On APAP, bumping up lower pressure seems to bump up pressure

[sam1234]

I bumped up the lower range from the settings of 4 - 20 to 6-20. My pressure went from 13.6 to 15.6 on the lcd readout. The AHI went down from 3.6 to 2.4. My original prescribed pressure was 11.

My main concern is the increase in pressure. Is that normal?

Would the pressure rise even more if I raise the lower range higher?

Perhaps this is only a temporary rise in pressure?

Thanks

[nomoore]

I assume the 13.6 to 15.6 pressure you're talking about is the 90% pressure? I experienced the same thing when I was bumping my minimum pressure up on my Respironics machine. It doesn't seem to be temporary. As long as your AHI went down and you're still sleeping good I wouldn't worry about it too much. I'm surprised though that your using such a low minimum pressure when you were titrated at 11. If you had the min pressure set at 8 or 9 then the machine would be able to get to the needed pressure a lot quicker to stop apneas.

[Bluebonnet_Gal]

I'm surprised though that your using such a low minimum pressure when you were titrated at 11. If you had the min pressure set at 8 or 9 then the machine would be able to get to the needed pressure a lot quicker to stop apneas.

and because it gets to the needed pressure quicker, it stays there longer. That's why the pressure on your readout is higher, and probably why your AHI is lower. The machine has an easier time getting to the pressure you need in time to prevent apneas. You might want to slowly increase the minimum pressure until you get to 8 or 9 (monitoring your results as you go).

[boston]

I was originally prescribed 6-15 pressure, after 3 months of getting a 90% of 13.5-14.5 i changed it to 12-15 and my Ahi has gone from hovering around 3-7 to less than 1, usually .3-.5, but the last few days I shot up to .7

as i understand it, the closer your minimum number is to the pressure that works for you, the faster it gets there, so it responds to apneas quicker.

[GumbyCT]

If my titrated pressure was 11cm I wouldn't start any lower than 9cm.

If you are feeling better, do the numbers really matter?

[alexcue]

I noticed the same the first week but after that it settled down.

interesting, my original prescription was for 11. Now that I'm on an APAP and having fiddled around with the pressures, I'm averaging 10.4

My low settings are 7.6 and high of 15. My AI average is only .6 What i get concerned about are the HI's they are consistently between 6-10 the past week. But I'm sleeping like a log and feel much, much better.

[sam1234]

The pressure readings are currently from my LCD display. Hopefully, I will have software and a card reader this weekend.

The reason I haven't bumped it up higher is that the DME had the pressure set for 4-20. I have had the machine for about three days before bumping the low pressure setting to 6. I would rather do this in small increments as I am not sure what the results will be. I have had it set to 6 for the past two nights.

I hope the software will give me a better indication of where my optimum pressure will be. I was surprised to see my pressure rising. It makes sense that the machine was to slow to adjust to the best pressure given the algorithms that ResMEd uses.

[Goofproof]

The wider the pressure range your machine is set for the poorer the treatment. $ to 20 CM is the standard DME with no clue setting 6 to 20 cm means they almost stopped burning the fries before they were fired. Better treatment would start at 9cm to 13 cm if your true CPAP pressure was 11 CM. You want the machine to have time to respond to your needs. This is true if you have leaks under control, if you don't nothing else matters. jim

[sam1234]

The wider the pressure range your machine is set for the poorer the treatment. $ to 20 CM is the standard DME with no clue setting 6 to 20 cm means they almost stopped burning the fries before they were fired. Better treatment would start at 9cm to 13 cm if your true CPAP pressure was 11 CM. You want the machine to have time to respond to your needs. This is true if you have leaks under control, if you don't nothing else matters. jim

I was the one to increase it to 6. My DME left it at the range of 4-20. I wouldn't trust them around food.

It's difficult to say what my true pressure is because the last study was done at least twelve years ago.

Perhaps I will set the min. to be 9 tonight.

[Hawthorne]

If your titration pressure was 11 cm, then 9 cm, in my opinion, would be a very good minimum pressure.

You are, however using the LCD display for your data which is not as accurate as software data AND you titration study was 12 years ago you say.

Getting the software will really let you know what is happening and you will get a much more detailed and accurate look at your situation. Moving the minimum up slowly is a good idea even with software but I still think that 9 is a better minumum for you given the titration of 11 cm. You may notice the difference if you move from 6 cm to 9 cm minimum.

I am assuming you were using a straight cpap machine for some years since autos would not be available 12 years ago. Were you using the straigth cpap at 11 cm? If you were then a minimum of 9 cm should not be too big a jump.

[sam1234]

Yes, I have been using a "straight" CPAP since the beginning. I have until recently, only had very simple machines.

I did bump the bottom of the range to 9. Interesting results, albeit from one night.

Pressure 12.8 actually back to when machine was set from 4-20
leak .02
AHI 2.5 lower than any previous reading, although I have only had a high of 3.2
AI 0
HI 2.5

Readings are from LCD at end of night.

I expect to have software tonight or tomorrow. Then I hope to have a more accurate picture of what is occurring.

[Hawthorne]

Those are great results from that minimum pressure raise to 9 cm!

I'm not surprised that your 95% (I guess it is with a Remed machine) is 12.8 cm. The important difference is that you are getting to the therapy level you need much faster when you start at 9 cm instead of 4 cm - or even 6 cm. You get proper therapy for most of the night instead of spending quite a bit of time getting up to the pressure you seem to need.

You had no Apnea and Resmed score Hypoapneas higher than other other machines so you are doing very well! Your leak rate is excellent as well!

You will really see the detailed data when you get your software and it will be more accurate but it sure looks like you are doing very well! I would leave any further changes until you see you software data. After a week or so you MAY want to make a few more adjustments but you will have more detail to go on then.

[Goofproof]

You are probably as good as it gets, Resmeds tend to score HI's higher than other brands. the best to hope for is AI's under control, and the leaks, looks like they are. jim

[JOMOMA]

My main concern is the increase in pressure. Is that normal? Would the pressure rise even more if I raise the lower range higher?

I have been having the same results. Initially I was set at a straight 10. I couldn't tolerate it related to all the air I would ingest, so I set a range.
I started at 6-12. Then as I increased my lower pressure I found my 90% pressures rising. First 12.3, 12.8 last night with my numbers set at 8-14 it was 13.8.
My weekly average was
Pres 12.4
AHI 7.5
AI 1.6
HI 6.1
Leak is not a problem.

I also have a card reader and software on order. I can't help but think if I had left it on a straight 10 how I would not have been recieving adequate therapy.
Tonight I will try 9-15.

By sneaking up on the pressures I found I have been able to develop a tolerance and have less problems with air. I also wonder if now that I am more relaxed and sleeping sounder, I might be needing higher pressures because of that.
Jo Ellen

[sam1234]

Wouldn't you do better to leave the ceiling alone and just adjust the low range?

My thought is that there are times that I may be well exceeding a pressure of 15, but the LCD display wouldn't provide enough detail to note that change.

Because of others talking about response time, I decided to bump up the low range. That is when I saw my pressures increase, prompting me to start this thread. I will see where my pressure is tomorrow morning. Perhaps it will again be between 12 and 13. That is less scary than seeing it climb over 15, as it did with my first change.

I am fairly comfortable with the new machine. I only wake up three or four times a night in order to change my body position.

With my last machine, I would wake trying to inhale. I wasn't sure if it stopped and restarted or if it just didn't meet my pressure needs. Apparently, it was the latter.