question about auto settings

[boston]

I use a resperonics auto with a-flex, i recently moved my minimum pressure from 6 to 12 and it has lowered my AHI significantly, I left my max at 15, would it make any sense to change my max to 20, would leaving it wide open like that be beneficial in any way ??

[Bluebonnet_Gal]

I use a resperonics auto with a-flex, i recently moved my minimum pressure from 6 to 12 and it has lowered my AHI significantly, I left my max at 15, would it make any sense to change my max to 20, would leaving it wide open like that be beneficial in any way ??

What's your AHI now? If it's good, I would leave it alone.

[Hawthorne]

If your AHI is good, I would leave it like it is (12 - 15). Some people, including myself, do way better on a narrow pressure range.

Edit 1 - If your 90% pressure is close to or at 15 it might make sense to raise the maximum as well. I thought of that after I posted!

[boston]

my ahi is consistently under 1 now. and my 90% pressure is typically around 14
I was just wondering because I just got the software and card reader yesterday and was looking at my info this morning, and it looks like i am running at max pressure (15) quite a bit, just wasnt sure if there would be any benefit raising the max to 20.

[Wulfman]

my ahi is consistently under 1 now. and my 90% pressure is typically around 14
I was just wondering because I just got the software and card reader yesterday and was looking at my info this morning, and it looks like i am running at max pressure (15) quite a bit, just wasnt sure if there would be any benefit raising the max to 20.

In my opinion, it depends on what's driving your pressure upwards. If it's leaks, I'd restrict the upper pressure.....if it's events like apneas and hypopneas, then maybe your minimum pressure is not high enough. Snores can also drive the pressure upward, but sometimes they go hand-in-hand with leaking. So, scrutinize your reports and try to discern WHY your pressures are doing what they're doing. When you see the pressures increase, look directly below that and see what events caused it to do that.

Den

[nomoore]

In my opinion, it depends on what's driving your pressure upwards. If it's leaks, I'd restrict the upper pressure.....if it's events like apneas and hypopneas, then maybe your minimum pressure is not high enough. Snores can also drive the pressure upward, but sometimes they go hand-in-hand with leaking. So, scrutinize your reports and try to discern WHY your pressures are doing what they're doing. When you see the pressures increase, look directly below that and see what events caused it to do that.

Den

+1

There's several reasons why you wouldn't want to keep the max wide open. Like Wulfman said, snores and leaks can drive the pressure up higher than needed. Also one more thing to look out for is Central Apneas. If you set the max higher, your AHI gets worse, and your leak rate stays normal relative to the pressure then you are probably getting central apneas. In that case you would want to limit the max pressure. Your Respironics machine has no way to detect central apneas.

[Wulfman]

my ahi is consistently under 1 now. and my 90% pressure is typically around 14
I was just wondering because I just got the software and card reader yesterday and was looking at my info this morning, and it looks like i am running at max pressure (15) quite a bit, just wasnt sure if there would be any benefit raising the max to 20.

nomoore,

Boston did say his AHI was less than 1......so, Centrals may not be an issue in his case.
But, leaks and snores can become a self-feeding frenzy.

Interestingly, a weekend or two ago, I took a nap with one of my autos with the pressure at 12 - 15 and just ONE single Flow Limitation (according to my report) shot my pressure up several centimeters near the beginning of that nap. In some cases, it doesn't take much to set these machine pressure changes in motion.

Den

[Hawthorne]

I agree with the 2 previous posters. Now that you have software and a reader you can check you leak rate against the Mask Users Guide (the graph for your 90% pressure is what you should look at, in my opinion). If you are at or near that your leak rate is fine.

If it's leaks that are driving your pressure up you need to improve your leak rate before making any more changes. If your leak rate is good then you may want to consider raising your minimum pressure so that it is about 1or 2 cm below the 90% and putting your maximum pressure at 20 cm.

You need to see about a week's data to consider more changes though,UNLESS you leak rate is bad. Then you may want to do it sooner.

Someone enlighten me please. One poster said that Respironics has no way to detect Centrals. Is that correct? What are NRs then? Thanks.

[DoriC]

Wulfman, is that nap data an example of why you favor cpap over auto?

[kest874]

I was told by my SD that the Flow Limitation is a Central? Is that not correct?

[Hawthorne]

Anyone else? Are Flow Limitations the "Centrals" on this machine? I didn't think so. I'd really like to know for sure if they are or are not and what NRs are.

[Wulfman]

Wulfman, is that nap data an example of why you favor cpap over auto?

Not entirely, Dori. I did a full week of Auto settings back in 2006 with the pressure settings of 10 - 15. I just started doing naps with an APAP last year.....just out of curiosity. Unfortunately, I don't take nearly as many naps (in bed) as I used to, so the "tests" are few and far between. In fact, the one last summer and the one a couple of weekends ago have been the only ones when I've hooked up to my Auto.
I realize that a few hour nap isn't like a full night's sleep, so they're more "experimental" in nature.....to see how my Autos respond to my sleep......however short it may be.

Den

[nomoore]

my ahi is consistently under 1 now. and my 90% pressure is typically around 14
I was just wondering because I just got the software and card reader yesterday and was looking at my info this morning, and it looks like i am running at max pressure (15) quite a bit, just wasnt sure if there would be any benefit raising the max to 20.

nomoore,

Boston did say his AHI was less than 1......so, Centrals may not be an issue in his case.
But, leaks and snores can become a self-feeding frenzy.

Interestingly, a weekend or two ago, I took a nap with one of my autos with the pressure at 12 - 15 and just ONE single Flow Limitation (according to my report) shot my pressure up several centimeters near the beginning of that nap. In some cases, it doesn't take much to set these machine pressure changes in motion.

Den

Yeah but his max is set at 15. If he sets the max higher and the machine raises higher then that higher pressure could cause centrals. I'm not saying he has centrals and I'm not saying he shouldn't try it higher. It was meant as a warning of what to watch out for if he does raise it because it could happen.

[Wulfman]

Yeah but his max is set at 15. If he sets the max higher and the machine raises higher then that higher pressure could cause centrals. I'm not saying he has centrals and I'm not saying he shouldn't try it higher. It was meant as a warning of what to watch out for if he does raise it because it could happen.

I realize that......but the software will tell him the nature of the events.....if they start showing up as Non-Responsive or if the pressure raises three times and then takes a sudden drop, that would be the clues on a Respironics Auto.
A couple of Centrals here and there are not an impending warning of imminent death. Think of how many apneas (obstructive or central) we all had each and every night BEFORE we got into our therapy.

My point (previously) was that he needs to evaluate the events on the reports and try to determine what is driving the pressures now.

Den

[boston]

I think I am going to wait, get a good weeks worth of info and evaluate it then. my leaks seem to be allright, they seem to spike when I move around, not worried there. after a weeks worth of data, if i still need help, ill see about posting copies, never done that before so ill have to figure that one out, i think i saw a thread on it recently.

thanks for all the responses