I need to talk about pressure setting. HELP

[kpacman]

I've been a member of this site for all of 5 minutes and need to discuss pressure settings.

A brief background: I'm 69 years old and have had a bad snoring problem for most of my adult life. My younger brother and I would go motorcycle camping and he would punch me at least 5-6 times per night to get me to stop snoring.
About 9 years ago he went in for a sleep study and it was determined that a CPAP would be appropriate, and he has used several models over the years. He got on my case about getting one and I finally broke down and found a very lightly used Philips System One on Craigslist. I decided to purchase this on my own because I saw how the insurance companies handle CPAP usage (lease the machine and you never really own it).

I have been using this machine for about 5 years now and really love it. I sleep soundly every night (with the help from 10 mg. of THC) and wake up totally refreshed. I went on YouTube to see how to adjust the settings, and settled on a pressure setting of 12.5 coming in and 7.5 going out.

Everything was fine, and I thought of purchasing an Airsense 11 after my brother started raving about his. Of course, after discussing this with my GP, she referred me for a sleep study so I could purchase one officially with a prescription.

I completed the study last night, and the tech. told me no apnea was observed and my oxygen levels were good. In his opinion, use of a CPAP isn't recommended. I'm stunned and a bit conflicted because I sleep so much better using the CPAP, and I told the tech. that I was inclined to continue using it on my own. I feel like a a patient who is disappointed he is free of cancer because he wanted to continue taking Oxycontin!

When I discussed my pressure settings, he felt 12.5 was extremely high, and that using a CPAP at that pressure can actually CAUSE central apnea because it is training the brain it doesn't have to work hard to get oxygen.

I'm at a loss. Is 12.5 a high setting, and should I back it down to a lower setting and experiment with different settings until I find one that renders a modicum of comfort.

I'm really confused and could use some advice from others that may have found themselves in a similar position.

Thanks.

[Pugsy]

he felt 12.5 was extremely high, and that using a CPAP at that pressure can actually CAUSE central apnea because it is training the brain it doesn't have to work hard to get oxygen.

Bullshit.

Question for you....did you continue to use your machine right up to the night before the sleep study?

Did you ever take a break from using the machine prior to the sleep study???

[kpacman]

No, I used my CPAP the night before the study.

Would there be carryover from this?

You replied "Bullshit". Bullshit that 12.5 is too high, or that it won't CAUSE apnea?

[zonker]

You replied "Bullshit". Bullshit that 12.5 is too high, or that it won't CAUSE apnea?

the latter.

after i posted that, i realized it applies to 12.5 being "too high".

[Pugsy]

You replied "Bullshit". Bullshit that 12.5 is too high, or that it won't CAUSE apnea?

Both.

No, I used my CPAP the night before the study.

Would there be carryover from this?

Yes...it is possible that a carryover effect from you past cpap use has given you a night with no apneas.
Depending on the severity of the OSA and length of time using a machine....the airway retains some patency and isn't as likely to collapse.
Generally....it is recommended no machine for 4 to 7 nights prior to the sleep study.
Some places recommend 2 weeks but I think that's a bit over kill myself.

[kpacman]

Pugsy,

Thanks for your follow up.

One last question, in your opinion is a setting of 12.5 considered "high"?

If a setting like this doesn't run the risk of creating central apnea, I'm inclined to keep running my cpap at that level. I sleep very comfortably at that setting.

Also, any hints or tips on acquiring an Airsense 11 without a prescription?

[zonker]

One last question, in your opinion is a setting of 12.5 considered "high"?

i currently have my upper pressure set at 25.

Also, any hints or tips on acquiring an Airsense 11 without a prescription?

see forum user lsat who sells machines. he often has one for sale. send him a private message and see if he has one currently.

also, did you know that any doctor can write a cpap prescription? even a dentist.

good luck!

[Pugsy]

One last question, in your opinion is a setting of 12.5 considered "high"?

Nope. Not that high at all.

I, myself, routinely see higher than that every night and I don't have centrals pop up.
I have seen pressures over 20 in the past....no centrals.

Here's the thing about pressures and centrals...it doesn't have to be any sort of "high" pressure to cause centrals if someone is predisposed to having cpap cause centrals. It can happen with as little as 5 cm pressure if someone is sensitive in that regard. I know people using over 20 cm every night all night long and they don't have centrals.

Years ago we took a poll here as to what pressures people used and 10 to 12 was just the median average. As many people used more than used less.

While higher pressures MIGHT cause centrals in SOME people.....it really isn't all that common. Maybe 5 to 10 percent of people will have a problem with centrals at ANY pressure.

[palerider]

When I discussed my pressure settings, he felt 12.5 was extremely high,

"he" is full of shit. 12.5 is maybe a little higher than 'average', absolutely not "extremely" high, or really even "high".

and that using a CPAP at that pressure can actually CAUSE central apnea because it is training the brain it doesn't have to work hard to get oxygen.

also, bullshit. This person is clearly incompetent.

I'm at a loss. Is 12.5 a high setting, and should I back it down to a lower setting and experiment with different settings until I find one that renders a modicum of comfort.

No, it's not high, and no, you shouldn't change it if it's working for you.

[kpacman]

I would like to thank all of those who responded to my inquiry. Your feedback has been valuable and somewhat comforting too.

I bumped my cpap down to 10 cm last night and slept restfully, so I'll probably try to stay at 10 and see what happens.

Again, Thanks to all.

[dataq1]

Just for clarification, is your machine set for CPAP or APAP mode (that is to say, your machine does or does not vary the pressure in response to events or flow limitations)?
Also, it was a bit confusing when you said:

....settled on a pressure setting of 12.5 coming in and 7.5 going out

BTW, did the sleep tech say anything about flow limitations?

[kpacman]

My IPAP setting is 12.5

EPAP setting is at 7.5

I have it set on Bi-PAP mode.

There was no conversation about flow limitations.

I feel like I'm in a rowboat here on the high seas. I was hopeful my sleep study would come out indicating a need, but that not being the case I will still need to wing this on my own.

With that said, I've been using this instrument for 5 years now and get the sleep results I'm happy with. I just want to be sure I'm not doing any harm to myself.

[palerider]

I just want to be sure I'm not doing any harm to myself.

You're absolutely NOT doing any harm to yourself.

Stop worrying.

[Miss Emerita]

Good on you for finding a solution to your problem. I just wanted to add that I got my machine from LSAT, and everything went entirely smoothly.