*Updated with SleepyHead - Autoset 10 Pressure Issues

[triumph65]

Hi,

New to the forum. I recently got an Autoset 10 with an Airfit 10 full mask and Swift FX Nasal Pillow. I haven’t decided if I like the pillow or full mask better but use the mask when I have nasal congestion.
My insurer would not approve the second night’s sleep study (titration) so my prescribed pressure settings are 4 to 20.

I have been congested lately (cold & allergies) therefore using the full mask.

Lately my machine has been ramping me to 14.5 psi and blowing my mask off, not literally but air blowing out my cheeks and waking my wife and I up.

I have found that I cannot sleep when the machine exceeds 12 psi. It may be trying to stop an apnea but the effect is it wakes me up and my mask can’t handle the pressure without leaking.

Any tips? Should I just lower the machine pressure to 4-12 and see how I do?

[Pugsy]

Without seeing the reports as to what the machine is actually doing and wanting to do....here's what I would do if it were me.

Probably considering raising the minimum from 4 to something close to where the overall average pressure is (not the 95% number) and since you know that 12 seems to cause wake ups and air in the cheek issues....limit the max to 12. If using SleepyHead...look at the statistics for the median pressure (it's just to the left of the 95% pressure statistic) and set the minimum close to that number.

The reason I suggest increasing the minimum a bit is because often when the minimum pressure is more optimal the machine won't need to go a lot higher (like the 14 you are seeing at causes a problem) and thus the maximum pressure can sometimes actually reduce a bit or a lot.

Then evaluate the pressure needs with the new max at 12...you may see the max line getting pegged out occasionally but as long as it isn't allowing a large number of apnea events to slip past the defenses then I wouldn't worry about it.
You need to be using SleepyHead software though...do you use it or know about it?
If not..get it and use it
https://sleep.tnet.com/equipment

[triumph65]

Without seeing the reports as to what the machine is actually doing and wanting to do....here's what I would do if it were me.

Probably considering raising the minimum from 4 to something close to where the overall average pressure is (not the 95% number) and since you know that 12 seems to cause wake ups and air in the cheek issues....limit the max to 12. If using SleepyHead...look at the statistics for the median pressure (it's just to the left of the 95% pressure statistic) and set the minimum close to that number.

The reason I suggest increasing the minimum a bit is because often when the minimum pressure is more optimal the machine won't need to go a lot higher (like the 14 you are seeing at causes a problem) and thus the maximum pressure can sometimes actually reduce a bit or a lot.

Then evaluate the pressure needs with the new max at 12...you may see the max line getting pegged out occasionally but as long as it isn't allowing a large number of apnea events to slip past the defenses then I wouldn't worry about it.
You need to be using SleepyHead software though...do you use it or know about it?
If not..get it and use it
https://sleep.tnet.com/equipment

Thank you for the advice!!!
I will download the sleepyhead software tonight and post the data here. Maybe that will help with some insight.

I appreciate you taking the time to help me .

[triumph65]

[ajack]

If it were my chart, I'd have min 9 max 15 or min 10 max 15, depending how the min 9 went.
you will get us to the pressure, I was bouncing around 20 on cpap.
adjust your mask for leaks or buy a new one, perhaps the f20 is worth trying?
youtube have a lot of mask fit videos.

[jim22]

Your numbers look good, with not very many events. I would raise the minimum pressure a bit, to 8 or 9. Then see what happens. If the pressure still goes up maybe limit the maximum to 12 or so. You can make the changes in steps over a week or two if your uncomfortable. Lets seemwhat other advice you get.
Jim

[Pugsy]

You spend very little time up around 15 to 16...and it appears that Flow limitations are probably driving the pressures. It's not OAs ...your AHI is already really low.

Since you know that when the pressure gets up around 14 that you start having mouth leak issues that wake you up...I think you can probably limit the max to 12 and still do very well. It may max out briefly at the 12 but I don't think that it will do it very long and the few Flow Limitations it might let slide won't be that much of a big deal or at least as big of a deal as the wake ups are when the pressures get over 12.

Technically the 4 cm minimum is doing an okay job in terms of AHI reducing but I still think that you might have better Flow Limitation prevention (FLs and snores is part of what the machine will try to kill) if the minimum was a little higher. Don't need a lot higher though.

I would suggest that you try 6 or 7 cm minimum and 12 maximum.
See how it goes with the mouth leaking wake up thing.
And you might be pleasantly surprised to find that with a more optimal minimum pressure the machine won't need to go so high fighting those FLs and snores.