Minimum Pressure setting

[Thefrog]

I've been playing around with my Resmed S9 Autoset. Does the Minimum pressure setting really matter if I run it on Autoset? My Dr set it at 5cmH20 I've slowly moved it up to 10.8cmH20 Should I go back down or up? See lots of different things on here. Here is last nights sleepy head graph.

I just switched to a Airfit F10 full face mask, not sure how much I like it? I was using Amara View, but having some leakage, so I switched to this, I woke up tired the last two mornings and my girlfriend said I am snoring with the Airfit F10. I didn't snore with the Amara View. Any thoughts?

[kteague]

Hi. Question for you - did you have a titration study done to determine an effective fixed pressure? Just wondering how close your lower pressure is to that pressure. While your AHI looks good, you still snoring makes me think upping your lower pressure just a tad might help. It does appear that most of your time is above your current starting pressure. That said, I admit I am not the one for studying the details of the graph. By morning some of those folks will chime in.

[Thefrog]

Hi. Question for you - did you have a titration study done to determine an effective fixed pressure? Just wondering how close your lower pressure is to that pressure. While your AHI looks good, you still snoring makes me think upping your lower pressure just a tad might help. It does appear that most of your time is above your current starting pressure. That said, I admit I am not the one for studying the details of the graph. By morning some of those folks will chime in.

No I did not have a titration study done, never heard of it until now, I just googled it. Maybe I can ask my Dr for one. I can bump it up to 11cmH20 tonight and see if it helps. Lots of stuff to figure out here before I get the right combo for a restful nights sleep.

Thanks for input.

[Thefrog]

Or should I be raising my Maximum pressure setting?

[big_dave]

I would suggest continuing to increase your minimum pressure a little at a time. Based on your 95% pressure of 18.9, I wouldn't be surprised if your minimum pressure ends up around 16 or 17. You cannot increase your maximum pressure because it's already at 20, which is the machine's limit. If you could increase the maximum, it wouldn't make a difference anyway because the pressure hits 20 only briefly.

[LSAT]

Or should I be raising my Maximum pressure setting?

With your pressures you are almost to the point of needing a bi-pap machine which goes higher than your apap. You need ths full max of 20 and your minimum should be about 12.

[Wulfman...]

I've been playing around with my Resmed S9 Autoset. Does the Minimum pressure setting really matter if I run it on Autoset? My Dr set it at 5cmH20 I've slowly moved it up to 10.8cmH20 Should I go back down or up? See lots of different things on here. Here is last nights sleepy head graph.

I just switched to a Airfit F10 full face mask, not sure how much I like it? I was using Amara View, but having some leakage, so I switched to this, I woke up tired the last two mornings and my girlfriend said I am snoring with the Airfit F10. I didn't snore with the Amara View. Any thoughts?

After looking at your reports, I believe using ranges of pressure will NEVER get you to therapeutic settings. Your Flow Limitations are driving your pressures up and causing lots of pressure changes that needn't be.

You're having very few events (AHI) to begin with, so if you can find a fixed pressure that prevents most of them, you'll have better therapy and sounder sleep.

My initial "instinct" is to suggest a straight pressure of about 13 cm. for a few nights and see how that works. It's possible that an even lower pressure might work (I'm looking at where your pressure is on the reports in relation to where there are fewer events occurring), but if you can try a straight pressure for a bit, you may see how that's going to work.

As it is with these reports, it's hard to figure out what's causing what. But, the Flow Limitations do present a problem for the machine trying to give decent therapy.


Den

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[Thefrog]

Thanks for the input, I'll try bumping up the minimum to 13cmH20 tonight and try that for a few nights, then try out continuous at the same and see how it works. I'll post the data in a few days.

[dtsm]

The key is the max not the minimum. With apap, it will ramp up pretty quick to the optimum level. If you have historical record of averaging, say 10, it wouldn't hurt to set minimum at 8 and maximum to 20.

My titration study said 9 years back. After tracking my therapy with the S8 and S9, I switched from cpap to apap, tweaked the min/max settings. Almost 6 years later, and 5 extra pounds, now set to 9-14.

A little tweaking will optimize your therapy....YMMV

[RachelM]

I decreased my AHI by upping the minimum. I was having events while the machine was trying to get up to where needed. AHI went from 3.5 to 1.0.

[Thefrog]

I've been playing around with my Resmed S9 Autoset. Does the Minimum pressure setting really matter if I run it on Autoset? My Dr set it at 5cmH20 I've slowly moved it up to 10.8cmH20 Should I go back down or up? See lots of different things on here. Here is last nights sleepy head graph.

I just switched to a Airfit F10 full face mask, not sure how much I like it? I was using Amara View, but having some leakage, so I switched to this, I woke up tired the last two mornings and my girlfriend said I am snoring with the Airfit F10. I didn't snore with the Amara View. Any thoughts?

After looking at your reports, I believe using ranges of pressure will NEVER get you to therapeutic settings. Your Flow Limitations are driving your pressures up and causing lots of pressure changes that needn't be.

You're having very few events (AHI) to begin with, so if you can find a fixed pressure that prevents most of them, you'll have better therapy and sounder sleep.

My initial "instinct" is to suggest a straight pressure of about 13 cm. for a few nights and see how that works. It's possible that an even lower pressure might work (I'm looking at where your pressure is on the reports in relation to where there are fewer events occurring), but if you can try a straight pressure for a bit, you may see how that's going to work.

As it is with these reports, it's hard to figure out what's causing what. But, the Flow Limitations do present a problem for the machine trying to give decent therapy.


Den

.

Den,
So you think I should run a fixed pressure setting? I've been struggling with this machine since last April, I've gone through 4 mask and finally I put the pressure setting back to 6min and 20Max as prescribed by my Dr. I also have a Oral Appliance Therapy that wear for traveling. I've worn that a bit lately and I feel like I have more energy in the morning with that? Any other suggestions?

And can you explain why the fixed pressure would be good?

Thank you

[Julie]

I think he's already explained about the fixed pressure, but instead of his having to do it again, why not just try it and see what happens? We all do as much of our own research as we can here, and learn from doing it first hand. My suggestion would be to also try a soft cervical collar to keep your head up off your chest (if it tends to fall down), keeping your airway open more consistently, and your jaw closed... the FF mask taking care of your lips. Not about leaks, but air flow. Sometimes the best mask and side sleeping (vs back sleeping) aren't enough, depending on your habits.

[palerider]

I've been playing around with my Resmed S9 Autoset. Does the Minimum pressure setting really matter if I run it on Autoset? My Dr set it at 5cmH20 I've slowly moved it up to 10.8cmH20 Should I go back down or up? See lots of different things on here.

the minimum pressure is the most important pressure in an auto machine. the max is rarely an issue.

you need to carefully look at your graphs, and see what's going on... as Den said, you have flow limitations, however, instead of dismissing them as he does, you want to, if possible, TREAT them, by setting the minimum pressure up to a point where they don't occur.

when you have a FL, that means you're working harder to breath, and that takes away from restful sleep, and that is why your machine *aggressively* responds to flow limitations, that and the fact that they are often precursors to hypos and apneas.

doctors are often lazy, and just set the machines for factory defaults or near it (wide open) and say "the auto machine will handle it) however, your machine thinks "well, someone said I should get back down to this pressure, they must know what they're doing" and keeps trying to get you back to your minimum... as you can see, and then you have another event, a/h/fl/snore, and it goes "nope! must raise pressure to keep 'em breathing". and it seesaws.

raise the minimum to a point where you have very few issues, (a good starting point would be a bit above where the pressures keep jumping back up) and you'll have a better night, and won't bother your girlfriend with snoring.

the newest resmed autosets in the most advanced mode will raise the minimum pressure during the night and quit trying to go back down to a too low pressure.

[Wulfman...]

I've been playing around with my Resmed S9 Autoset. Does the Minimum pressure setting really matter if I run it on Autoset? My Dr set it at 5cmH20 I've slowly moved it up to 10.8cmH20 Should I go back down or up? See lots of different things on here.

the minimum pressure is the most important pressure in an auto machine. the max is rarely an issue.

you need to carefully look at your graphs, and see what's going on... as Den said, you have flow limitations, however, instead of dismissing them as he does, you want to, if possible, TREAT them, by setting the minimum pressure up to a point where they don't occur.

when you have a FL, that means you're working harder to breath, and that takes away from restful sleep, and that is why your machine *aggressively* responds to flow limitations, that and the fact that they are often precursors to hypos and apneas.

doctors are often lazy, and just set the machines for factory defaults or near it (wide open) and say "the auto machine will handle it) however, your machine thinks "well, someone said I should get back down to this pressure, they must know what they're doing" and keeps trying to get you back to your minimum... as you can see, and then you have another event, a/h/fl/snore, and it goes "nope! must raise pressure to keep 'em breathing". and it seesaws.

raise the minimum to a point where you have very few issues, (a good starting point would be a bit above where the pressures keep jumping back up) and you'll have a better night, and won't bother your girlfriend with snoring.

the newest resmed autosets in the most advanced mode will raise the minimum pressure during the night and quit trying to go back down to a too low pressure.

I wish you would stop misinterpreting or reinterpreting what my logic and reasons are.


Den

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[chunkyfrog]

As you can see, we have a variety of solutions here.
We also have a diversity of personalities. ---And opinions.
Each may be right in their own situation..
You may now try a variety of suggestions and find your own Goldilocks combination.
Welcome. And rest well.