I'm changing my pressure

Ritap1965 · Post by **Ritap1965** » Fri Mar 10, 2006 5:32 pm

First of all, CPAP is fantastic. I have a Remstart Auto with C-Flex and it has improved my life. My prescribed pressure is 10-16cm. I was Titrated at 15 during my sleep study (but I did suffer from congestion at that time). The problem, it is very high. With this pressure though, my AHI is usually between .5-2.0 at night. Have not had one night above 5 since I started with CPAP in December.

My problem, I find that my auto will put me at the high end of the spectrum every night, with an average pressure of 15.5. Even with C-Flex it is hard to breathe against.

Looking at my encore pro I found that long term, my AHI vs. Pressure (Dependence of Apnea/hypopnea indicds (AHI) on pressure) was the lowest at a setting of 11. So last night I turned APAP off and went straight CPAP without C-flex and with a setting of 11. I slept really well. Here are my numbers from last night.

AHI: 2.2 events an hour
Total Obstructive apneas: 2
Total Hypopneas: 14
Total Time in Apnea: 18 seconds
OAI: .27
HI:1.88
Variable breathing: 14.1%

So, I'm fine with the numbers. And I am thinking of making the change permanent and leave it straight CPAP on 11cm. I slept so much better. To make sure I'm not hurting myself I will chat with my sleep doctor about it. He is also having my due an oximeter in a few weeks, and that would be the other indicator that this is ok.

If you are against people changing their own settings, please don't reply because I know the arguments. If you are a person who take charge of your own health please let me know if you have tried anything similar, and if you found that you can be more successful with your therapy at a lower specific setting.

Wulfman · Post by **Wulfman** » Fri Mar 10, 2006 8:40 pm

Ritap1965,

Sounds like a good plan to me. Find the settings that work best for you. Just because you've got an APAP, doesn't mean you always have to run it in that mode. Some/many people do better on fixed pressure. And then you've always got your C-Flex settings to experiment with, too. Lots of variables.

In my case, my doctor prescribed a pressure of 18 and I'm doing much better on a pressure of 10 (changed it myself on day one without consulting my sleep doc). Didn't make him any too happy when I told him, but he couldn't argue with my success.

Best wishes,

Den

Goofproof · Post by **Goofproof** » Fri Mar 10, 2006 8:53 pm

It looks like you made a good choice, I do like the C-Flex on, and no ramp.

It's a blast the first two breaths, but after that it's heaven. I guess I'll never get used to the burst of pressure, but at night I have to check the vent to see if the machine quit. If you play with the pressure in about 5 day time periods going up and down by .5 cm jumps you may be able to do a little better but you are so close. Good Work.

InflatableMan · Post by **InflatableMan** » Fri Mar 10, 2006 9:12 pm

Had almost the same problem but left mine in auto and just kept dropping the low end pressure a little at a time until snores and events started to go up. When that happened i bumped the low end up 1 cm and set the top 5 over that. It's working for me. I like having the auto there in case its needed but now it seldom pushes the pressure more than 1 or 2 over the low end.

It seems that if I up the low end it still goes up 1 or 2 over without improving the AHI.

Darth Vader Look · Post by **Darth Vader Look** » Sat Mar 11, 2006 1:49 am

Ritap 1965 posts - If you are against people changing their own settings, please don't reply because I know the arguments.

Whatever you do don't post this on ASAA forum or any other or hell will cometh . You did choose the right site to post though. With your Auto set to CPAP mode your data should help you find that right level and I believe from what you have posted that you are doing great. Not a bad idea to keep the doc in the loop if he understands and is good about it. Once I find my sweet spot in PAP therapy I plan to do just as you and try my APAP in CPAP mode.

Ritap1965 · Post by **Ritap1965** » Sat Mar 11, 2006 12:35 pm

Thanks for the input. You are so right, I would not post this over on the ASAA site. I wanted input from people who take charge of their own health, not people who put blind faith in the medical community. Don't get me wrong, I need my doctor since I am not a doctor, but I like to be in charge of my own treatment.

11cm is not my sweet spot. My hypopneas went up last night to 23, but my apneas remain low at 2. With a total AHI of 2.8. My variable breathing has been way up the last 2 days, and I feel great. I am going to increase to 12cm, but I think that is my limit. I rather sleep well and have a few events, then have the best numbers and not sleep well. I am still WAY under AHI of 5, so I know treatment is working. The beauty of having an AUTO, Software and know how to change the settings is that I can eventually get to the sweet spot where I don't feel like my face is in a tornado, and where I have great results.

Thank you for all your help and input.

roztom · Post by **roztom** » Sat Mar 11, 2006 1:12 pm

RItap:

Very good.

Have you tried giving it a little room?

1 or 2 cm above & below? Narrowing the band vs straight CPAP?

Now what you are doing may be absolutely best for you.

The reason I mention this is you were titrated at a much higher number.

Also, in my case I was titrated at 9 and still have a lot of events in CPAP at 9 so I went APAP and like you are looking for enough data to identify a sweet spot. I have opened up 6 - 14 but am having events at the lower pressure so I can see where I may need to raise the low end.

How long is your data for your sweet spot determination?

Thanks,

Tom

Ritap1965 · Post by **Ritap1965** » Sat Mar 11, 2006 3:57 pm

I had my auto set for 13cm-16cm, and most of the time I would end up at 15.5 or 16 by morning. The problem with that is that I would wake up feeling sore. It felt like my chest had been through a hard workout. I rather feel better so that is why I am trying it on the lower settings. My plan is to stay on 11 or 12 for a week and see what my apnea's and hypopneas are doing. Right now my apneas are great, and I suspect they will stay that way. I'm going to see if 12 will bring my hypopneas down. If it does I will stay with 12, but going back up to 13-16 will bring the soreness back, and I'm not willing to deal with that when I have an AHI below 2.5 on 11.

Just to make sure I will use an onximeter next week to make sure I'm getting enough oxygen at a 11-12 setting.

One other thing to take note of. With a range of 13-16 my variable breathing is always below 10%. At 11 it is between 15-17%. I take this to mean I am sleeping better and having more rem sleep. Please correct me if this is a incorrect assumption.
_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): AHI, auto

Goofproof · Post by **Goofproof** » Sat Mar 11, 2006 4:10 pm

Your body will adapt to the added pressure in time. I.m at 15.5 and the opened me up. I started at 14 cm one month after the operation, scary.

suefox51 · Post by **suefox51** » Tue Mar 14, 2006 6:00 pm

Been reading this thread and I'm looking to lower the pressure on my CPAP - it's set for 17 and I feel like I'm blowing my brains out trying to exhale lately!
Can anyone help me figure out how to lower the pressure without having to deal with the "knowledgeable" person who set it up?
Thanks.

Ritap1965 · Post by **Ritap1965** » Tue Mar 14, 2006 9:05 pm

It depends on your CPAP machine. Let us know the brand and model and somebody here should know how to change it on your machine.

suefox51 · Post by **suefox51** » Wed Mar 15, 2006 6:08 am

It's an Invacare Polaris EX CPAP. The booklet that came with it does not indicate how to change the settings.
Any help will be greatly appreciated.
Sue

Skodobah · Post by **Skodobah** » Sat Mar 18, 2006 3:08 pm

I just reset my ResMed S8 to 10 (from 13) and it seems to be a better pressure for me. I cannot understand how I titrated at 13 during a sleep study where I did not sleep! How can they determine that number if you are not actually sleeping? 13 was blasting my brains out and with my sinus issues I had to stop cpap on and off the last month. With the new pressure, I feel better and according to my husband, I am not snoring... rather I am breathing normally.

- jules

p.s. Your health ultimately is in your hands. Do what feels right.

Ritap1965 · Post by **Ritap1965** » Tue Mar 28, 2006 9:11 pm

My sleep doctors office called me today. They had looked over the readings from the oximeter, one night which was with 12cm of pressure, the 2nd night with 15cm of pressure. According to the readings both nights I was over 80% oxygen saturation, with the 15cm pressure being a little better. Both readings were acceptable and the doctor said I could leave the machine on 12cm, even though I was titrated at 15cm.

Even though my readings are slightly better on 15cm, both AHI and oxygen saturation, I sleep better at 12cm. I have less issues with sore lungs, back pain, bloated stomach etc. So I think I have found my sweet spot. I love having the software and card reader so I can take charge of my own health (in conjunction with my doctor). Without this board I would have been stuck on 15cm, and eventually I'm afraid I would have given up because of the discomfort, and never known that 12cm would be a better option for me.

Next step, adding the Comfortlite 2 to my collection.

Rita

Darth Vader Look · Post by **Darth Vader Look** » Wed Mar 29, 2006 12:18 am

Sounds like good news to me. I am however surprised that your doctor didn't want to get your O2 level up to at least 90. Did he say anything about the lower O2 level .

I'm changing my pressure

I'm changing my pressure

Invacare Polaris EX CPAP

I got the call