I need a reverse ramp

[Uncle_Bob]

I can use my APAP with a starting pressure of 4cm and the machine is telling me that its mostly using a pressure of 4.4 - 4.6 with no events.
The trouble is getting to sleep with such a low pressure is uncomfortable. I feel like i'm suffocating and not getting enough air.
What I really would like is a reverse ramp feature to start with a higher pressure to help me get to sleep and then ramp down to the lower pressure as needed. I can't think of any way of getting that to happen with either my S9 Autoset or PR System One Series 60 Auto

I could set my APAP to start 1cm or 2cm higher but I have a concern about using a pressure higher than needed. Can using a higher pressure than needed stretch your airway making it likely that you will need a higher pressure as you get older?

I think i am seeing my pressure drop as a result of my deviated septum surgery and diet and excercise. I was 230lbs when i was diagnosed just over 3 years ago and titrated at 7cm. My 2nd titration (after surgery) put me at 6cm (it was between 5cm and 6cm but the doc wrote my up for 6cm). Now I am 190lbs it seems the pressure needed is so low i could get away with sleeping with my mouth open and ceiling fan on

~UB

[Pugsy]

I could set my APAP to start 1cm or 2cm higher but I have a concern about using a pressure higher than needed. Can using a higher pressure than needed stretch your airway making it likely that you will need a higher pressure as you get older?

I don't see how it could stretch the tissues...even at 20 cm it won't blow up a balloon.
I would use whatever I could comfortably sleep with and not worry if it was a little more than I really needed.

[Xney]

Higher pressure might do two things: a) increase air swallowing, b) give you central apneas

(I suppose it could also cause more leaking but I doubt it matters at your pressures)

You're at a low enough pressure that I don't think either would be a problem. Increase it until it feels comfortable! It has to be comfortable for you to be compliant in the xPAP therapy.

[Julie]

If I were you, I'd ask for a new sleep study.

Between your being healthier and the ridiculous low pressure you're trying to breathe at, you may not need Cpap at all - BUT read this thread from someone who's still doing great because he did his own (and then an official one) step by step study, very carefully and intelligently before coming off Cpap.

There's more to it than you'll think at first glance, so go through the whole thing...

viewtopic.php?f=1&t=70205&st=0&sk=t&sd= ... ea+Therapy

[neverbetter]

See if you can't get another sleep test after all that weight loss. Unless you have centrals, you may not need a blower anymore. It's worth getting checked. Too much air is as bad as too little.

[Bobby269]

If your events aren't centrals. It seems that you can raise the pressure a small amount and experiment.As someone mentioned the other option to have a sleep study to see if you still need treatment. The least expensive idea is the pressure experiment.
I was told to use 14 in case I sleep on my back, but 12 or 11 on a good night takes care of most of my events. A pressure of less than 6 would be terrible for me.

[robysue]

A purely practical suggestion for the original idea about an inverse ramp:

Since both the System One and the S9 respond pretty aggressively to snores, do some fake snoring at the beginning of the night. When the pressure has increased enough to be comfortable, stop the intentional snoring and go to sleep. Once the snoring stops, the machine will slowly start to decrease the pressure. Hopefully you'll be asleep before it starts to bug you.

[ozze_dollar]

Good job with the weight loss Bob. I would be having another sleep test.

[Uncle_Bob]

Thanks for all the replies, i wasnt even going to make the original post but i like the suggestions here.
I'll try the fake snoring tonight.