Overtitration a possiblility on Resmed AutoSet S9?

[acc0mpl1ce]

I am a relatively new CPAP user. It's been about a month since I have gotten my machine. Originally I had the pressure set to limit at about 10 I believe as max pressure.
My AHI was 31 at diagnosis and dropped to 2 with the original setting. My sleep doc thought it would be good to open to open the machine up to the max possible level to see if it might completely correct my apnea completely.

For the first couple weeks, I felt so much better, like a new person. After the calibration was changed, I feel super tired again and I have been experiencing a new phenomenon. Embarrasing enough to say, I have gotten extremely gassy in the middle of the night, belching and farting are happening a lot throughout the night.

Is it possible my Resmed is overcompensating and in turn, not helping me? I have felt like total crap for the last week.

Any insight into this would be helpful.

[ozij]

Yes, it's possible for a self adjusting CPAP machine (an automatic machine, an APAP) to misread your breathing pattern, and raise your pressure too much.

I have to limit my Autoset 9, or else it will supply too much pressure, and cause exactly what you describe: gassy, belching, farting -- and in my case, at one point, lots of pain too.

Get the pressure back down to where it did you keep -- and do it ASAP -- no reason for you to suffer like that.

[sleepnationtv]

Yes it is very possible, first off its almost impossible to completely correct the apneas and get the AHI down to zero. Plus the machines calculation is not 100% correct so an AHI of 1 or 2 is expected. You may be swallowing air due to the increased pressure. Here is my recommendation as a sleep technician. First of all watch our video so you are familiar with changing the pressure and accessing the advanced data of your machine. http://www.sleepnation.tv/post/2337667545/resmeds9

Then go into the advanced info menu, (hold down both silver buttons together) Then turn the no9b to see the sleep report. Click the turndial to enter the menu. Click on period and change it to 1 month. THen scroll down to pressure and look at the number. That number is your 95% number meaning that is what the machine is at 95% of the night. Then you want to set your range from 5 as min to a few numbers above that 95% number to ensure that is high enough to take care of most apneas.

If you have questions email me at sleepnationtv@gmail.com

Thanks,

Dane Schapper

[Lizistired]

My AHI was 31 at diagnosis and dropped to 2 with the original setting. My sleep doc thought it would be good to open to open the machine up to the max possible level to see if it might completely correct my apnea completely.

That just makes no sense. I got a dollar that says your doc doesn't have sleep apnea. What was the original setting? Did they do a titration study? Or is he doing it on the machine?
My experience is that the narrower the range the better. Otherwise the machine is chasing apneas and I think the pressure changes cause arousals, at least for me. Once I got my range down to 1 CmH20 my apneas disappeared. I'm under 1, mostly 0 for the last week, with NO "Sleep Hygiene" practices.
My script says 7, I'm running 7.4-8.4 and considering raising my minimum. Although it is functioning as a ramp right now. Once it goes up it doesn't come down that far.

[Uncle_Bob]

Any insight into this would be helpful.

I sent you a private message.

[rested gal]

That number is your 95% number meaning that is what the machine is at 95% of the night.

Dane, your videos are great. Kudos for making them and having them available to CPAP users. The videos are very well done -- excellent information clearly presented. You all have put a lot of work into them.

I don't think the sentence I quoted is correctly stated, however. It's my understanding that the 95% number means that during 95% of the night, the machine used THAT pressure AND/OR pressures BELOW that pressure. A person might have spent very little time actually "at" that pressure, and the majority of the time at pressures well below it.

[Mary Z]

Sounds like you should go back to your original prescription of 10. An AHI of 2 is not bad at all. I don't know why your doc would do such a thing, except for the reason he gave which doesn't make good sense. Good Luck.
Mary Z.

[ladyhen]

I just finished night 4 on the same machine.

I was doing well - but last night, my machine wanted to keep me at 5 FOREVER. I feel like I can't breathe at 5. I have the ramp turned off and it didn't matter.

According to my data, my pressure averages around 8.9 throughout the night and goes up to 13.8 at times. I'm thinking about bumping my minimum pressure setting up to 8 but am wondering what the therapist will say when she reads my card?

I hope you get some answers! Sounds like sticking to what was working is your best bet.

[billbolton]

My sleep doc thought it would be good to open to open the machine up to the max possible level to see if it might completely correct my apnea completely.

That is very poor advice for a whole bunch of reasons....... you need to find a new sleep clinician.

Cheers,

Bill

[Pugsy]

I was doing well - but last night, my machine wanted to keep me at 5 FOREVER. I feel like I can't breathe at 5. I have the ramp turned off and it didn't matter.

According to my data, my pressure averages around 8.9 throughout the night and goes up to 13.8 at times. I'm thinking about bumping my minimum pressure setting up to 8 but am wondering what the therapist will say when she reads my card?

I understand about the 5 cm of pressure. Not enough air for me either. What do they have your range set at?
Therapist may have a hissy fit. How about just calling and explaining the situation and that you would like just a little more? Might not need 8, 6 or 7 might be more comfortable than you think.

[ladyhen]

I was doing well - but last night, my machine wanted to keep me at 5 FOREVER. I feel like I can't breathe at 5. I have the ramp turned off and it didn't matter.

According to my data, my pressure averages around 8.9 throughout the night and goes up to 13.8 at times. I'm thinking about bumping my minimum pressure setting up to 8 but am wondering what the therapist will say when she reads my card?

I understand about the 5 cm of pressure. Not enough air for me either. What do they have your range set at?
Therapist may have a hissy fit. How about just calling and explaining the situation and that you would like just a little more? Might not need 8, 6 or 7 might be more comfortable than you think.

I'm set at 5-20. They didn't do a titration study and are just letting the machine figure things out on its own.

[Pugsy]

I'm set at 5-20. They didn't do a titration study and are just letting the machine figure things out on its own.

Ahh, Understood. Perhaps a phone call to them to explain that you don't feel like you are getting quite enough air.
It won't be the first time that they have heard it. How long will this go on? Is this machine a loaner or will you be keeping it?