One Constant Pressure?

[Cannuck 1]

I’m new to the forum and I really like the folks that are helping us Apnea people dealing with our condition.
Its my nature to experiment with my new machine to tweak it and get good results.
My AHI is low (.3-1.27) and I like to experiment with different pressures and the A10 gives me this access to play & with Sleepy head I can see what is happening.
What I don’t know if I’m damaging the machine by leaving the machine on pressure range that is set at max8- min 7.8- epr@2 on auto set to basically getting a constant 8 setting.(1st night AHI.2 reading- snoring reasonable)
I always wanted to have a constant pressure( more natural) to play with my auto Remstar aflex-m series but I was ignorant to the whole language and cpap devices.
On Auto set 4-20 pressure range the machine bounces around and I tend to wake up around 3am in the morning(this was happening with the auto Remstar also-thinking I needed a new device because 7 yrs old) Age and lifestyle changes occurring to me and all of us.
I don’t think I would experiment if my AHI was high, I have window of opportunity to test now with my low AHI range.

I know I’m not the only one to experiment and asking for insight with one constant pressure.

[JDS74]

Setting the pressures in any manner that the machine supports will not hurt the machine.

Setting it to a narrow range is one way to experiment to see if better results can be obtained. One caution though, take a little time between changes as normal variation in night time sleeping followed by changing the pressures can have you chasing a ghost. Try each new setting for several days, even a week before making a judgment about the efficacy on that setting.

[jnk...]

One pressure to help us all
One pressure for breathing
One pressure to heal us all
While in the darkness sleeping

-The Lord of the PAPs: The Fellowship of the CPAP, Vol. 1.

[Hopefullady]

As I peruse the site, I'm finding everyone's threads to be very interesting and helpful.
I think it's great that people stay here and serve after they've found treatment that works.
Thank you so much for that!

Do most people find that it's better or more comfortable to have one pressure?

[jnk...]

The people whose pressure needs don't vary through the night, or from one night to another, have no reason to get used to APAP.

But the people whose pressure needs vary may find APAP to be a godsend.

It's a highly individual thing.

[Pugsy]

Do most people find that it's better or more comfortable to have one pressure?

Some do and some don't and some simply prefer one way over the other for their own personal reasons (and your own personal reasons are what that matter anyway).

Example...Myself. My OSA is worse in REM sleep when compared to non REM sleep. Like AHI in non REM is around 12 (but I had desats to 73% so they must have been ugly in duration) but in REM sleep it worked out to be around 53 per hour. I discovered that not only is my OSA worse in REM but I also happen to need significantly higher pressures only during REM and only some of the REM time and not necessarily all REM time.
Sleeping position didn't seem to be a factor (did a month long experiment with a wall built so there was only side sleeping) in pressure needs.

I found out that using APAP mode I could get by with 10 to 12 cm pressure but sometimes it went up to 17 or higher. It was pretty easy to spot the pattern on my reports.
If I were to try to use a fixed single pressure I would have to use upwards of 16 to 18 all night long and while I could probably get it done....using 10 to 12 for the bulk of the night and letting the machine go to 18 only when it needed to was a better choice for me. It was simply more comfortable.
I am fortunate in that the pressure swings never seemed to bother my sleep and I only found out about them or realized they happened when I would look at the reports.

So for me and my personal reasons... I don't want to use 17 cm all night long...auto adjusting pressures is my preference. I could use fixed pressure if I had to but I would either have to get used to a lot higher pressure all night long or compromise and use less and allow some apnea events to happen.
Fairly easy choice for me...let the machine do the work and use lower pressures most of the night and higher pressures only when actually needed.
A side benefit is I rarely have aerophagia which might not be the case if I used higher pressures all night long.

[jnk...]

Especially nicely worded post, Pugsy.

[Raheel]

Example...Myself. My OSA is worse in REM sleep when compared to non REM sleep. Like AHI in non REM is around 12 (but I had desats to 73% so they must have been ugly in duration) but in REM sleep it worked out to be around 53 per hour. I discovered that not only is my OSA worse in REM but I also happen to need significantly higher pressures only during REM and only some of the REM time and not necessarily all REM time.
Sleeping position didn't seem to be a factor (did a month long experiment with a wall built so there was only side sleeping) in pressure needs.

Pugsy, Please tell me how can I find when does Rem sleep occur in sleepyhead reports.

[Goofproof]

There are good reasons for both types of treatment. A single pressure keeps some from being bothered from a pressure change, (duh!), but requires the pressure set to what's needed to stop the apnea period. That means at times during the night you could get by fine with less pressure. Less pressure means less leaks, less swallowing of air.

A range of pressure, let's you get by with the least pressure you truly need to hold your airway open, this can cut down on leaks (but the mask needs to be adjusted at the highest pressure the machine is set for), you will be less likely to swallow air .

WARNING INFO: Many machines are set up at the FAILURE PRESSURE of 4 cm to 20 cm, by Doctors, DME Providers and Fools. For the avg person 10 cm seems to be the avg pressure norm, when using a APAP, the range of pressure I set it 2 cm under my best CPAP pressure, and 1 cm over it, allowing about a weeks data for your body to accept change. (Normalize)

FOR THOSE USING THE RAMP FEATURE: The ramp rate is set at 4 cm, many find that to low and cause starvation while breathing. While the ramp is supposed to allow you to get used to XPAP, it can cause you poorer treatment, by not providing the pressure you really need. I have never used it for that reason, and I started CPAP at 15 cm, after having my chest opened up.

It is most important you get a full data machine and the software to monitor your treatment, doing less leaves you to the mercy of the system, not good! Jim

[Wulfman...]

I’m new to the forum and I really like the folks that are helping us Apnea people dealing with our condition.
Its my nature to experiment with my new machine to tweak it and get good results.
My AHI is low (.3-1.27) and I like to experiment with different pressures and the A10 gives me this access to play & with Sleepy head I can see what is happening.
What I don’t know if I’m damaging the machine by leaving the machine on pressure range that is set at max8- min 7.8- epr@2 on auto set to basically getting a constant 8 setting.(1st night AHI.2 reading- snoring reasonable)
I always wanted to have a constant pressure( more natural) to play with my auto Remstar aflex-m series but I was ignorant to the whole language and cpap devices.
On Auto set 4-20 pressure range the machine bounces around and I tend to wake up around 3am in the morning(this was happening with the auto Remstar also-thinking I needed a new device because 7 yrs old) Age and lifestyle changes occurring to me and all of us.
I don’t think I would experiment if my AHI was high, I have window of opportunity to test now with my low AHI range.

I know I’m not the only one to experiment and asking for insight with one constant pressure.

Highly unlikely that changing pressures could "damage" the machine. I've never seen or heard of any evidence that could happen.

However, for "some" people, the changing pressures MAY disrupt/wreck their sleep architecture........not all, but some.
I'm one of those people who found that the changing pressures disturbed my sleep, even with a fairly narrow range.
That's why it's VERY important that people use software to monitor and scrutinize their nightly data, including what happens regarding their breathing characteristics while they're sleeping. AND........go by "how they feel".
APAP machines (in ranges of pressures) typically change/increase pressures if Flow Limitations or Snores are present as they're programmed, with the belief that those conditions precede apneas. So, if they have enough flow limitations and/or snores present and the pressure changes disrupt their sleep, they need to be able to recognize that in their reports. Some folks don't have those conditions and their apneas can occur without those preceding events. Another indication is that over longer periods they don't feel "rested" because of the changing pressures.

This whole issue is highly subjective to each individual. I've always suggested that people get APAP machines whenever possible (because there are more options), but to use software to monitor their therapy and learn to recognize if/when their therapy is optimized. If you'll notice in my profile (below), I actually own four APAPs, but use them in single pressure mode.

Hope that answers some of your questions.


Den

.

[WindCpap]

You can probably switch the APAP to CPAP mode for constant pressure (most apaps will do both). There was a study done that shows equal effectiveness through several different methods of self-titration.

To self-titrate using the APAP algorithm, keep your machine in that mode for a few weeks, and then use the 95% pressure as your constant pressure.

If you want to have fewer pressure swings during the self-titration, use your current median apap pressure as the low pressure. The upper pressure should be under better control when you don't start with too low a pressure.

[Hopefullady]

There are good reasons for both types of treatment. A single pressure keeps some from being bothered from a pressure change, (duh!), but requires the pressure set to what's needed to stop the apnea period. That means at times during the night you could get by fine with less pressure. Less pressure means less leaks, less swallowing of air.

A range of pressure, let's you get by with the least pressure you truly need to hold your airway open, this can cut down on leaks (but the mask needs to be adjusted at the highest pressure the machine is set for), you will be less likely to swallow air .

WARNING INFO: Many machines are set up at the FAILURE PRESSURE of 4 cm to 20 cm, by Doctors, DME Providers and Fools. For the avg person 10 cm seems to be the avg pressure norm, when using a APAP, the range of pressure I set it 2 cm under my best CPAP pressure, and 1 cm over it, allowing about a weeks data for your body to accept change. (Normalize)

FOR THOSE USING THE RAMP FEATURE: The ramp rate is set at 4 cm, many find that to low and cause starvation while breathing. While the ramp is supposed to allow you to get used to XPAP, it can cause you poorer treatment, by not providing the pressure you really need. I have never used it for that reason, and I started CPAP at 15 cm, after having my chest opened up.

It is most important you get a full data machine and the software to monitor your treatment, doing less leaves you to the mercy of the system, not good! Jim

Jim, my Apap is set for 5-15 with ramp starting at 4. I was woken up probably from snoring which I've always done as soon as entering REM and was gasping for air.
Would it help to set the ramp at 5? Wouldn't that mean there was no ramp?
Also, what is "flex"? It was suggested by RT I turn it from 2 to 3.

[Hopefullady]

Pugsy, thanks for that wonderful explanation.

[Cannuck 1]

Thanks for all the advice and different experiences you have all tried and time will tell the outcome.

[Goofproof]

There are good reasons for both types of treatment. A single pressure keeps some from being bothered from a pressure change, (duh!), but requires the pressure set to what's needed to stop the apnea period. That means at times during the night you could get by fine with less pressure. Less pressure means less leaks, less swallowing of air.

A range of pressure, let's you get by with the least pressure you truly need to hold your airway open, this can cut down on leaks (but the mask needs to be adjusted at the highest pressure the machine is set for), you will be less likely to swallow air .

WARNING INFO: Many machines are set up at the FAILURE PRESSURE of 4 cm to 20 cm, by Doctors, DME Providers and Fools. For the avg person 10 cm seems to be the avg pressure norm, when using a APAP, the range of pressure I set it 2 cm under my best CPAP pressure, and 1 cm over it, allowing about a weeks data for your body to accept change. (Normalize)

FOR THOSE USING THE RAMP FEATURE: The ramp rate is set at 4 cm, many find that to low and cause starvation while breathing. While the ramp is supposed to allow you to get used to XPAP, it can cause you poorer treatment, by not providing the pressure you really need. I have never used it for that reason, and I started CPAP at 15 cm, after having my chest opened up.

It is most important you get a full data machine and the software to monitor your treatment, doing less leaves you to the mercy of the system, not good! Jim

Jim, my Apap is set for 5-15 with ramp starting at 4. I was woken up probably from snoring which I've always done as soon as entering REM and was gasping for air.
Would it help to set the ramp at 5? Wouldn't that mean there was no ramp?
Also, what is "flex"? It was suggested by RT I turn it from 2 to 3.

You have had your APAP over 7 months, it should be full term, I'd cut the cord, I started at 15 cm first night because I want the most good out of my treatment, from day one. Yes, starting at 15 cm cold turkey caused chest discomfort, I'd just been opened up for a quad-by-pass, that caused some discomfort also, but in the interest of keeping O2 levels as good as they could be, lack of treatment wasn't a option. Even with O2 24/7 my levels were 91. As fair as cflex settings they are comfort settings 3 is the most exhale relief. I ran 3 for years but lately have changed to 2, in hopes of building up my lung pressure. I haven't noticed any change. Jim