Advice needed regarding adjusting APAP pressure

[porete]

My AHI numbers have been bouncing up and down lately and I am considering changing my pressure to see if that will help . I have also been feeling much more lethargic. My APAP is currently set at 4-14. According to SH, my average pressure has been about 9, but will go up to my max for a short while during the night. It does not seem that the machine has enough time to get to the proper pressure to prevent more AHI's. I think I am going to change the pressure range to 8-14 and see if that helps. Any advice or comments are appreciated. I do plan to take my SD card to my DME on Monday, so they can fax all results to my MD. This is just something I plan to do before I can consult with her next week.

[johnthomasmacdonald]

I'm not at all an expert at it but when i had the same problem as you, pugsy recommended doing just what you are doing - cut down the range of the apap to a much tighter zone ( how about something even tighter - like 8-12?)

[porete]

I thought about changing the max, but SH tells me that my max pressure some nights has been 13.6, so I think I better leave it at 14.

[Xney]

Sounds like a good plan

[2 B Sleeping Soundly]

Porete,
I would agree that you should think about increasing your lower APAP pressure range because it is certainly taking some time for the machine to get to a therapeutic pressure level to treat your Apneas / Obstructive Apneas from your starting pressure of 4 cmH2O. I would use a little caution and increase the pressure by 1 cmH2O each night until you get to 8 cmH2O, instead of jumping immediately to 8 cm H2O, so you give yourself time to adapt to the increase. Normally, it would be a good idea to make pressure increases over a longer period of time, especially when you are making small tweaks to optimize PAP treatment that is already going well. Since your starting pressure is set at the lowest that the machine will go it will probably be an easy adjustment to your new lower APAP pressure of 8 cmH2O. I would also agree with you and leave your high APAP pressure of 14 cmH2o alone unless you find yourself hitting the Max ceiling often enough to warrant a increase and would not think about lowering it right now because of your max pressure getting to 13.6 cmH2O. I hope that you are able to improve your therapy and become more rested !
John

[zoocrewphoto]

I thought about changing the max, but SH tells me that my max pressure some nights has been 13.6, so I think I better leave it at 14.

I think your plan sounds good. I was prescribed 11-17 which is perfect for me. I spend most of the night in the 11-13 range. I occasionally get up to 15, and on some nights, almost 17. So, I want it there even though I don't go there often.

I also believe that I sleep less on my back with my cpap machine than without. I think this is because my sleep apnea is worse on my back (proven in sleep study and pretty typical), so my pressure goes, which then causes leaks. So, in my sleep, I have learned to go back to my side. If my machine didn't go up as high, I would probably sleep more on my back and miss treating the very problem that the higher pressure was designed for.

[Wulfman...]

My AHI numbers have been bouncing up and down lately and I am considering changing my pressure to see if that will help . I have also been feeling much more lethargic. My APAP is currently set at 4-14. According to SH, my average pressure has been about 9, but will go up to my max for a short while during the night. It does not seem that the machine has enough time to get to the proper pressure to prevent more AHI's. I think I am going to change the pressure range to 8-14 and see if that helps. Any advice or comments are appreciated. I do plan to take my SD card to my DME on Monday, so they can fax all results to my MD. This is just something I plan to do before I can consult with her next week.

You posted this problem over a week ago in this thread "AHI numbers are erratic", but still haven't taken the advice I (or others) gave you then.

From your stated "average", I would suggest setting your minimum pressure to at least 8 or even 9 and see what happens.
I suspect you actually need a setting of something like 12 or 13, but you need to work up from some starting point.


Den

.

[porete]

My AHI numbers have been bouncing up and down lately and I am considering changing my pressure to see if that will help . I have also been feeling much more lethargic. My APAP is currently set at 4-14. According to SH, my average pressure has been about 9, but will go up to my max for a short while during the night. It does not seem that the machine has enough time to get to the proper pressure to prevent more AHI's. I think I am going to change the pressure range to 8-14 and see if that helps. Any advice or comments are appreciated. I do plan to take my SD card to my DME on Monday, so they can fax all results to my MD. This is just something I plan to do before I can consult with her next week.

You posted this problem over a week ago in this thread "AHI numbers are erratic", but still haven't taken the advice I (or others) gave you then.

From your stated "average", I would suggest setting your minimum pressure to at least 8 or even 9 and see what happens.
I suspect you actually need a setting of something like 12 or 13, but you need to work up from some starting point.


Den

.

wulfman...the reason I didn't change my pressure a week ago was because I was trying to give my lungs and body time to heal from the flu and see if that made any difference.

[porete]

Porete,
I would agree that you should think about increasing your lower APAP pressure range because it is certainly taking some time for the machine to get to a therapeutic pressure level to treat your Apneas / Obstructive Apneas from your starting pressure of 4 cmH2O. I would use a little caution and increase the pressure by 1 cmH2O each night until you get to 8 cmH2O, instead of jumping immediately to 8 cm H2O, so you give yourself time to adapt to the increase. Normally, it would be a good idea to make pressure increases over a longer period of time, especially when you are making small tweaks to optimize PAP treatment that is already going well. Since your starting pressure is set at the lowest that the machine will go it will probably be an easy adjustment to your new lower APAP pressure of 8 cmH2O. I would also agree with you and leave your high APAP pressure of 14 cmH2o alone unless you find yourself hitting the Max ceiling often enough to warrant a increase and would not think about lowering it right now because of your max pressure getting to 13.6 cmH2O. I hope that you are able to improve your therapy and become more rested !
John

I increased my pressure last night to 8cmH2O - 14cmH2O and my AHI came down to 1.32. I would have done it incrementally as you suggested, but I had already logged off before you posted. I did okay with the pressure, though. Thank you for all your help.

[RachelM]

I started APAP with 4-20 range, AHI was from 3.0 to 5.0 first few weeks on CPAP.
Couldn't breathe at 4 so upped the low number to 7. AHI then fell to 2-3. Upon suggestion from a member here I nudged bottom number up to 8. AHI fell to below 2. Sleep doc feels even lower is better and to up bottom number is 9. Haven't done this yet. Isn't AHI between 1-2 pretty good or should I aim for lower?

[JohnO]

Isn't AHI between 1-2 pretty good or should I aim for lower?

Between 1 and 2 is very good. Better 0 and 1 is better. Give 9 a shot and see what you get. For comparison, I have not had a night with an AHI above 1 since my fourth night of therapy about 5 months ago.