Just received my new Auto...Question for you Pro's

[stipton]

I have been on CPAP for 10 years. It was time for a new machine so I took advantage of the cpap.com sale. My original Rx called for a pressure setting of 8. About 2 months ago I raised that to 10. I am wondering what range I should have my new auto set at? It came from cpap.com set at 4-20. Should I just leave it there? Any thoughts?

[nanwilson]

Usually we use a range of 5..... 2 below and 3 over. You do realize that your auto can be set in straight cpap mode too right. My straight mode is 11 and I had my auto set at 10 - 15, but noticed that the "pulsing" woke me up, so set it back to cpap mode and I prefer it.
Good luck
Nan

[sleeptimeinNY]

I'm the opposite. I have been using my Autoset in straight CPAP at 11 but just recently changed it to a range of 10 - 14 because I started to have clusters of OA's during some nights. It's only been about a week, so I will leave it and re-evaluate it in another week or so.
4-20 seems much too wide for a range. I would suggest to tighten it up and keep an eye on the results.

P.S. I'm not a pro!! only been at this for about six months.

[JohnO]

My original Rx called for a pressure setting of 8. About 2 months ago I raised that to 10. I am wondering what range I should have my new auto set at? It came from cpap.com set at 4-20.

I'm no pro (30 days in, but learning fast!). At my sleep study, they titrated me starting at 6, and raised it to 9. They set my auto-CPAP with a range of 9-15. So far, I'm typically in the 10-12 range. So - based on my - many days- of experience, and your prescription plus modifications listed above, I would start with a range of 8-15.

I'll be watching to see what the more experienced folks say. I'm sure one key will be that, regardless of what you set it to, be ready and willing to start looking at the data.

John

[Pugsy]

OP's 10 yr old machine was a brick if I remember right. So we don't really know how effective the previous pressure was or wasn't.
After using a pressure of 10 for a long time it is very likely that someone trying to start out with a lot less pressure is going to feel rather stifled...that 4 cm starting point is going to seem like trying to breath through a cheese cloth.
I suspect it would not be very comfortable going from 10 down to 4 cm as a starting pressure. So I would suggest starting at something that is relatively close to what has been used in the past AND is comfortable. I would try 6 cm minimum and see if it is comfortable if not...try 7 cm or even 8 cm.

Someone who has never used a variable pressure machine might also find the pressure changes themselves rather disturbing. The brain may wonder what the heck is going on. Everyone here knows that I say let the machine go where it wants to go PROVIDING that its going there doesn't create any problems. Just because it can go higher doesn't mean that it will go higher. These new machines don't chase leaks nearly as much as the older APAP machines did but they can chase them under the right circumstances and that chasing can sure create some problems. Chasing leaks is really the only down side to having a more open maximum. If leaks aren't an issue then the machine won't go chasing them and any increases in pressure that the machine wants to do will be for legitimate reasons. Those changes in pressure may or may not be disturbing. If a person sleeps right through them and never know they happened until the next morning then let the machine do its job. If the changes present problems then deal with them as they occur. If someone starts developing aerophagia symptoms..then we limit the machine's range in hopes to limit the aerophagia.

For a first night on an APAP in this situation I would use whatever minimum is comfortable and leave the max at 20. I doubt it will ever get close to the max but you never know.
I seem to spend about 30 minutes a night on a regular basis at 18 or so...the other night I hit 19.67...must have been my alien friends stopping buy for a visit.
Unless sleep is really disrupted by the changing pressures I would give it a few nights to see where things want to go and then decide what further adjustments need to be made. Let's see where it wants to go first and see if there are any problems that come up because it wants to go somewhere before we start trying to fix things that we don't know if they are broken yet.
If by chance the first night is horrible with the changing pressures...then an immediate change to a tight range would be my next thought. Something like 8 cm minimum and 11 cm maximum. Don't spend any time doing something that is disrupting or uncomfortable in hopes that you will "adjust".

In all honesty...probably starting with the tight range would be the smarter of the 2 ideas.. but people being people think APAP and ranges of pressure and want to try it. Heck, I would if I were in the same situation.
10 years of straight cpap and making the switch to APAP is going to be a bit of a change and the body may not like the change....then again it might love the change. Don't know till you try.
Some experiments are successes and some are dismal failures. I have had both but even with failures we learn something.

I do suggest playing with the Flex settings to see which one "feels" the best. There is a Demo..use it and choose the one that feels the best with your own breathing. Don't pay attention to the setting...go by how it feels to you. When it works it lets you feel almost like you are breathing totally naturally.

[KEQ5]

Putting the data into Sleepyhead gives a good idea of what pressures the machine preferred to run at and what pressures worked.

I ran my machine on 4-20 for about 9-10 days (that's how the script was written). I noticed a lot of snore flags when the machine was below 8cm and the machine was usually up in the 9-13 range, so I bumped the minimum up to 7cm. I liked how the EPR felt, so I bumped that from 2 to 3. I found that I was getting aerophagia at 16+, so I changed the maximum to 17.

Been running 7-17 as a result for the past 2-3 weeks. Now I'm considering tightening it up slightly more, but my follow-up doctor visit is next week so I'm waiting until then.

I try not to fiddle too often. Waiting at least a week or two before changing settings again seems sensible.

[Xney]

If you are used to 10, I would definitely NOT use 4cm or 6cm as your minimum. It will feel like sucking air through a straw, probably. 8 is a good minimum probably. 8-15 sounds good.

Some people prefer straight CPAP rather than auto, it just depends. Don't be afraid to just go to straight CPAP if auto feels weird and less good.