adjusting pressures help

[sleepymama]

ok so i adjusted my pressure from 9 to 9.6... i noticed that after the second day on this pressure my machine stopped giving me that much pressure and is only giving me 9.3 so i changed the machine to 9.4 and it's been only giving me 9.3.
i am still having events and my leak rate is okay since going back to the nasal pillows. i am not sure if i should go up more or if i should always have that much events... i think it ranges from 3-6

does anyone know?

i am also having an issue with keeping my mask on. i've been taking it off and turning my machine off and taking the tape off. i wake up in the morning with nothing on and wondering what the heck i did the night before.

[sleepymama]

also wanted to add that my epr level is 3 and it's full time. i am wondering if this makes any difference in my events.

[Muse-Inc]

Many of us would not recommend fiddling with our therapy pressure until we find a mask we'll wear all night and get our leak under control...numbers are not to be trusted until that happens. If you have much leak, an APAP will increase pressure to compensate thus making the overnight pressure readings suspect as being what you need for therapy.

[rested gal]

also wanted to add that my epr level is 3 and it's full time. i am wondering if this makes any difference in my events.

With pressure set at 9 and EPR set at "3" for a 3 cm drop in pressure each time you breathe out, you are getting only a pressure of 6 during exhalation AND during any pause after the end of exhalation. If a pressure of 6 isn't enough to hold your airway open and allow you to get another breath started .... well, you get the picture.

I'm not a doctor and I'm no expert on EPR or machine stuff, but here are my thoughts (just my opinion) about what might happen for some people:

Jan 2010 - "Cflex 1-3 Levels"
my post(s) describing my understanding of how C-Flex works
and how EPR works differently.
viewtopic.php?p=436054#p436054

Nov 2009 - "EPR"
my post answering a question by Paul56
viewtopic.php?p=310021#p310021

Feb 2009 - "Adjusting my Clinical Pressure Settings"
topic started by jda1000
viewtopic.php?p=342731#p342731

Aug 2008 - "What's the difference"
topic started by Arizona-Willie
viewtopic.php?p=289251#p289251
and
viewtopic.php?p=289264#p289264

April 2008 - "Resmed vs. Respironics - Help"
topic started by Needsdecaf
On page 22 split_city and -SWS discussing apneas
viewtopic.php?p=260224#p260224

Oct 2006
my post replying to jskinner's question
viewtopic.php?p=121621#p121621

Dec 2007
my post replying to khvn's question
viewtopic.php?p=231782#p231782

Feb 2008
discussion of how EPR behaves differently from true "bilevel"
viewtopic.php?p=245729#p245729

[ozij]

I have to disagree with you, Muse, on both counts.

Many of us would not recommend fiddling with our therapy pressure until we find a mask we'll wear all night and get our leak under control...

Pressure fiddling: If the pressure is intolerable (too high or too low) we will find ourselves removing the mask, nor matter how comfortable the mask itself is.
However,based on this thread, viewtopic.php?f=1&t=55426&st=0&sk=t&sd=a&start=15 , sleepymama, your leaks seem OK, and I agree with Muse the foucus should be on mask comfort - discomfort may make you remove the mask.

If you have much leak, an APAP will increase pressure to compensate thus making the overnight pressure readings suspect as being what you need for therapy.

Actually, Respironics drops pressure when it encounters a high leak, and Devilbiss, does not respond to any detected event as long as there's a high leak. I don't know how the ResMed responds to high leak.

ok so i adjusted my pressure from 9 to 9.6... i noticed that after the second day on this pressure my machine stopped giving me that much pressure and is only giving me 9.3 so i changed the machine to 9.4 and it's been only giving me 9.3.

Why did you conclude you needed to adjust your pressure from 9 to 9.6?
Where did you find the info on the supplied pressure and why did you drop the pressure to 9.4?

[Hawthorne]

It appears, to me, that you should be adjusting your EPR setting as a first try at resolving this. As Rested Gal said, with Resmed, each level of EPR drops your pressure by 1 cm. With your EPR at 3, you are dropping to 6 (very low with a set pressure of 9 something) on exhale and that may let your airway close too much. Then when you inhale and it goes up to 9 something, it takes too long to go up 3 cm to your therapy pressure and more events may happen. I would try an EPR of 2 and then, If necessary 1 or turn it off altogether. That EPR setting and having to go up 3 cm on inhale, may be causing arousals and that may be why you take your mask. I'm just taking a stab at it here but it may well be like too large a pressure range in auto ranges.

Leave your pressure setting as is while you experiment with EPR settings.

You need to leave it for a a few days anyway when you make ONE change and then see if things are better or worse.