Can someone tell me if I should increase my pressure?

[king_alvaro]

For the first time, I finally checked the software and transferred the data to rescan. These were the results for the last 60 days.

Minimum pressure set: 7.4
Maximum pressure set 9.4

Median daily usage: 7:55 hours
Median AHI : 0.9 AHI
Pressure median: 8.3
95 percentile 9.2
Maximum 9.3
Hardly any leaks.
.
It seems that I am very close to my maximum pressure. Should I bump my minimum pressure to 8 and maximum to 10?

Two months ago I had a titration study and they found out the my median pressure on the Respironics was 7.5 and my highest was 8.3. So they prescribed me at a pressure of 8 on CPAP. Because prior to that pressure I was at a 6 and I wasn't feeling good all day even if I sleep 8 hours. So, I paid out of pocket to have another titration study. How can pressure go up that quickly if it has been 2 months that they told me my median pressure was 7.5 and now the median is 8.3.

After 2 weeks of that titration study I decided to take more control of my health, so I decided to buy the APAP and I love it.

[Classic SleepCare]

What does your Primary Care say? AutoPAP, nice machine. Your AHI is .9? That is outstanding! That's great even for somebody not on CPAP therapy so why change the pressure?

[Sheriff Buford]

Your numbers look good. I'm not sure why you would want to increase your pressure. Are you feeling good? You can bump to high number up 1 cm/h2O and see how it goes. Take your time and be sensitive to your body's response to the bump-up.



Sheriff

[greg-g]

Download your data and look at the pressure and flow limitation curves.
In general the pressure shouldn't flat line at the maximum pressure. If it is flat lining and the flow limitation curve increases significantly at the same time you should then probably increase the pressure.
I personally leave my maximum pressure at 15 although the actual pressure normally never goes above about 12 and the 95% pressure is about 10. My minimum pressure is 8.
As your AHI is very low I don't think you have a problem.
If you find varying pressures a problem, or higher pressure causes leaks, then I wouldn't change the pressure

[Bobby269]

How are you feeling in the morning? For me when my numbers go above 0.5 I don't feel as well. Mind you there are days when I do go higher.
If your apnea's are centrals be careful about raising your pressure to much. Do small amounts at a time. But the key is how you feel in the morning.

[Pugsy]

How can pressure go up that quickly if it has been 2 months that they told me my median pressure was 7.5 and now the median is 8.3.

One night in a sleep lab doesn't necessarily mimic nights we have at home.
Even at home we don't sleep the same every night and we can have normal variations in pressure needs.
One night we might need a little more and one night maybe a little less. It is normal.

The difference between 7.5 and 8.3 is really insignificant in the overall grand scheme of things anyway.
Nothing to worry about and your AHI is superb and I see no reason to change anything. If you start hitting your maximum often you might increase the max a little just to give yourself more wiggle room just in case you have a super stubborn event. The machine won't go there unless it needs to anyway.

FWIW....the titration study doesn't always get it right anyway. In my case they said 8 cm was great and when I was home my AHI was near 10 with 8 cm. Come to find out I only got to REM sleep for 6 minutes during my titration study and REM sleep is where I am worse and have the most stubborn events.
So the fact that they came up with one number and you came up with a slightly different number is not surprising at all. They got close though.

[XSnorer]

I found this post interesting.... Because, when I first got my S9 from the DME (Oct 2010) they left the machine at full range with maximum pressure (25 I think?). I asked about leaving the machine at max pressure. Their comment was that they thought it best to let the machine find the right pressure. Well, since my previous CPAP machine which I had for over 5 years was set at a constant 8, I decided it would be safe to at least lower the max to 12 or 13, which I did. And honestly, it's been so long since I changed the max that I've fogotten where I set it. What is interesting is that the recommended origninal settings on my S9, as received 18 months ago, were inconsistent with the settings noted above. No doubt opinions differ.

Regarding the comments actual pressure needs, as noted above it varries. Currently my 95% pressure is running in the 7 to 8 range each night. A few months ago it was in the 8 to 9 range each night.

These autoset machines are wonderful devices. (I only have experience with the S9 but I'm sure others are just as effective.) Just wondering if at some point they will phase out the CPAPs and only have APAPs....

[Pugsy]

What is interesting is that the recommended origninal settings on my S9, as received 18 months ago, were inconsistent with the settings noted above. No doubt opinions differ.

If the machine doesn't ever go near the maximum setting (whatever it is) it doesn't really matter what the maximum setting is because it never joins the ball game. It is just a number up there.
The minimum pressure is the most critical pressure though. Needs to be close enough to the needed pressure to get there in a timely manner. They can't go from a minimum of 4 cm to 12 cm in a blink of an eye and if it takes too long to get to where it is needed the events come and go while the machine is making its way up to where it needs to be.

If a person only needs 7 or 8 or 9 pressure then setting the minimum lower isn't much of a problem because the machine is already pretty close to what is needed.

If someone never needs more than 9 cm pressure...it doesn't really matter what that maximum is because the machine never goes there anyway. Heck, the maximum could be 100 and if the machine never goes above 10 it is a moot point.
But it doesn't hurt a thing to limit the maximum either.

[XSnorer]

What is interesting is that the recommended origninal settings on my S9, as received 18 months ago, were inconsistent with the settings noted above. No doubt opinions differ.

If the machine doesn't ever go near the maximum setting (whatever it is) it doesn't really matter what the maximum setting is because it never joins the ball game. It is just a number up there.
The minimum pressure is the most critical pressure though. Needs to be close enough to the needed pressure to get there in a timely manner. They can't go from a minimum of 4 cm to 12 cm in a blink of an eye and if it takes too long to get to where it is needed the events come and go while the machine is making its way up to where it needs to be.

If a person only needs 7 or 8 or 9 pressure then setting the minimum lower isn't much of a problem because the machine is already pretty close to what is needed.

If someone never needs more than 9 cm pressure...it doesn't really matter what that maximum is because the machine never goes there anyway. Heck, the maximum could be 100 and if the machine never goes above 10 it is a moot point.
But it doesn't hurt a thing to limit the maximum either.

concur... and so your recommendation to the OP would be what?

[Ticman]

I would go ahead and try the 8 to 10 pressures. Your median is over 8 already and given that small a change it's nothing to worry about. Try is for a week if you sleep better keep if not put it back. Nothing wrong with trying to get the best sleep you can.

[Pugsy]

concur... and so your recommendation to the OP would be what?

Same as I said in one of my responses that probably was missed.

The difference between 7.5 and 8.3 is really insignificant in the overall grand scheme of things anyway.
Nothing to worry about and your AHI is superb and I see no reason to change anything

[king_alvaro]

Thank you everyone especially Pugsy. I will just leave my pressure settings as how I had them. Anyways I have a great AHI number.

[XSnorer]

Yep Pugsy, did miss your "I see no reason to change anything" comment - So my aplogies.

But, based solely on the logic as stated in your reply to me I guess I'd be inclined to bump the higher pressure a point or so. I say that because my pressures tend to vary over the days, weeks, months. So having the extra room on the max side might come in handy one evening. Also, as you noted, it will never use the higher pressure if there is no need for it.

[Pugsy]

But, based solely on the logic as stated in your reply to me I guess I'd be inclined to bump the higher pressure a point or so. I say that because my pressures tend to vary over the days, weeks, months. So having the extra room on the max side might come in handy one evening. Also, as you noted, it will never use the higher pressure if there is no need for it.

That is what I did. I let the APAP have full maximum range and sometime it used most of it and sometimes it didn't. Pressure variations never disturbed my sleep though. If it had then I would have had to compromise probably and limit the max to a point where it didn't bug me and still got the bulk of the higher pressure needing events. Some nights I might have seen 16 to 18 cm max a couple of times and some nights the pressure barely got about my minimum.

I am now using bilevel auto..I did pick an arbitrary maximum of 16 cm just as a number to pick with full intentions of increasing it as I expected I would see the need for 18 again but so far after 3 months...I barely nudged 16 once and it was a barely nudge. So I haven't bothered to change the maximum. Last month out of 30 nights in April...I had AHI less than 1.0 for I think 21 nights..worst it ever went to was 2.4 I think and the bulk of the higher AHI was central index anyway.