to increase or decrease? !!

[Junaid]

I started my therapy with a pressurre range of 6 to 16 and stayed there for about 2weeks. I then changed to the range to 8 to 14 and stayed there for 1week, I then moved to 9 to 14 and was used that range for 1week. Im now on 10 to 14 and have been there for 3days (I intend staying there for a full week). However, Im still not noticing a significant difference.

What range should I select next. Do I stay at 10 (lower limit) and decrease the upper limit (which is at 14) or do I increase the lower limit tto 11 and keep the upper limit at 14. Ive been tweaking the ranges to get my ideal range/setting but dont know where to next

any ideas?!! my results also havent varied much. my AHIs are between 2.5 and 3.5

[Marietjie]

I started my therapy

Hi, fellow South African and welcome to this forum
Junaid, click on this link - it shows you how to register your equipment - viewtopic.php?f=1&t=49225
Hang on! some very clever and helpful members will soon answer all your questions.

[GertJan]

Hi Junaid,

Can you distinguish between AI and HI and tell us the numbers.
Do you have numbers for time in apnea perhaps?
Did you have a sleep registration and what AHI (untreated) did they find?
Do you have software to readout your machine yourself.

If the posted info is all you have, I would determine the optimum pressure using the best measuring device I know of: your own body!
At what pressure range did you feel best during the day.
That would be my optimum pressure range.
By the way, AHI between 2.5 and 3.5 is not bad at all!

Gert-Jan

[Junaid]

I use a Devilbiss Intellipap and my results dont give me an AI? what is that? Is it called by another name. below is the list of results i get

% Days at least 4 hours 100%
Day Count 1
Days at least 4 hours 1
95th Percentile Pressure 11.5
90th Percentile Pressure 11.0
AHI 4.0
Pressure Plateau Time 0%
High Leak Flow Time 0%
NRI 0.00
EPI 3

[Junaid]

Hi Junaid,

Can you distinguish between AI and HI and tell us the numbers.
Do you have numbers for time in apnea perhaps?
Did you have a sleep registration and what AHI (untreated) did they find?
Do you have software to readout your machine yourself.

If the posted info is all you have, I would determine the optimum pressure using the best measuring device I know of: your own body!
At what pressure range did you feel best during the day.
That would be my optimum pressure range.
By the way, AHI between 2.5 and 3.5 is not bad at all!

Gert-Jan

i dont have software. my titrated pressure was 11.

[bdp522]

Another question, how many hours do you use the machine nightly? ( Do you sleep without it at all?)

Keep in mind that even if you have everything 'right' it can take more than a week to feel the results. Some get almost instant results, some feel only the tiniest results over large periods of time. Your AHI is below 5 and that's good. I would give it more time rather than playing with the settings every week.

AI is apnea index, HI is hypopnea index, AI + HI = AHI

Brenda

[Junaid]

Hi Brenda

I hardly ever take my mask off. So 99.9% of the time I sleep with my mask on all night. Ive been tweaking my range on previous advice that I got. I was also told one week is a good time period to judge whether one has the right pressure/range.

if all else fails then Im going to try using my machine in cpap mode (some have suggested that).

still searching for that elusive good night's rest (or I should rather say...A day where I dont have to nap at the red traffic light or pretend im thinking just so I can close my eyes )

[LinkC]

Find your 90% pressure on your report. Use that as the center point of your range. Start with your limits at -3 and +3 from that. Example: 90%=12cm Lower Limit=9cm Upper Limit=15cm

After a week, if you have not dropped back to the lower limit during the night (except your startup, of course), bump it up a notch. If you have never reached your upper limit, bump it down. -2/+2 is a good range of limits.* If you should start hitting the max or the min thru the night, move the range accordingly. All this assumes your leaks are under control.



*I use a range of -1/+2. My theory is that by starting at a lower limit that is closer to my 90% I will avoid events which would occur while getting from my start pressure to my 90%.


UPDATE: Just saw your numbers. 8-14 to start. (11- 3, 11+3)

Best of luck

[bdp522]

My next idea was for you to switch to cpap and see if that helped. I need to use one set pressure all night or the constant pressure changes disrupt my sleep. If you're ok with a pressure of 11, That's where I would set the cpap pressure.

Yep a week is good to be sure you have the right pressure. Your AHI is under 5 so I would stop there. Give it a few weeks. I found that once I got a good AHI and set the pressure, the AHI continued to improve over the next couple of weeks as I adjusted to it. My snores also decreased more over time.

Brenda

[GertJan]

Must say, I agree with Brenda.
Give treatment some time, and your body as well to recuperate from sleeping without XPAP.
Many of us have experienced a temporary setback after using the machine 4-8 weeks.
This is "normal", you may feel worse than ever before, but it will last only 2 or 3 weeks.

If you still do want to tweak the pressure I would reduce the maximum pressure to 13, but do not go below the 12 (95-percentile is 11.5).
Unnessesary high maximum pressures increase the risk on central apneas.
The minimum pressure can be set as low as you like.
You are using an APAP that will increase pressure when you need it.
You could set it at 6 if thats comfortable for you.

Just to be clear, I am no doctor. Just offering some well meant advise.
If possible you should consult yours after using the machine for 3 or 4 months to evaluate the results.

Gert-Jan

[Junaid]

thanks for the advice...discussions here always renews my hope and positivity...

[Wulfman]

I always recommend to new users that they at least TRY their titrated pressure for a period of time......to either prove or disprove whether they got it correct.......sometimes they do and sometimes they don't. With data-capability, it's very easy to adjust from there. Using an APAP with a range of pressures can be very frustrating for new users......most commonly because they're trying to get used to this new way of sleeping, the mask, the air blowing in their face/nose, humidity levels, etc., etc., etc. At least a fixed pressure will give the person a "constant" while they work around the other issues. The pressure fluctuations of the APAPs can disturb sleep, create leaks and other problems that can be difficult to figure out.

I agree with Brenda. Set it in CPAP mode to your titrated pressure of 11 cm. for a week or two and see what things look like.


Den

[Junaid]

Hi Den



Ive tried that previously...I used a cpap at my titrated pressure (11) for about 4weeks with no good results. That was the reason I decided to purchase an autoadjust. Im very comfortable with sleeping with a mask and machine (I dont wake up because of changing pressures as deilvered by the apap, I hardly ever remove my mask while sleeping, fall asleep relatively quickly, no leaks etc etc).

I now feel that my only problem now is getting the right pressure for me.

fixed pressure didnt work for me so now im looking for that ideal pressure range

[Wulfman]

OK. Then, I would recommend moving the minimum pressure up......and if the numbers improve, you know you're going in the right direction.


Den