Reducing APAP range

[cfairchi]

I just started using a resmed s9 autoset a few days ago. My titration indicated a 7 pressure. I had to talk my sleep doc into writing my prescription for an APAP instead of a straight CPAP at 7. When she finally relented she said she would write it for APAP 4-20 because the APAP will figure out the right pressure. So I guess I am looking for opinions on how long I should watch the data before making the range closer to what the APAP data says it is using. Or should I always just leave it wide open? I have only had it a few days, but I noticed on my data for one of the nights that the pressure ramped up to 12 even though there did not seem to be any indication of an event (no reduction in flow or increased snore or any data that looked like something was changing to require a pressure increase), and within like 10 minutes of the ramp up in pressure I woke up. All previous data the pressure never went over 10. I guess in general whats a good time range (days, weeks, a month) to get a good idea on a trend.

[Pugsy]

A week of trend should give you a good starting point but if the increases in pressure are waking you up there's no sense it making things worse. If you are okay with changing things yourself then if it were me I would tighten that range up now..you can always make adjustments from that as easily as you can from the wide open range.
Maybe try minimum of 6 (close to your original RX of 7) and maximum of 10 and see just how often it wants to bump up to the 10 cm line. With the higher minimum it might not even need or want to go over 10 and if it does maybe not need to stay there very long so it might be worth it to just let it hit the max briefly if you sleep better.

We can't always see the reasons why the machine wants to increase the pressure. The changes in flow rate that go along with a flow reduction or limitation aren't so easily seen on the graphs. Rest assured it wouldn't go there if it didn't think it needs to but sometimes the need isn't as critical when compared to the pressure changes waking you up. Sometimes we have to compromise.

Some people are bothered by the least little change in pressure and if that is the case with you then maybe cpap mode might be better or apap mode with a tiny range...like 6 to 8 or something along those lines depending on what the reports show.
Some people can sleep through changes from 8 to 20 and never know it happens until they see a report but some people find the least little change is a bother. I regularly sleep through hurricane force winds...and never know it but I know that many people find the changes are more of a bother than a help.

[Nozzelnut]

I'd wait long enough to have most types of sleeping covered. Some things to consider; whether or not you drink or take any kind of other medicines that might effect it; ie a muscle relaxer if your back tightens up; different sleep positions... If you can have data on those kinds of nights as well as your regular nights that should cover most of things that effect your OSA.

You might have had a night with a little runaway pressure that gave you the odd night. Starting at 4 might not give the machine enough time to properly adjust the pressure and it ended up over shooting. You might have to look at the individual breaths to see them start to flatten...

I didn't change anything during the compliance period; no need to let them know I have an idea of what's going on with my therapy and can adjust my machine. Adjusting the starting pressure up is as important as dialing in the max pressure.