Can pressure increase cause more obstructive apneas?

[prefer2breathe]

I know that an increased pressure may produce more central apneas but I was wondering if it can cause more obstructives as well. I have slowly tweaked my minimum pressure and have found that my central apneas reported are about the same (.6 to 1.5 on average) but my obstructive apneas have increased. Does this make any sense to any of you? I am only basing this analysis on one night of increased pressure. I have found that as I have increased my minimum pressure, my 95% steadily increases as well.

[KatieW]

I would suggest waiting and watching your data for a week. I find that my apneas may go up for one night, for no apparent reason, then level out again.

It could be leak-related, positional (sleeping on your back), congestion, or more REM time.

If you're raising your minimum, then the 95 percentile would go up too, since that number is the pressure you were at, or below 95% of the time.

[DoriC]

An interesting observation I made. Mike went to sleep the other night with a nasty mosquito bite in a sensitive area that had seemed to quiet down after taking a Benedryl and the usual anti-itch creams,etc. But the data the next day showed an unusual AHI=3.5(normal is 0.5-1.5) and a higher Leak Rate,although he said the itching did not bother him or wake him? Last night 's data was back to normal. There are so many things that can affect data that don't require tweaking. That was one of the hardest lessons for me to learn and even now when I see something askew on any given night I might think about "problem-solving" but I don't act upon it and usually find it's only temporary.

[Julie]

Well, my little theory is that, if you use a nasal mask, and it provokes sleeping with your mouth open (all that 'extra' air) you'll lose that air to the room instead of your airway, won't be getting treated, and your numbers can look like you need more help. You raise your pressure settings and lose even more air though and feel worse than before, so maybe it's time to consider a full face mask or taping, etc.

[Goofproof]

Well, my little theory is that, if you use a nasal mask, and it provokes sleeping with your mouth open (all that 'extra' air) you'll lose that air to the room instead of your airway, won't be getting treated, and your numbers can look like you need more help. You raise your pressure settings and lose even more air though and feel worse than before, so maybe it's time to consider a full face mask or taping, etc.

Yes, the less pressure you need that does the job. (Sweet Spot) The higher the pressure, the more leaks occur, the more leaks occur, the less true are the readings. Dog chasing his tail syndrome.... Julie, is on the money. Jim

[Raj]

Aside from Julie's sensible observation, it makes intuitive sense to me that even without leaks, at some point of increasing pressure beyond the ideal, excess pressure might invoke protective responses from your body that a machine could interpret as obstructive events. These home devices assess breathing patterns through airflow coupled with machine-regulated changes in airflow. They have no way to determine if a temporary cessation of breathing stems from your body's attempt to properly balance CO2 with oxygen rather than an obstruction.

[neverbetter]

I see you have an autoset. Is the pressure increase automatic?

[prefer2breathe]

Yes, I have an auto. My leaks are not a problem....around 0.0 to .10 consistantly. Someone pm'd me and mentioned that it is NOT a good idea to be messing with my pressure ranges when I have centrals. I did NOT say I had a problem with centrals, just that the machine reports a few here and there. But, who knows, they might not be centrals and if they were, a few a night is normal. As far as my 95% pressure going up, I understand what your saying Katie W. But my 95% goes up even higher above my minimum. It's not flat lined on my minimum which I think would happen if my pressure was too high. Just for example, if I set my pressure range from 10 to 20, no leak problems, my 95% pressure is say 13.1. It stays around that for a week. The next week I up minimum pressure so my range is say 12-20. My 95% goes up to 13.8 consistantly for a week and so forth. That's whats been happening to me. Please correct me if I'm wrong but wouldn't it be correct to assume that as long as the machine pressure is going higher than my minimum setpoint, that my pressure range is not set too high. That being said, I also have to look to make sure centrals are not increasing. Like you guys say, find the sweetspot. It just seems that as I up my minimum pressure, the machine always goes higher yet to maintain the 95% than it did with a lower minimum pressure. Sorry for not explaining this very good but I hope someone can decipher what I'm trying to say.

Thanks everyone for your help!

[prefer2breathe]

Aside from Julie's sensible observation, it makes intuitive sense to me that even without leaks, at some point of increasing pressure beyond the ideal, excess pressure might invoke protective responses from your body that a machine could interpret as obstructive events. These home devices assess breathing patterns through airflow coupled with machine-regulated changes in airflow. They have no way to determine if a temporary cessation of breathing stems from your body's attempt to properly balance CO2 with oxygen rather than an obstruction.

Maybe that's what's happening because my leaks are not in the equation. I just wish I understand what you said!