Right Pressure To Get HIs under 5 Consistently

chdurie2 · Post by **chdurie2** » Sun Jan 20, 2008 11:16 am

Hi All,

I haven't been here for a long time because I've had a long "medically excused" absence from CPAP/APAP. But I'm getting back on it. I have my Vantage S8 Resmed APAP, which I'm not sure is pictured here, and I just started using the Resmed Quattro in XS and S (I guess XS is better but it doesn't make a big difference for me.) Anyway, my leaks are under .4 but my HIs are sometimes going over 5. My tested level was 8, but I have always needed up to 13 in reality, so I set it at 6 to 14, since on my test about 18 months ago, there was activity at 6. But anyway, now with 6 to 14, I am sometimes going over 5.

Now, about the "medically excused" absence, I'm wondering if I need a new sleep test, although I just hate sleep tests, and I've spent enough time in the hospital in the last year or so. So if my level has changed because of what has been going on with me, I'd just rather play around with the APAP levels and get it right. Sound reasonable? Only how do you do that? Raise one top level one per night? Or raise a bottom level one per night? Alternate? Just do tops? The reason I am asking is that my mediical problem over the last year did affect my breathing---I was in a horrible accident as a pedestrian, punctured a lung, was put on a ventilator and trach and had serious tracheal surgery to restore both my speech and my breathing. I haven't talked to my sleep doc, who actually was one of my regular docs in the hospital, but my guess is he'd want another sleep test after telling me no cpap for me after I was in such danger. Anyway, as I said, I'd just rather fiddle around and get the numbers right myself?

Can anyone help?

Thanks.

Caroline

sleepycarol · Post by **sleepycarol** » Sun Jan 20, 2008 11:20 am

So sorry about your accident!!! I don't have any answers but do hope you get to feeling better!!!

Good luck on finding your "pressure" and if it was me I would probably play around with it myself.

Some of the more experienced forum members will jump in and advise you better!!!

kteague · Post by **kteague** » Sun Jan 20, 2008 11:55 am

Caroline,

Wow, you never know what's going on when someone drops off here. Sorry to hear of your accident, but glad you're on the other side of it all. Are your injuries such that there is an advantage to doing this under a doctor's care? Considering they were to the respiratory system, I don't think I'd resist a current sleep study if recommended. Not that you can't tweak your pressure, just wondering if the changes might be significant.

Welcome back.

Kathy

rested gal · Post by **rested gal** » Sun Jan 20, 2008 12:57 pm

Caroline, good to see you back again. What a terrible thing you went through!!

I'd check with your doctor(s) before changing whatever pressure they prescribed for you when you resumed using your autopap.

That said, it's generally the minimum pressure that needs to be raised in order to lower the AHI. The maximum pressure need only be high enough that the person is not hitting it regularly. It's the minimum pressure that's more important to "get right" (i.e. high enough to prevent most events right from the get-go) imho.

Since your recovery from the accident involved breathing issues, do check first with your doctors.

Welcome back!!

chdurie2 · Post by **chdurie2** » Sun Jan 20, 2008 1:17 pm

Thank you rested gal, kathy and carol,

Thanks for all your good wishes and urging to go back to the sleep doctor.I may--we'll see. I guess I'm reluctant because I think he'll order another sleeo test. If I need it, it's not bad, but...

For the moment, anyway, I'd just like to see how I do if I get the settings "right" myself. So I just changed my machine down to 5, and I'll see in a few nights if it needs to go down to 4.

i guess one thing i didn't think of is whether now i would be better off with bi-pap. i'm a noisier breather than i used to be, if that means anything, even while not sleeping.

Thanks again.

Caroline

rested gal · Post by **rested gal** » Sun Jan 20, 2008 1:32 pm

chdurie2 wrote:For the moment, anyway, I'd just like to see how I do if I get the settings "right" myself. So I just changed my machine down to 5, and I'll see in a few nights if it needs to go down to 4.

I'm not sure why you decided to drop the minimum pressure down. I'd be raising the minimum pressure if I wanted to try to get a lower AHI.

Actually, with a resmed machine, I wouldn't worry too much about striving for an AHI under 5, especially if it's the hypopnea index registering high while the apnea index is nice and low. That brand is very likely to mark more flow limitations as "hypopneas" than the other brands do.

Doesn't mean it's wrong (about hypopneas) and the others are right, or vice versa. It's simply a difference in the way each manufacturer chooses to design their machines to identify what they call "hypopnea" as opposed to a lesser type of flow limitation.

Wulfman · Post by **Wulfman** » Sun Jan 20, 2008 1:50 pm

Caroline,

I'm so sorry to hear of your "medically excused absence"......WOW!....but, glad to hear you're still around.

I won't get into the discussion on your pressure-setting issue......just wanted to extend my best wishes to you and welcome you back.

Den

chdurie2 · Post by **chdurie2** » Sun Jan 20, 2008 2:35 pm

gosh, rested gal, I guess I was unfortunately "running" over your post and not reading carefully. Okay, 6 goes to 7. And yes, these are mostly, mostly hypos--sometimes i get a fraction of an apnea, but never a whole one and not often.

Den, great to talk with you! Yes, I'm still counting my blessings that I made it through this thing.

thanks again everyone.

caroline

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Right Pressure To Get HIs under 5 Consistently

Right Pressure To Get HIs under 5 Consistently

So that's where you've been