Pressure upon waking up in the morning

[ChristianC]

Upon waking up some mornings I find that I need only breathe normally (slowly) yet the pressure on my machine is pretty high. When that happens, I use the ramp button to bring it down so as to enjoy a few minutes of relaxed breathing before getting up. My question is: why doesn't the pressure diminish automatically when I control my breathing to a regular slow pace??

[Julie]

The machines are designed to respond to your breathing while asleep, and however you breathe consciously while awake is not going to replicate the same thing for the machine - and while it might not 'know' that you're awake, semi-awake or sleeping as we are aware of it, it is geared to a complex range of breathing during different types of sleep which may change for you at different times of the night and on different nights. I hope you're not making special efforts to control your breathing when going to sleep either, because you'll defeat the machine's purpose, which is to respond to your natural breathing (with apneas and/or other events that occur). Why do you not simply turn off the machine once awake and put it aside?

[Pugsy]

The PR S1 machine responds slowly to breathing changes no matter what the cause...it goes up slowly and goes down slowly.
When you wake up to a higher pressure eventually the machine will sense that there is no need for the higher pressure and start it's trip back down...this might take 3 to 5 minutes depending on how high it was when you woke up and how far back down it needs to go.

Example....if your minimum pressure is say 8 cm...and during the night you wind up near 14 cm then wake up...it doesn't drop from 14 down to 8 in a split second..it actually takes its own sweet time testing the pressures along the way as it reduces.
It doesn't know that you woke up and don't need it working at the higher pressure. So it reduces slowly maybe as little as 0.5 cm every 30 seconds or so. There's nothing you can do to speed up the reduction in pressure beyond what you are doing already...hit ramp or a quick turn off and back on of the machine so that the pressure resets immediately to the lower pressure.

[Wulfman...]

Upon waking up some mornings I find that I need only breathe normally (slowly) yet the pressure on my machine is pretty high. When that happens, I use the ramp button to bring it down so as to enjoy a few minutes of relaxed breathing before getting up. My question is: why doesn't the pressure diminish automatically when I control my breathing to a regular slow pace??

Since you're asking this question, I presume you're not using software to see what's happening during the night and how your therapy is working.
If you would use the software and download your data, you would probably find out why it seems "high".

What are the pressure settings in your machine? Maybe you need to raise your minimum pressure and lower your maximum pressure.


Den

.

[cosmo]

Every time I wake up, I always think I have forgotten to connect the air hose to my mask. But a quick check of the exhaust port confirms the machine is on and working. Cpap feels natural to me.

Try cpap mode?

[ChristianC]

Since you're asking this question, I presume you're not using software to see what's happening during the night and how your therapy is working.
If you would use the software and download your data, you would probably find out why it seems "high".

What are the pressure settings in your machine? Maybe you need to raise your minimum pressure and lower your maximum pressure.

Den
.

I use EncoreViewer 2 to chart my data. However, I see nothing in any of the charts that explains why my pressure is still, say at 10, when it should be at 5 based on the fact that I am now awake and feel "force fed" by too high a pressure. I understand some of the answers stressing that the machine will adjust slowly to new conditions but I am also questioning whether my machine might not be functioning properly.

In answer to your question, my pressure settings are:

* Minimum: 5
* Maximum: 12

[Wulfman...]

Since you're asking this question, I presume you're not using software to see what's happening during the night and how your therapy is working.
If you would use the software and download your data, you would probably find out why it seems "high".

What are the pressure settings in your machine? Maybe you need to raise your minimum pressure and lower your maximum pressure.

Den
.

I use EncoreViewer 2 to chart my data. However, I see nothing in any of the charts that explains why my pressure is still, say at 10, when it should be at 5 based on the fact that I am now awake and feel "force fed" by too high a pressure. I understand some of the answers stressing that the machine will adjust slowly to new conditions but I am also questioning whether my machine might not be functioning properly.

In answer to your question, my pressure settings are:

* Minimum: 5
* Maximum: 12

Did you have a sleep study and titration?
Did/do you have a prescribed pressure?

I guess I'm trying to find out why you're using an APAP with such a low minimum pressure and/or why they came up with that pressure range.
10 or 12 cm. isn't really that "high". Did your sleep study/titration reveal central apneas above 12 cm.?

The primary things that cause an APAP to increase pressures are snores and/or flow limitations. If your reports show either of those, those would be part of the explanation why your pressure is or stays higher.


Den

.

[ughwhatname]

Every time I wake up, I always think I have forgotten to connect the air hose to my mask. But a quick check of the exhaust port confirms the machine is on and working. Cpap feels natural to me.

Try cpap mode?

I have the same experience. The machine seems to be working with me, not against me. Only difference is I'm using APAP mode.

[Pugsy]

I understand some of the answers stressing that the machine will adjust slowly to new conditions but I am also questioning whether my machine might not be functioning properly.

How much time are you giving it to reduce the pressure back down to 5 from 10? 1 minute....2 minutes....5 minutes...10 minutes?

[NotLazyJustTired]

I use EncoreViewer 2 to chart my data. However, I see nothing in any of the charts that explains why my pressure is still, say at 10, when it should be at 5 based on the fact that I am now awake and feel "force fed" by too high a pressure. I understand some of the answers stressing that the machine will adjust slowly to new conditions but I am also questioning whether my machine might not be functioning properly.

In answer to your question, my pressure settings are:

* Minimum: 5
* Maximum: 12

This is one of those places where "a picture is worth a thousand words". If you wouldn't mind letting us see one of your graphs showing pressure, events, snores, and flow limitation, I think we might be able to understand better what you are saying and offer better help.

[Julie]

Are you finding it difficult to exhale? If so, the EPR or c-flex feature (depending on whether you're using a Resmed or Respironics machine) can be set to relieve that pressure, but if it's just generally too strong you might even want to check with the DME and be sure the machine is running properly.

[archangle]

Instead of using the ramp, turn the machine off and back on. It will start back at the minimum pressure and only go back up if it sees apnea, snoring, or problems in the flow rate.