Questions re; Minimum Pressure settings...

[salinas212]

I've read average min. pressure settings are in the 6-10 range. Purely curiosity on my part but how does that number compare to what people here use? I fully expect it to be totally in the widely accepted 6-10 norm but curious if anyone here runs above or below that oft-touted average. Thanks in advance!

[ChicagoGranny]

Many people are using the factory setting of 4.0 as the minimum. No one has told them any better, and they don't have the curiosity to study it.

Don't forget that many use an exhalation pressure relief function which changes the "minimum" (and maximum) effective pressure.

What pressure settings are you using?

[lazarus]

It seems to me that many medical pros hand out autos with the minimum set to 4cm, since they follow the manufacturers' recommendation (flawed in my opinion) of doing that, handing out autos set "wide open." In fact, I believe that's what most pros consider to be "using an auto."

Among patients who believe in tweaking their own machines to the most effective and comfortable pressure(s), however, I believe most find that a min. set at 6cm or above works best for them. Just my impression from reading posts.

I find I sometimes need a minimum pressure of at least 8 during allergy season, for comfort reasons, myself.

Others find with experimentation that keeping the minimum pressure up to 7 or above on a ResMed auto allows them the added comfort of giving the machine room for the EPR set at 3cm to do its full thing from the get-go. There's something to be said for that.

I am a patient, not a medical pro.

[LSAT]

My minimum is 12 and my average nightly pressure is about 13.5. Once you have a sleep study, that should determine a starting minimum pressure. After 60-90 days, your doctor should review your reports and make necessary adjustments. I agree that too many doctors use 4/20 as starting pressures. Thats the way machines come pre set from the factory.

[salinas212]

What pressure settings are you using?

Thanks CG and others who have or will participate in this thread. I'm sorry for not including my numbers which I'll list below:

My pressure is set at 9 with EPR on normally tho I'll occasionally try a 10 with EPR on. I can manage up to 8 with EPR off however my COPD struggles with EPR off on all numbers above 9 and prevents me from falling asleep. I dabble with this at the behest of my VA sleep pulmonologist that tells me to venture out off my normal settings once or twice a month. Apparently it does helps as I was using a setting of 5 w/EPR on for the first 5 years and now I've worked my way up to and am totally comfy with a number nearly twice that for the past 2 years with consistently fewer AHI's.

At the other end I'm only using 15 as my max setting as my COPD likely precludes any benefit whatsoever at a higher setting.

[zonker]

11 min 25 max

[salinas212]

11 min 25 max

I envy that pair of lungs!

[ChicagoGranny]

I envy that pair of lungs!

CPAP pressure is not about the lungs. It's about the size of the airway and its propensity to collapse.

(However, judging from Zonker's loud posts, he has strong lungs.)

[zonker]

11 min 25 max

I envy that pair of lungs!

well it didn't happen all at once!

besides, those are the settings. I have no idea if I ever get up to 25. I DO know that on my auto machine, it flat lined at 20.

[salinas212]

I'm sorry Granny and perhaps I misunderstood when he (my VA pulmonologist) said my COPD today has dramatically reduced my lung capacity and both my minimum and maximum CPAP air settings will continue to be significantly affected by the volume it can move in/out of my lungs comfortably regardless of my OSA causes or settings. That due to that reduced volume I'm destined to take significantly smaller breaths than normal even under CPAP's positive pressures at any setting and will always struggle getting the same or similar volumes of air moving through my lungs "comfortably" to someone without COPD both on or off CPAP/BiPAP. He was surprised in 2023 to find I could go to sleep comfortably at a low setting of 8 which is 3 ticks above what he had originally prescribed for me in January 2018, after my sleep study night in late December 2017. Subsequently, two years later I'm now at a low setting of 9. And because of diminished volume/capacity I presumed anything higher than my originally prescribed high setting of 15 is even possible for me to attain, let alone surpass. But he did mention my continued striving for a higher "Low" pressure setting is a good thing and that it is helpful in minimizing the effects of COPD as it relates to my CPAP therapy and I should continue once or twice a month raising that number, trying to become comfortable enough with it to fall asleep. Essentially the same method I've used the past 7 years getting up to the low of 9 I use today. I can actually fall asleep today with a low setting of 10 but not easily, 'comfortably' or with EPR off.

With my perma-fog I have no trouble accepting I misunderstood/misinterpreted or even misconstrued the Dr's statement above. But that's what I understood/interpreted he was saying and what I took away from what he told me at the time.

[lazarus]

Although I'm sure Zonker has admirable lungs, it is his kind heart that I most envy.

I believe Granny's statement may best be understood as a general statement made regarding simple OSA.

OSA and COPD as an overlap syndrome can have unique considerations that your doc may wish to address with specific PAP modes and settings.

https://www.ncbi.nlm.nih.gov/books/NBK589658/

[ChicagoGranny]

I'm sorry Granny and perhaps I misunderstood when he (my VA pulmonologist) said my COPD today has dramatically reduced my lung capacity and both my minimum and maximum CPAP air settings will continue to be significantly affected by the volume it can move in/out of my lungs comfortably regardless of my OSA causes or settings.

No need to apologize. This particular comment plus everything that follows it is very interesting to me. It sounds like you are doing your best given a difficult situation. Best wishes for your therapy.