Should I try increasing my pressure? Please advise

[cake321]

I've been on CPAP since late September. It seemed like when I first started using it, I could definitely feel the difference. It was easy to get out of bed, even when I only slept about 5-7 hours, which is what I normally get during the week. I've noticed over the last few weeks, it has once again become hard to get out of bed, and I find myself still getting tired throughout the day, especially in the afternoon (this never totally went away, but I definitely had improvement). I am not doing anything differently. I have no leaks, and my spouse confirms that I do not snore. I am wondering if I should try raising my pressure. It is currently at 11. I cannot afford to go back to the doctor as I no longer have insurance. The only thing I can possibly think of is that I may have gained 5-10 lbs over the last few months. Could this matter? I was already about 30-40 lbs overweight to begin with.

Thanks for any advice. I just can't stand feeling this way again.

[cake321]

Some additional details that I thought of after I posted... I have no problem falling asleep or staying asleep. In fact not once have I ever woken up and had to get up and pee, which was a common problem before I started CPAP. Thanks again for any help.

[BlackSpinner]

I don't know if your machine has data. Someone else will help with that.
If you decide to try that up it by the smallest amount the machine will allow and leave it there for a week. Keep a journal.
There have been studies done that people are quite capable of finding their own pressure needs even without data.

The only caveat is that if you feel worse the pressure may be triggering centrals - in which case you reduce it again.

However since you use a nasal only mask you may want to try a chinstrap first. mouth breathing leaks therapy.

[cake321]

I don't know if your machine has data. Someone else will help with that.
If you decide to try that up it by the smallest amount the machine will allow and leave it there for a week. Keep a journal.
There have been studies done that people are quite capable of finding their own pressure needs even without data.

The only caveat is that if you feel worse the pressure may be triggering centrals - in which case you reduce it again.

However since you use a nasal only mask you may want to try a chinstrap first. mouth breathing leaks therapy.

Thank you. I do use a chin strap, as well.

[porete]

I wouldn't increase the pressure without your doctor's consent. If your machine is data capable, you can take the data reports to your doctor and both of you can figure out what would be the best step for you to take.

[porete]

I looked your machine up on cpaptalk.com and it IS data capable.
"For therapy tracking, the SleepStyle 234 CPAP is compatible with Compliance Maximizer software, using F & P's Compliance Download Cable to transfer data between machine and computer."

[Pugsy]

The SleepStyle 234 has only hours of use..compliance hours. No other useful data.
http://www.fphcare.com/osa/cpap-solutio ... e-200.html

The only thing you have to go on is how you feel. It is unlikely that things would have changed so quickly to cause you to need more pressure but it would not be impossible. You have a very basic machine and there is no way to obtain any data to see what is going on. I would think something else like leaks compromising therapy. If there is no money or insurance for a doctor visit then you have to decide if you want to try a little more pressure. If you do decide to try it...go up slowly. Also before you try it be sure and check all your gear to make sure everything is fine...no tiny holes in hose...no loose fittings...mask fittings, etc. Just to make sure you aren't losing pressure via a leak that you are unaware of.

A few extra pounds shouldn't make a huge difference (heck if we lose that much we don't often get to reduce the pressure) but again, it wouldn't be impossible especially if you were perhaps borderline needing a bit more.

[cake321]

The SleepStyle 234 has only hours of use..compliance hours. No other useful data.
http://www.fphcare.com/osa/cpap-solutio ... e-200.html

The only thing you have to go on is how you feel. It is unlikely that things would have changed so quickly to cause you to need more pressure but it would not be impossible. You have a very basic machine and there is no way to obtain any data to see what is going on. I would think something else like leaks compromising therapy. If there is no money or insurance for a doctor visit then you have to decide if you want to try a little more pressure. If you do decide to try it...go up slowly. Also before you try it be sure and check all your gear to make sure everything is fine...no tiny holes in hose...no loose fittings...mask fittings, etc. Just to make sure you aren't losing pressure via a leak that you are unaware of.

A few extra pounds shouldn't make a huge difference (heck if we lose that much we don't often get to reduce the pressure) but again, it wouldn't be impossible especially if you were perhaps borderline needing a bit more.

The pressure settings go up in increments of 0.5, so the next highest setting would be 11.5. Do you all suggest going up in .5 increments or 1.0? Also, how many days should I wait before upping it if I feel no improvement?

[Kairosgrammy]

Is your machine data capable? If so, have you checked your ahi, rera's etc. What are those numbers.

Gaining weight can make a change in OSA sometimes but at other times, it is inconsequential. There are people of normal weight who have severe OSA and in fact there is the arguement of "Which came first" OSA and then weight gain or weight gain and then OSA. There is a lot of research out there that would favor OSA & then weight gain and with me, I would say there is a lot of truth, Even if I were to lose weight and get down to a healthy weight, I will still probably need cpap for the rest of my life and that's fine. I feel better.

If I had to change something, I would first work on increasing # of hours sleeping. As the old saying goes, we can't be teenagers forever living on 4 or 5 hours of sleep.

Some additional details that I thought of after I posted... I have no problem falling asleep or staying asleep. In fact not once have I ever woken up and had to get up and pee, which was a common problem before I started CPAP. Thanks again for any help.

[freshair]

I have had my pressure increased twice since triation...I requested another...they said no...the reason is if my pressure is too high it could shut off my breathing.....so in may when i return hm i'll setup another study....she did tell me to change my c-flex to setting one and also turn off the system one humification selection...its working better now....me and my sleep tech are 1000 miles apart.....tks--FA

[archangle]

I have had my pressure increased twice since triation...I requested another...they said no...the reason is if my pressure is too high it could shut off my breathing.....so in may when i return hm i'll setup another study....she did tell me to change my c-flex to setting one and also turn off the system one humification selection...its working better now....me and my sleep tech are 1000 miles apart.....tks--FA

Geez, what they're saying is "We ripped you off by giving you a non-data capable CPAP machine. Now we're going to refuse to adjust your pressure upwards since it might give you central apneas, and the machine we screwed you with can't tell the difference. How would you like another uncomfortable, expensive, sleep test that may not tell us much because you may not sleep the same way you do at home?"

[Guest]

my insurance pays 100%

[Pugsy]

With no data to rely on....I would only increase the pressure in 0.5 cm increments. I would leave it for 7 days. I would start a journal and document how I felt and how many hours of sleep I got. Did I wake often during the night? If so, for what reason.

Keep a journal so have something to correlate things with. Hours of sleep are critical....so is waking often for any reason...it messes with how we feel.

You will need to be very thorough with your journal... I know that it is real easy to forget how bad or good I felt 2 days ago... Looks for patterns. Don't expect a sudden change in how you feel with a small pressure change. We don't sleep the same each night even if we don't change anything.

If you start feeling horribly worse....discontinue the experiments and go back to RX pressure.

Finally, if your finances would permit it at all or if you had a friend with a full data machine you could borrow....you need the data available to really see if you even need a pressure increase...it may not be the pressure causing your problems...it might be something else. Could you scrape together a couple hundred dollars to get a machine that offered data? Craigslist sometimes has some good deals. Just have to shop smart. Even if it was limited to on screen data (like the ResMed S8) it would be better than flying blind like you are now.