pressure question

cflame1 · Post by **cflame1** » Mon Sep 11, 2006 4:22 pm

I recently changed my bottom pressure from 5-6 and I have this nasty habit of waking up at 4AM... at 5 I could convince myself to not totally wake up but this morning, it felt like there was a ton of bricks sitting on my chest... do I push it up, or do I push it down pressure wise?

Gasping, I can see going up... but this I'm not sure

Current pressure is sitting at 6-10... and I've only hit the 10 a couple of times... one of which is shortly after the 4AM thing this morning.

I just want to be able to sleep all night!

lferrel · Post by **lferrel** » Mon Sep 11, 2006 5:08 pm

cflame,

I think you might want to raise the pressure up. I get the suffocation feeling at 8. I think most people start feeling uncomfortable below that point. It feels like sucking air through a straw, right? It gives one a claustrophobic type feeling. You will be much more comfortable at a higher level. A range of 8 to 12 might be some thing to try.

Lowell

cflame1 · Post by **cflame1** » Mon Sep 11, 2006 9:30 pm

dunno if this will work or not, but this was last night's report.

DreamStalker · Post by **DreamStalker** » Mon Sep 11, 2006 9:42 pm

Looks like you are doing fine with your upper limit ... you have real good indicies for AHI and OA.

If you are feeling short of breath you can bump up your lower limit by one point and see if that helps ... then try bumping again if you need. It may be that you do best with straight CPAP aound 9 or 10 cm.

Do you have the c-flex on if so how much?

- roberto

cflame1 · Post by **cflame1** » Tue Sep 12, 2006 5:10 am

cflex is off... causes me to hyperventilate. I'm asthmatic.

I bumped the lower to 7.5 last night... going to need to bump the upper now too... largest percentage of the time was spent there. The lower's better but still not right... still woke up but only sort of. At least I managed to convince myself not to get up (needed the sleep).

Here's last night's

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): cflex

Wulfman · Post by **Wulfman** » Tue Sep 12, 2006 5:58 am

Suggestion:
Why don't you try a single pressure setting (CPAP mode) of say 8 or 9 and see what happens?.

Den

oldgearhead · Post by **oldgearhead** » Tue Sep 12, 2006 6:14 am

I agree with the 8-12 pressure suggestion.

Wulfman · Post by **Wulfman** » Tue Sep 12, 2006 8:53 am

When I read this thread earlier this morning, I didn't read DreamStalker's post well enough (missed the part where he also suggested a fixed pressure). So, I agree with him and still believe that even starting with a fixed pressure of 8 and working up to 10 would be worth a try. You're not even getting past 10 (at least on these two charts), so there would be no need to set the machine above your 90% pressure. The pressure changes may very well be disturbing your sleep.
Just because you have an APAP doesn't mean you always HAVE to run it in a range of pressures.....it's designed to find your best therapy pressure....be it a single pressure or a range. For some of us, a range is not necessarily the best therapy.

Best wishes,

Den

Goofproof · Post by **Goofproof** » Tue Sep 12, 2006 9:16 am

Your are having to go to a higher pressure because of the leak rate. The high leak rate, is letting problem in, and the machine will raise the pressure to try to correct them, causing even more leaks. My $0.03 worth, I've played that game. Jim

oldgearhead · Post by **oldgearhead** » Tue Sep 12, 2006 10:46 am

Leak rate? My two month average leak rate for my CL2 was 42.5 LPM with
pressures in the 8.6 cm/H2O area. Therefore, I don't see anything out of
ordinary with your 41.5 cm/H2O...

Goofproof · Post by **Goofproof** » Tue Sep 12, 2006 12:57 pm

oldgearhead wrote:Leak rate? My two month average leak rate for my CL2 was 42.5 LPM with
pressures in the 8.6 cm/H2O area. Therefore, I don't see anything out of
ordinary with your 41.5 cm/H2O...

His Avg leak rate for the 11th, was 46.66LPM. His top leak rate was between 60 and 65 LPM

The spec for output for the BiPAP Auto is < 35 LPM.

The spec for output for the Pro 2 is <34 LPM.

The APAP is probably close to the same spec.

Where is that extra volume of air going to come from? You don't think it matters?

When my leak rate goes past 45LPM, my snores go up, then all _ ELL brakes loose. Jim

DreamStalker · Post by **DreamStalker** » Tue Sep 12, 2006 1:02 pm

She is listing the Hybrid as her mask ... it has a high exhalation exhaust rate.

Her AHI and OA numbers are pretty good. She stated her problem was not being able to breathe well when she wakes in the morning.

She may just be one of those who does better on straight CPAP.

- roberto

Snoredog · Post by **Snoredog** » Tue Sep 12, 2006 1:22 pm

I think you should do NOTHING. 90% pressure is MOVING, 8cm in one report, 10cm in another. Any CA's or MA's seen on your PSG?

Machine appears to be responding and doing its job. It only flat-lined a couple times in the 2nd report (didn't see any in 1st report) and those are associated with higher snores seen.

Machine realizes that the 3 pressure increases did NOT resolve snores seen so it "paused" and snores subsided afterward, pressure dropped back to probe.

Snores were the most likely trigger for the pressure response and flat-lining seen on both reports. Flat-lining is where you see the Purple pressure line disappear in the Yellow Max. set pressure line.

Is that bad? So should you increase the Max. Pressure? NO. The event that triggered the pressure increase is snore, you have snores from from start to end of your session(s), at low pressure and at high pressure. Your snores do NOT appear to respond well to pressure (such as palatal snores), infact your report shows snores worsening with increased pressure.

Your report does show some FL's. You could increase the bottom pressure by .5cm to 1cm (I would not go to 8cm) to see if that lowers them and improve awake breathing, but remember snore frequency increase with pressure in your case.

If you increase the Min. pressure from 6.0 to 6.5cm all events will show up under 7.0cm setting (there will be no events listed under 6.0cm in the Daily Events chart).

Set the Min. pressure to where you can breathe comfortably but keep in mind what it does to your snores.

cflame1 · Post by **cflame1** » Tue Sep 12, 2006 5:25 pm

Hey guys... thanks for the advice... don't think that I'm going to do the flat 8... been there, done that... even at that pressure (that's where I started originally).

last night's was set to 7.5 to 10... so I'm going mess with it some more... probably raise them both and see what I get. The night before was 6-10.

liked the 8-12 idea... might actually do that one... might pick the top up higher.

my 90 percent pressure moved... yes, because I moved my bottom number from 6 to 7.5

i had no CA's reported on my PSG (the joke of a PSG that I had).

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