sleep specialist changed my pressure settings

[Jak3099]

I have been on CPAP for about 6 weeks now. The sleepyhead numbers look fine, but my sleep quality is still poor. I saw the sleep specialist yesterday and told him how I was leaking air through my mouth (I use nasal pillows) and also swallowing a lot of air. He suggested I change my pressure settings from 10-16 to 4-16.

Four cm H2O seems low to me, and I felt like I was breathing through a stuffy nose at times. No dry mouth this morning, but I had a slight headache.

Here's last night's sleepy head report. I'm debating whether I should increase from 4 to ~7, or stick with what the doc said for now. I just realized from my sleep study I needed at least 5, so I'm surprised that he suggested 4.

Any suggestions/feedback are much appreciated!

[kteague]

It seems your sleep specialist was hoping allowing your pressure to stay as low as posssible would help with the air in your belly, and maybe even reduce blowouts that can lead to mouth breathing. All good in theory, but it will be in looking at your data that you can figure out how low is too low. If a pressure of 4 adds to your discomfort, it is counterproductive. Maybe increasing that start pressure to 6 or 7 would be more comfortable, but not yet high enough to be problematic, but the technical people will be better to listen to on that. If you continue to mouth breathe at lower pressure, you will need to address that to get effective treatment.

[Jak3099]

Thanks for the reply! As far as leaks go, I'm fairly certain I didn't leak air through my mouth, even without the chinstrap or tape over my mouth!

Perhaps my nose was extra stuffy last night? If I can bump it up to 6, and still avoid swallowing air, and mouth-leaking, I think that may be better for me. I definitely think the mouth leaks/gas in the belly cause arousals!

[Pugsy]

It's hard to feel like there is enough air moving at 4 cm pressure.
Maybe that was the reason behind the difficulty or maybe in combination with a little nasal congestion.
Any pressure below 6 cm and I feel like I am sucking air through a straw with a cheesecloth on it. I know in my head that I am not suffocating but it sure feels like I am.
Looks like from your report that you are lucky in that you don't need much pressure to effectively prevent the apnea events and while the 4 cm minimum seems to get the job done it likely is rather stifling.

Your leak line looks better than mine did last night.

[islandboy5150]

Hi Jak, have you monitored your SPO2 at night to see what your O2 levels are? Just thought about that since you mentioned getting headaches.

[Jak3099]

That's a good point. I don't have a device to measure my O2 saturation. Are there relatively inexpensive ones to buy, possibly to integrate with the ResMed S9?

[Pugsy]

Are there relatively inexpensive ones to buy, possibly to integrate with the ResMed S9

The one that works with your machine and ResScan is several hundred dollars so I don't know of anyone who has got that one but there are a lot of forum members using the Contec CMS overnight recording pulse oximeters and SleepyHead seems to work well with most of them except maybe the blue tooth (which I hear is problematic period).
I went the el cheapo route because I knew I would only be spot checking on a rare occasion...so I got the CMD 50 D Plus...that Plus is important as the 50 D without the pulse doesn't record over night.

You can check them out here.
http://www.pulseoxstore.com/Downloadable-Pulse-Ox.html
He may not have all of them but that will get you started.
I did buy mine from the guy here because he is real good with the software support for these models and I had heard that the Chinglish that comes with the ones from China (check EBay for those) left a little to be desired. So it was worth a few bucks more in my case.

[Jak3099]

Thanks for the info Pugsy! I'll check out the CMS50plus