Pressure drops

[marmaduke451]

Hello all,

It turns out that my machine is set to C-Check from 7 to 13cmH20 (10 +/- 3). Started at 10 in August, then approximately a month later went down to 9, and down to 8 another month later. Couple days ago it dropped to 7. These pressures have been stable all night. There is a ramp setup - originally starting at 5. But that was hard going trying to breath, so I increased it to 6.5. However I have found myself never using the ramp feature.

Night before last, I found myself waking up a few times, having a hard time breathing. Last night, after 15 minutes, I was gasping for air and ended up not using the machine at all for the night. First time since I got the machine that I didn't use it.

Looking at sleepyhead, I note that there were almost no leaks when at 8. Some leaks when at 9. AHI remains about the same between these 2 pressures (generally below 2, sometimes between 2 and 3, and a couple times a hair above 4), always with hypopnea being the main culprit.

I am meeting my sleep specialist in December for a follow-up and will discuss pressures with him at the time. In the meantime, I've contacted my DME by email and am awaiting a response to see if they will change the pressure. If not, I'm going to have to grab the vendor's version of the manual and go in and change settings myself, I think.

I'm just rambling and thinking outloud here, but would love anyone's input if there's something you think I should be considering Thank you.

[Jay Aitchsee]

I'm just rambling and thinking outloud here, but would love anyone's input if there's something you think I should be considering Thank you.

You should be thinking about posting your SleepyHead charts so that we can see what you are talking about.

[marmaduke451]

Thanks Jay,

I'm working on it, but imgur appears to be stuck at processing. Will post soon as something "uncorks"

Bob

[Jay Aitchsee]

Thanks Jay,

I'm working on it, but imgur appears to be stuck at processing. Will post soon as something "uncorks"

Bob

OK. In the meantime, go on over to Apneaboard and get a Clinician's Manual: http://www.apneaboard.com/adjust-cpap-p ... tup-manual .
Yes, you should know how to adjust your own pressure if you want to.

[marmaduke451]

A few graphs

Most recent night with a pressure of 7



My best night



A recent night with pressue of 8



My worst night

[Pugsy]

It looks like any of the pressures will work well in terms of keeping the apnea events prevented.
I couldn't quite understand what your question was about the pressure but if the question is "is it okay to maybe use more pressure simply because it is more comfortable for me than I might really need to prevent the apneas"...then the answer is yes.
It hurts nothing to use a little more pressure all the time than you might technically need to keep the airway open and get a nice low AHI.
And if that is what you wish to do I would take the machine out of C Check mode and go to straight cpap mode so that the machine won't keep making adjustments for you that you don't want.

If you don't know where to get the clinical/provider manual..you can request it here
http://www.apneaboard.com/adjust-cpap-p ... tup-manual

[marmaduke451]

Thanks Pugsy,

Yes, I guess my poorly phrased question was "is it ok to increase the pressure slightly so I'm more comfortable"

Taking the machine out of C-Check seems like a good recommendation. I've requested the clinician manual, as suggested by Jay.

Thanks again

bob

[Pugsy]

The machine in C Check mode is just reducing the pressure because you don't seem to technically need the higher pressure to keep the AHI low. It's just going by AHI results. It doesn't have any way to measure your comfort level and it's not unusual for some people to simply be more comfortable at a higher pressure than what is maybe technically needed. If you don't take it out of C Check mode it will keep lowering the pressure each time it does the evaluation of the past AHI.

The only potential drawback to using higher than you might technically need might be aerophagia or central issues and you've already shown with the past use of higher pressures that you didn't have a lot of centrals develop (it's a rare thing anyway) or have trouble with aerophagia (bloating in the belly).

[Jay Aitchsee]

Yes to all of the above. The goal of CPAP therapy is to control apnea. Technically any AHI under 5 would be considered "treated". However, this leaves out one important aspect: How one feels. As Pugsy says, the CPAP machine has no way to measure the overall quality of sleep, it can only sense the number of events and report an AHI. One could be awake all night and still have a low AHI. Obviously, that would not be good quality.
Even though an AHI under 5 would be considered treated, most of us, I think, feel better with still lower AHI's, I'd say under 2. But at some point under that, in my opinion, quality, as measured by how one feels, becomes the most important metric. So, if one feels more rested and refreshed with a certain combination of settings, then that is what should be chosen, regardless of AHI.

[marmaduke451]

Brief update:

I switched to CPAP mode, with a pressure of 8.5. Probably too early to tell properly, but so far things *feel* fine.

In other news, I just heard back from my DME vendor (Vitalaire, see viewtopic/t114075/VitalAire.html ) that they weren't going to adjust anything pressure-wise without a new prescription from my sleep specialist... So... I shan't be going through them for much of anything at all from now on.

Thanks for your help Pugsy and Jay, very much appreciated.

[Julie]

The dealers aren't allowed to adjust your pressures without the doctor's say so... so you have to do it yourself (or talk to the doctor). We all just do it ourselves.

[marmaduke451]

Thanks Julie, I was not aware they were not allowed to adjust pressure like that. In any case, the point is moot, I fixed it myself over the weekend.