Using the 95% number to establish low pressure

[track]

If your 95% pressure was 13....where would you put your bottom pressure number for an apap?
12?,13?,14? This is a self titration question...so no questions please about sleep study results. Appreciate any input from you, rested gal.
I have been limping along for over a year with side sleeping. My numbers are good at cpap pressure of 9...typically the AI is between .5 and .9 but I don't feel rested. It's like I don't get in a deep sleep unless I am on my back which I don't allow....and my back doesn't feel very good either. Last night I set the pressure at 14-17 with no sleep restrictions...AI was 1.1 and AHI was less than 5. I felt better today than when I side sleep...but it felt like a hurricane inside my mask. The downside is I had a AI of 25 seconds last night..probably on my back.... whereas on my side it's never over 10-12 seconds.

[Goofproof]

I don't play the 90%, 95% game, I use the software (Dailies) to see where the best numbers are. If is didn't I'd take the 95% number and add 1 or 2 CM for the high, and set the low at 1 or 2 CM under the 95% number. Jim

[track]

Thanks Jim...I have looked at my resmed software every way possible and I can't see a pattern or any useful info other than length and number of apnea events. It seems pretty lacking in useful info.

[GumbyCT]

If your 95% pressure was 13....where would you put your bottom pressure number for an apap?
12?,13?,14?

Maybe 12 and set the upper either 18 or wide open until I found out where it needed to be.
Sounds like your pressure may not be enuff to stiffle your events. But as your pressure goes up you will have more leaks to contend with.

If you find you need more pressure but can't tolerate it, leave it where you can tolerate it then increase .5 to 1cm each week until you can tolerate it with no problem

[track]

One little mini bump

[bigk]

I set my minimum pressure at the median value I think - I did look at the pressures for the night for a few weeks. I just don't see any point in setting the minimum pressure below that. The Resmeds do tend to hunt a bit if the minimum pressure is set too low. I also really don't see a problem with the resmed not responding to apneas above 10cmH2O - why in hell set the pressure below 10 just because of that - it makes no sense to me at all.

[roster]

..........
I have been limping along for over a year with side sleeping. My numbers are good at cpap pressure of 9...typically the AI is between .5 and .9 but I don't feel rested......

Wow Track! 30 days ago I could truthfully sign that exact statement. I am seeing some improvement in the last 30 days due to adding melatonin to my nightly routine.

Are you having any insomnia? How many hours are you sleeping? Do you have any soreness from side sleeping? GERD?

BTW, I gave up on apap and titrated on straight 8.5 cm to consistently achieve AHI< 1.0.

Regards,

[track]

Thanks Rooster for responding.
The only way I can stay off my back is to wear a humongous backpack filled with hard pillows and towels and pulled tight at the chest and waist so it doesn't move. By morning there is some discomfort in my back, hips and shoulders but nothing that is major. My numbers never get as low as yours. My HI is always 4 or 5 with AI typically running less than one. It's a major improvement over regular sleeping numbers. I use cpap strictly on my side and get about the same numbers regardless of whether I put it on 7.6 or 10.0.

The last three nights I have tried 13-20, 13.6 -20 and 14-20 with no backpack. My AI was slightly over 2 at the first two numbers with AHI being around 6-7. At the 14 number it as slightly over one with AI and AHI being just below 5....but it was only one night so hardly something I can base any conclusions on yet...but I don't feel noticeably worse or better during the day than I did side sleeping...except I did not wake up the normal one or two times during the night that I do when I side sleep.
I take a Zantac an hour before bed time and usually don't go to bed unless I have waited about 5-6 hours since eating..makes me have to eat early. If I don't take the zantac I can get that burning in the throat from acid reflex. I never had this problem prior to using CPAP. I have my bed elevated 5 inches and the last three nights I have proped myself up on pillows.I typically sleep 6.0-6.5 hours but do have nights where I sleep 7 to 7.5 hours. I don't have any problems with insomnia or falling asleep.

[roster]

Track,

Yours seems to be a difficult case (aren't many of them?). I really don't know what to suggest but I will ramble on some anyway.

We did not discuss leaks. I assume you monitor them and they are under control.

Sleeping with the backpack can cause arousals due to getting poked by the pack and squeezed by the straps. If you can tolerate the higher pressures and have no aerophagia, how about an extended trial without the backpack? I like to titrate using straight cpap pressures. Maybe start at 14 cm and if AHI is not suitable then bump it 0.5 cm each night and see what happens?

Are you aware of any other health problems? I know you don't have insomnia but there could still be arousals you are not aware of. How is your sleep hygiene ( http://www.umm.edu/sleep/sleep_hyg.htm )?

Hang in there (TSCBH),

[track]

If you.... have no aerophagia

That's the rub. If that wasn't a factor I would just crank up the pressure and go to sleep. Thanks for the input, Rooster.

[track]

Rooster....Friday night ..... I set the pressure at Apap 15-20 and figured I would roll the dice and sleep in whatever position felt good. The next morning the 95% pressure was 15..so no movement upward during the night. My entire midsection was in pain...felt like someone had tried to blow up my guts up with an air pump...and that was even after I had set a bunch of pillows ..wedge style...up so I would be at an angle while sleeping.The slightest movement walking was painful all morning. It was late afternoon before the soreness subsided. My numbers were AHI 5.0 AI 1.0 and HI 4.0. No way I wanted to repeat the midsection pain last night so I set the pressure on Cpap at 7.4 and put on the backpack.This morning no aerophagia at all..stomach and midsection felt great. The numbers this morning were AHI 5.0, AI 0.5 and HI 4.5....AHI the same but half as high AI. Snoredog used to say it's the AI that really counts...so it's a no brainer. I guess I will just get used to that backpack like it's my friend. Problem solved. Thanks for help.

[roster]

......... My entire midsection was in pain...felt like someone had tried to blow up my guts up with an air pump...........

I remember well that feeling when I was trying to use 19 cm pressure! Let's stay on our sides the rest of this life.

BTW, if you want "everything" (euphemism ) to be taken care of first thing in the morning try this.

-Every morning eat a 3 oz measure of Kellog's Bran Buds in milk. Actually measure out the 3 oz of Buds with a measuring cup then add the milk.
-The next morning eat the Buds again plus breakfast. If you don't like to eat breakfast drink a warm cup of decaf tea or decaf coffee. Warm stuff helps to stimulate the bowel.
-Then shave and brush/floss.
-By the time you are finished, it will be time to take care of "everything" for the day. It is so amazingly consistent day after day just like a good factory process. The Buds have about 13 grams of dietary fiber including psyllium. They taste decent (contain sugar). I cheat and use whole milk most mornings.

If the whole country did this, you would get rid of all the workplace stinking morning restrooms.