Adjusting pressure...need advice from old timers

sleepylady · Post by **sleepylady** » Tue Jan 22, 2008 1:49 pm

Hello all,

I haven't been on here in quite awhile. Life has been great with my APAP and everything has been under control.

Now to the crux of my problem, I'm looking to tweak my APAP settings and would like a little advice. I have lost 55 lbs and just had weight loss surgery. I noticed the last couple of days I haven't been sleeping well and last night I kept getting pressure build up in one ear and kept waking up to relieve it. I was on a pressure setting of 14-17, however, changed it to 12-17. I did look at my readings this morning and I found my hypopneas since Saturday have been high, averaging 30 / night. Normally it's around 2-9. Now saying all that, how do those that tweak their pressures arrive at what they think will work best? After tweaking my pressure I ended up with 24 hypopneas for the night. My "plan" is to keep the pressure on 12-17 for another day or two and then evaluate if I should bump it down another notch. What do you guys think????

sleepycarol · Post by **sleepycarol** » Tue Jan 22, 2008 5:53 pm

I don't have any advice but want to bump this up so others may respond.

Good luck and congratulations on your weight loss!!

Snoredog · Post by **Snoredog** » Wed Jan 23, 2008 1:27 am

with that amount of weight loss, you may need to lower your Minimum pressure to 10 cm.

While HI or Hypopnea indice is important it is not the value you should first look at.

You should first observe your AI or OA indice, that is for apnea. Until you can get that number down near 1 or below, you may see your HI indice remain high.

For example; if pressure delivery is on the verge of eliminating a apnea or complete blockage, the residual result could be flow limited breaths or hypopnea. Similar to a flutter.

The thing to do is: observe your OA (Obstructive Apnea) indice and adjust pressure for that parameter, when you see your OA drop from 3 to 2 to 1 it may even drop to 0.6 or 0.4 and HI could be still at 10, further increasing pressure should then cause the HI index to drop.

You know you have gone too far when those numbers begin to rise again.

If you get the OA numbers down and HI remains above 5, then look for FL or Snores. If you are snoring continue to increase pressure, but doing that can cause you to wake up or the AHI to increase, when that happens you have to ignore the snores as some you cannot eliminate with higher pressure.

WNJ · Post by **WNJ** » Wed Jan 23, 2008 11:01 am

I would add also:

1) make changes in small increments, no more than 2 cm at a time.

2) change only one thing at a time, otherwise you won't know which change caused a difference in your results.

3) give each change at least 4 or 5 days, a week would be better, to thoroughly evaluate the difference each change has made in your results.

Wayne