Air Pressure question with Apap

[Daisy004]

Ok so the lab originally prescibed my air pressure number as a 7. I got the Apap machine and it was set for 6-9. Lately I noticed it was maxing out at 9 so my hubby moved it up to number 10. Last night it maxed out at 10! My leak was good at 7ml, AHI 1.4 as it usually is, can it be possible that sleep lab got it wrong and I actually need this higher pressure? Can I trust the Apap machine? Would welcome your comments, thanks.

[greatunclebill]

what program are you using? what does maxed out mean? how long? how many times? a screen shot from your program would help.

[Daisy004]

Im sorry I have no clue how to do that screenshot thingy or how to read sleepyhead, just not that computer savvy.

[Pugsy]

Screen shots of your reports are how we see what you are seeing.
We discussed how to get them and how to post them here in this thread.
viewtopic.php?f=1&t=81072&p=737779#p737779

APAP machines respond to snores and flow limitations and it is possible that the "maxing" out is just a normal response.
It is common to have varying pressure needs...sleeping position maybe, like supine sleeping or maybe REM related events causing an increase in pressure needs. We don't sleep the same each night so a set pressure doesn't always eliminate every possible snore or flow limitation. If you max out at 10 it might be just a brief kissing of that 10 cm line or it might be a prolonged time. It might mean that you would need a little more pressure during that particular time asleep.

We really can't offer anything more than general comments without seeing what you are seeing on the reports.
Is it possible that your sleep lab got it wrong? Yeah, sure is but it is also possible that normal things are causing the need for more pressure. My RX was for 8 cm but in REM sleep I often need a LOT more pressure but during the titration part of my sleep study I only got 6 minutes of REM. So it comes as no surprised that they didn't get it spot on. They were close though and likely for a good bit of the night I probably could use 8 cm and do well...I just need more pressure sometimes.
The sleep lab had one night in a foreign environment to try to come up with a pressure. It's not surprising that you need a slightly different pressure at home.

[Daisy004]

Thank you guys for the replys...I guess I am just scared Im getting too much pressure, silly I know, but it is an autoset so I will trust it. It just seems the higher I set the end pressure, the machine reaches it. Kinda freaked me out a bit. If I do manage to get into sleepyhead, how do I take a screen caption? Thanks

[Sheriff Buford]

I would "bump" it up to 11. The autoset won't go up to a pressure unless it needs it. Sheriff

[RandyJ]

An auto won't go to the higher pressures if it doesn't need to. As was said above, looking at your reports would help a lot, to see if the forays into higher pressure are brief or if you stay there for most of the night.

Another option is to set the machine for a range like 7-18 or 7-20 (or wherever you feel comfortable setting a maximum) and sleep with those settings for a week. After 7 days, Sleepyhead or ResScan will report a 95% pressure number and a median pressure number that will be helpful in determining your true pressure needs.

You could find that higher pressures bother you, or perhaps not. But the machine won't go where it doesn't need to.

[Daisy004]

Thank You Sherriff I will set it for 11. Im in Houston, I attempted to drive through Kingwood yesterday omg..crazy traffic!! I think they were all headed to the mall for the sales. We were headed to Lake Livingston taking the boys fishing. Anyhoo, I wil up the pressure to 11 tonight and see what happens. thanks.

[avi123]

Lack of sufficient OP data.

[Pugsy]

If I do manage to get into sleepyhead, how do I take a screen caption?

In my previous post I posted a link to forum thread where we discussed how to obtain screen shots and how to post them on the forum.

If your computer is Windows Vista or Win 7 (unless the basic version) you have the Windows Snipping Tool and using it is super easy. Just look at my above post for that thread. Links for how to use Snipping Tool are in that thread or you can simply Google "Windows Snipping Tool".

[Burkebang]

I would "bump" it up to 11. The autoset won't go up to a pressure unless it needs it. Sheriff

I would not trust that to be the case:
viewtopic/t84496/S9-goes-from-515-in-au ... 0-min.html

[Pugsy]

It's true the APAP won't increase the pressure unless it thinks it needs to but sometimes it thinks it needs to for something like a snore or flow limitation and the increase in pressure causes more of a problem than the snore or flow limitation would. Problem might be something like aerophagia at higher pressures or simply the changing of the pressure itself being disruptive to sleep. Some people are highly sensitive to pressure changes and some people can sleep through a hurricane.
Sometimes compromises are needed depending on the situation.

The thread that Burkebang mentions the machine is increasing the pressure while the user is awake and that shouldn't happen unless there is some sort of unusual situation or a possible problem with the machine.

[ughwhatname]

I'd say don't be scared of more pressure. You may find your tiredness improves with better treatment.

Thank you guys for the replys...I guess I am just scared Im getting too much pressure, silly I know, but it is an autoset so I will trust it. It just seems the higher I set the end pressure, the machine reaches it. Kinda freaked me out a bit. If I do manage to get into sleepyhead, how do I take a screen caption? Thanks

[squid13]

Some people just put it at 20 and let the machine go to where it needs to go. It will only go to the pressure it needs.

[archangle]

The main drawbacks to too much pressure are leaks, discomfort or increased apneas due to pressure induced central apnea.

As long as you're increasing pressure slowly and watching your AHI numbers, there's not a lot of risk of something bad happening. If you do start having central apneas, your AHI number will go up.

Many people are overly afraid of central apnea. It's probably no more harmful than regular obstructive apnea, but it's harder to treat. If you start having too many centrals as you increase the pressure, just turn the pressure back down.