Does a reducing 90% avg pressure indicate an improving apnea

LonghornGary · Post by **LonghornGary** » Sun Oct 30, 2011 10:05 pm

I'm currently on Apap and have average a 90% pressure of 10-10.5, recently I started eating better and exercising in an attempt to lose 40 lbs. since dropping some weight, my pressure avg. has dropped to 9.0. Now I know some people's apnea improves or can go away if they lose weight. If I continue to lose wright and see my pressures drop as well is this an indication of improvement

JointPain · Post by **JointPain** » Sun Oct 30, 2011 11:02 pm

Very hard to say.

To me, "improvement" would mean not having to do CPAP. (Sure the lower pressure might be easier to handle, if you want to count that as "improvement".)

I don't know if not needing CPAP will ever happen.

But please do not decide that you don't need CPAP any longer without first getting sound medical advice.

I stopped doing CPAP because I thought I could get away with it occasionally. Occasionally gradually turned into always, and I really paid the price for that with my health.

That previous life was before I found this forum.

NightMonkey · Post by **NightMonkey** » Mon Oct 31, 2011 6:04 am

LonghornGary wrote:I'm currently on Apap and have average a 90% pressure of 10-10.5, recently I started eating better and exercising in an attempt to lose 40 lbs. since dropping some weight, my pressure avg. has dropped to 9.0. Now I know some people's apnea improves or can go away if they lose weight. If I continue to lose wright and see my pressures drop as well is this an indication of improvement

What is your pressure range?

archangle · Post by **archangle** » Mon Oct 31, 2011 6:55 am

Yes, having your average pressure go down is probably a good thing. Congratulations.

If nothing else, CPAP is more comfortable and less problematic if you can get good control with a lower pressure.

Remember that even if your pressure drops to a low level, you can still have very severe apnea if you stop. Some people have extremely severe apnea without treatment, but get excellent results with a very low pressure.

LonghornGary · Post by **LonghornGary** » Mon Oct 31, 2011 9:54 am

My pressure range is 4-14

Mary Z · Post by **Mary Z** » Mon Oct 31, 2011 10:37 am

I would think it means your APAP is working. The weight loss may be contributing to your decreased pressure needs How is your AHI? If you are able to check your AHI you may be able to fiddle with the pressure a bit if you're knowledgeable and comfortable with that.
Congratulations on your weight loss.

NightMonkey · Post by **NightMonkey** » Mon Oct 31, 2011 4:46 pm

LonghornGary wrote:My pressure range is 4-14

A pressure range that wide rarely works well. What is your AHI?

Pugsy · Post by **Pugsy** » Mon Oct 31, 2011 5:11 pm

NightMonkey wrote:A pressure range that wide rarely works well. What is your AHI?

Not always. I used 10 min and 20 max. same range. Worked well for me. Sometimes I need 16 to 19..other nights never above 11 or 12. All depends on the minimum.

DoriC · Post by **DoriC** » Mon Oct 31, 2011 6:06 pm

Usually the therapy works better if your minimum pressure is closer to your 90% pressure, in your case 9-10cms. So a minimum pressure of 8cm might be better, the max is probably OK at 14 should you need the extra pressure. A narrower range also helps with any leak issues.

NightMonkey · Post by **NightMonkey** » Mon Oct 31, 2011 6:16 pm

Pugsy wrote:
NightMonkey wrote:A pressure range that wide rarely works well. What is your AHI?
Not always. I used 10 min and 20 max. same range. Worked well for me. Sometimes I need 16 to 19..other nights never above 11 or 12. All depends on the minimum.

This is about LonghornGary, not you and not me [my pressure is also 10 - 20cm (but rarely goes above 12)].

LonghornGary says his pressure range is 4 - 14cm. I seriously doubt that wide of a range is optimal. LonghornGary would probably do better with a considerably higher minimum.

Pugsy, with your widely varying pressure requirements, have you ever considered Mars' posts on positional sleep apnea? When I see a case like yours I always suspect the wide pressure swings are due to changes in sleeping positions.

Pugsy · Post by **Pugsy** » Mon Oct 31, 2011 6:52 pm

NightMonkey wrote:This is about LonghornGary, not you and not me [my pressure is also 10 - 20cm (but rarely goes above 12)].

LonghornGary says his pressure range is 4 - 14cm. I seriously doubt that wide of a range is optimal. LonghornGary would probably do better with a considerably higher minimum.

Pugsy, with your widely varying pressure requirements, have you ever considered Mars' posts on positional sleep apnea? When I see a case like yours I always suspect the wide pressure swings are due to changes in sleeping positions.

Tis true this is about LonghornGary but he hasn't mentioned that what his AHI numbers are and you assumed that a wide range may not be suitable for what reason? I was just explaining that wide ranges do work and work well for some people. If his AHI was 8...I might agree with you but I don't know what his AHI is. Without seeing his reports I don't know if his % pressure is leak drive or event driven.

My pressure variations are unrelated to sleeping position. I am documented much, much worse with my OSA in REM only. Sleeping position makes zero difference.
So your suspicions of why I might need pressure variations are completely wrong. Not everyone has worse OSA on their back.

A blanket statement about pressure ranges or using something closer to the 90% number is not always an accurate assessment. One really needs to look at several reports to see which might work best.
On nights that I see 18 or 19 cm my 90% pressure might be 16 or 17 cm. On nights that my pressure never varies much from my 10 cm minimum I might see 11 or 12cm 90% pressure. Where do you think my minimum pressure should be?
Closer to 16? My AHI will be the same and leaks aren't a factor and I have plenty of documented examples of each.

I don't want to hijack this thread anymore than this but if you wish to debate narrow range gospel rule, I will be happy to provide ample reports to to show what I am talking about in another thread if you wish.

To Longhorn Gary I apologize if I digress. I just hate to see blanket statements about something without knowing all the details. Your 4 to 14 may do very well for you and if your AHI is fine and you are well rested and comfortable with a lower pressure minimum....there is no proof that narrowing your range will make any difference. You would have to be the judge of this with your own tests. Now if you AHI is elevated or you feel crappy that is a different story. Since you didn't post with a mention to that fact, I assumed all was fine and you weren't requesting advice on where you pressures should be. You just wanted to know if perhaps the weight reduction has affect the need for pressure with a slight downward trend. The answer to that is of course yes. Sure weight loss can affect pressure needs. Does it always? No. But it sure can and if it did for you that is wonderful. Less pressure is simply more comfortable. If you lose all your excess weight will it enable you to ditch the machine? Who knows.. it may or may not make any more change than it has already. I hope for your sake it does. Only time will tell though.

NightMonkey · Post by **NightMonkey** » Mon Oct 31, 2011 7:05 pm

Pugsy wrote: I don't want to hijack this thread anymore than this but if you wish to debate narrow range gospel rule, I will be happy to provide ample reports to to show what I am talking about in another thread if you wish.

To Longhorn Gary I apologize if I digress.

Like I said Pugsy, this thread is about Gary, not about you or me.

And no I don't want to debate "narrow range rule". As I just posted I use a wide range myself. And I don't want to debate "wide range rule" either.

I think you are only confusing Gary at this point. Why don't you give Gary time to answer the question I already asked since you now also want to know the answer?

NightMonkey wrote:
LonghornGary wrote:My pressure range is 4-14
A pressure range that wide rarely works well. What is your AHI?

Pugsy · Post by **Pugsy** » Mon Oct 31, 2011 7:14 pm

NightMonkey wrote: I think you are only confusing Gary at this point

And how do you know? I assume he is educated enough to understand my reasoning. If he needs something clarified all he needs to do is ask. Most people find my reasoning quite clear.

Please don't try to tell me what to say and when to say it. Remember I am a curse to this forum.
And it is Halloween and my spells are at their most potent.

VVV · Post by **VVV** » Mon Oct 31, 2011 7:15 pm

A pressure range of 4 - 14 is unusual.

It sounds to me that the doc did not know what to prescribe and assumed the auto machine would "find" the right pressure. The doc probably capped it out at 14 thinking that the patient surely did not need more than that.

Likely the doc does not understand how slowly these machines respond to events and did not understand that you can have many apneas waiting for the machine to increase the pressure from 4 to, for example, 10 or 12.

It will be interesting to hear what Gary's AHI is. Better to see one of the daily graphs showing the pressure changes and events.

NightMonkey · Post by **NightMonkey** » Mon Oct 31, 2011 7:17 pm

Pugsy wrote: Remember I am a curse to this forum.
And it is Halloween and my spells are at their most potent.

Now you are confusing me.

Does a reducing 90% avg pressure indicate an improving apnea

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