Can lowering a CPAP setting ever help?

[DJ42]

New to board, but not to Sleep Apnea or CPAPs

Since 2005, I've had a CPAP set to 14. For most of that time, it's worked well. Lately (5-6 months) I've been having breathing problems and have been extremely tired all the time. Falling asleep at my desk tired. My pulmonologist recommended a sleep study to make sure my CPAP is set properly for my current needs. I had that study done, and it found that I am waking up 53.8 times per hour. They raised the setting to 10, and I wasn't waking up any more. At 12, it was the same. For some unknown reason, they didn't test 14, the setting I'm using now.

So, finally, I get to my question. Could it really be possible that changing my setting from 14 to 10 would help me sleep better? I find this very hard to believe. It seems to me that this sleep study simply indicates that my tiredness is not due to sleep apnea. Anyone have any experience with this or any reason why I should believe the people at the sleep lab and switch to 10?

[BlackSpinner]

Yes for some people cpap set too high can trigger central apneas. I t can also cause other issues that might be waking you up.

If you had a good data capable machine you could actually see this in your data

[Wulfman...]

New to board, but not to Sleep Apnea or CPAPs

Since 2005, I've had a CPAP set to 14. For most of that time, it's worked well. Lately (5-6 months) I've been having breathing problems and have been extremely tired all the time. Falling asleep at my desk tired. My pulmonologist recommended a sleep study to make sure my CPAP is set properly for my current needs. I had that study done, and it found that I am waking up 53.8 times per hour. They raised the setting to 10, and I wasn't waking up any more. At 12, it was the same. For some unknown reason, they didn't test 14, the setting I'm using now.

So, finally, I get to my question. Could it really be possible that changing my setting from 14 to 10 would help me sleep better? I find this very hard to believe. It seems to me that this sleep study simply indicates that my tiredness is not due to sleep apnea. Anyone have any experience with this or any reason why I should believe the people at the sleep lab and switch to 10?

You haven't been clear as to which machine you have and whether it has data-capabilities or whether you're monitoring your therapy with software.
Please inform us as to those circumstances. Because.......without actually SEEING the nightly reports, it's almost impossible to answer your question(s) definitively.

But, my sleep doctor originally wrote my prescription for 18 cm. The sleep lab actually stopped at 16 cm., but my sadistic sleep doctor felt he knew best and added two more centimeters to it.
When I got my machine, I had trouble breathing at that much pressure, so I dropped my pressure to 10 cm. (I had a fully data-capable machine and the software to monitor my therapy), and did very well at that pressure for about a year. After I figured I'd never be seeing my sleep doctor again (even though I fired him shortly after I got my prescription), I started experimenting with my pressures and eventually ended up at 12 cm. and have stayed there since 2006. So......"YES"......sometimes some pressure settings can be too much.
Other adverse situations/results of higher pressure can involve swallowing air (aerophagia) and contributing to Central Apneas.


Den

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[Julie]

Hate having to ask this, but it can be so insidious as not be thought of, but have you gained any weight over the time you began to feel tired and started changing the pressure up?

[robysue]

Hate having to ask this, but it can be so insidious as not be thought of, but have you gained any weight over the time you began to feel tired and started changing the pressure up?

Julie, I don't think the OP has been "changing the pressure up" at all. The OP writes:

Since 2005, I've had a CPAP set to 14. For most of that time, it's worked well. Lately (5-6 months) I've been having breathing problems and have been extremely tired all the time.

Sounds to me like the OP has been using CPAP at 14 for the last 10 years. And after the OP complained to his/her doc about the breathing problems and the fatigue problems, the OP's doc ordered another sleep test; and the recent titration test showed that a CPAP pressure of 10cm is effective in controlling the OP's OSA. That's why the OP is wondering if lowering the pressure from 14 to 10 might lead to better sleep.

Whether weight gain (or loss) might be the reason the OP now seems to need significantly less pressure is an interesting question. But it's not directly related to answering the OP's question.

To the OP: Since you aren't sleeping very well AND since you have had a new titration study done AND since the new titration study indicates that you might only need 10-12 cm of pressure, it is worth testing the hypothesis that you might sleep better with a lower pressure setting. As others have said, it would be better to test that hypothesis with a full data machine so that you can actually see whether the lower pressure does indeed control the OSA on a nightly basis.

[Julie]

Roby Sue - I may have misread something, but do you think you could take the didactic tone down just a notch? At least til we get outside the schoolroom and you've told my mother in private? Thanks!

[robysue]

Roby Sue - I may have misread something, but do you think you could take the didactic tone down just a notch? At least til we get outside the schoolroom and you've told my mother in private? Thanks!

I'll try Julie. I will try.

It's the end of final exams. So I'm unfortunately in full professor mode.

[Julie]

Got it.

[DJ42]

I didn't even know CPAPs could record data. Mine has an info button that tells me what it's set to and how longs it's been used, and a few other things that i couldn't figure out. But nothing like how effective it's been. I don't remember what brand it is, and I'm at work now so I can't check.

I have never changed my CPAP setting. I think i had a link to a page that explained how to do it, but I was afraid I might mess it up and have to take it to someone who is supposed to set these things, and they'd see that I'd changed it.

I did stop using my CPAP after I'd lost 145 lbs, but I've since gained it all back, and at some point I realized I needed it again and started using it again.

I have an appointment with a sleep dr. tomorrow. I'm wondering if my CPAP is not working as it should, since it's ten years old. It might not be actually giving me 14cm. I'll bring it to the dr. and see if they can measure the actual pressure it's putting out. If it's producing less than 10cm, then a new one would clearly work better. I'm hoping it's something like that, because I know how quickly and effectively the first CPAP I had cured my sleepiness. No more sleeping in the car at lunch time.

[OkyDoky]

Here is a link that will help you fill in your equipment profile. wiki/index.php/Registering_Equipment_in_User_Profile
And this one will help you determine which machine you have. https://sleep.tnet.com/cmd
Some have helpful data and some only have compliance data such as hours of use and over all AHI. Once we determine which machine then we can help you get the clinical manual.

[syrulijczyk]

of course it can help. A lot depends on people who use it

[Zomby Woof]

Could it really be possible that changing my setting from 14 to 10 would help me sleep better? ...
Anyone have any experience with this or any reason why I should believe the people at the sleep lab and switch to 10?

"Trust but Verify" said Reagan and Gorbachev.

My prescription for a bi-level auto-setting machine was written as 25IP 12EP with 8 Pressure Support.
Practically speaking this meant that the lowest pressure delivery I received was 20IP and 12 EP with IP pressures often peaking above 23cwp.

This pressure level blew three different masks high into Large Leak territory,
gave me weeks of bad sleep, and an average of about 14AHI - very poor results indeed.

My belief, after trying these settings for nearly a month, was that this prescription was incorrect.
When the observations and opinions of several members here coincided with my own,
I adjusted my pressures downward.

My current machine settings are: 18IP 9EP 3PS

Most of the night my pressure stays at 12/9 or 13/10 and it only rarely peaks above 15/12.

The result of this lowered pressure is an Apnea Index of 3.27AHI and far better days for me.

My view is that you should Trust the sleep lab prescription. Verify it with your own experience.
Change your machine settings when your experience and the consensus opinion of experienced forum members here are agreed.

Best of luck!

"If You Meet The Buddha On The Road, Kill Him!"