Finally working - Do I need to change pressure?

[tcaron]

Male, Age 56, 6' 1", 198 lb, 5 year CPAP owner, actual user for about 2 months.

Began seriuosly using my Resmed AutosetII after trying many masks. Settled on the Resmed Nasal Gel and a separete chin strap. I finally got the leaks down to 0 with the new mask.

2 months of successful full nights use has brought my morning BP down from 135/80 to 119/68.

The doc set me up with 6 has the low and 15 as the high pressure but the Apneas reported with Rescan were lowered when I uppped the low pressure to 9. Still getting about 6 to 8 hypopneas over an 8 hour period though.

Should I raise the lower pressure even further to deal with the hypopneas?

Recent research on the diabetes/CPAP OSA connection has me hopeful that over time my morning blood sugar will lower from my current average of 135.

Thanks!

[rested gal]

If the AI (apnex index) reported by your ResMed machine is very low (under 1.0) and it's the HI (hypopnea index) that is making up the bulk of the overall AHI (apnea/hypopnea index), and the AHI is no more than 10, I wouldn't worry about it a bit.

When using a ResMed machine, I mentally cut the "HI" in half, then add that to the AI to refigure the AHI for myself. If I do that, then I see an AHI that is comparable with the AHI I get using other brands of machines.

So, to answer your question, " Should I raise the lower pressure even further to deal with the hypopneas? "
Nah, I wouldn't. Not with a ResMed machine. I personally think you can be getting equally effective treatment with a ResMed machine showing, say 8 hypopneas, as you would be getting with another brand of machine showing 4 hypopneas.

That doesn't mean one brand is better or worse at identifying "hypopneas" than another. Nor does it mean one brand is letting more "hypopneas" through that another brand is preventing. It's simply a matter of different brands having different definitions of when a flow limitation is going to be called "hypopnea."

I think you did right in raising your minimum pressure to prevent apneas better. Sounds like you have it dialed in fine as it is now. I'm not a doctor. That's just my opinion.

Chart posted by Velbor showing the differing definitions used by the different manufacturers:
April 2, 2009
viewtopic.php?p=356255#p356255

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[tattooyu]

I completely agree with Rested Gal. You were definitely right by raising your lower pressure. As for everything else... LEAVE IT ALONE!

[Wulfman]

My answer is.....It's YOUR therapy......it's YOUR call.

You have the software. You have a machine with lots of options and settings. If you increase your pressure (minimum or otherwise) and the numbers get better, you know you're going in the right direction. If you end up not feeling as rested and there's a possibility that the pressure changes are disturbing your sleep, you can try switching to CPAP mode.


Den

[tcaron]

Thanks everyone!

Looks like I'm on the right track.

Hey Tattooyu, I'm a guitar player also. What do you play for music and what gear do you play with?

Thanks

[DreamOn]

Looks like I'm on the right track.

You're definitely on the right track! Your results look fantastic to me!!!

It's so great to see dramatic blood pressure reduction like that. Please let us know if your morning blood sugar lowers over time too. I think a lot of people would be interested to know, as there is a definite connection between sleep apnea and diabetes. I think that results may depend on how much physical damage has already been done, which is a good reason to start CPAP therapy as early as possible.

You mentioned that you've had your machine for 5 years, but have only been using it for the last 2 months. I'm glad you decided to start using the machine regularly, and it sounds like are too!!!

~ DreamOn