and the machine is blowing so hard that I cannot go back to sleep. If I reset the macine and let it "ramp up" again, I can return to sleep just fine. Is this OK?

Thanks,

Mark

Hi Mark,

I was also titrated at 14, and also have an apap. A good rule of thumb is 2 cms above and below your titrated pressure but like Brenda said, try each setting for at least a week so you know that's what's causing any difference. There are so many variables in this business, that you need at least a week to be thorough.

I think I read a comment from Snoredog that said if your upper limit is very high it means the machine will be slower to respond.

I found my pressure is consistently lower than 14 on apap as well.

Here is a screenshot and you can see how I've experimented with different settings and how the only time it's consistently 14 is when it's set at 14 in cpap mode.

Good luck

Peter

Pressure adjustment?

Pressure adjustment?

Re: Pressure adjustment?