sharing my story for advice:how to select the right pressure

[iricoboy]

Hi, everybody, i'm a sleep apnea patient from china,beijing. i wrote this post to ask for some advice on the use of my machine, it's a resmed autoset II

i'm 26 yrs old now, very very young boy who has suffered this kind of sleep disorder for almost 8 yrs,since high school, i know that nearly 90% of the cases are people older than 35-40, o people who is overweighted, but i don't belong to neither of those two groups, let me explain a little about my history: when i was in high shool, the second year, winter vacation, my mom had a benign tumor in her womb and stayed in the hospital for nearly 1 months for operation, so at that time i had to go to restaurants to buy something to eat( there is food in the hospital comedor, but my mother wants me to eat better and gave me the money to eat outside, that was the problem), i went to nearby restaurant for my lunch, eating a lot, and got very fat(before my mom's operation, i weighed no more than 55kg, thin, but after that period my weight increased as the inflated balloon until 70kg, it's a rapid increase, and now i weight 70kg), i guessed later if there was ilegal hormone added to the pork that i ate in the restaurant, hormones which helps the pigs grow faster. so, from that time i started snoring during the sleep, and the snores became louder and louder, my roommates in the university said it was like thunders and told me there was long suspension of breathing during my snores, it was 7 yrs ago that i first heard their comment, but neither i nor my parents took it into heart, though i thought it abnormal, i didn't go to hospital and my life went on, at that time i didn't know the severe consequences that i'll bring to me.

my blood pressure became high, 150-160/90-100 cmhg, i was tested with high blood pressure the day i'm admitted in the university(there is a physical test for the freshman), both the doctor and i thought i was too nervous(because i was young, and not very fat, 70kg,173cm), that was the first time i noticed my blood pressure，long before i noticed my thundering snores. And soon came my blood test result, my red blood cells is more than normal, and other two types of cells abnormal , one higher, and the other lower. (the university doctor interpreted my red blood cells as good nutrition, but told me the other abnormal two types that he didn't know why),and after that each time, i went to physical test, i got my blood pressure and my blood test the same results.

although the physical test results alerted me a lot, and i also discovered symptoms(which have accompanied me ever since) like, fatigue, head dizzy, and very sleepy after lunch, fast heart rate...i still didn't took any action, i owed the symptoms to bad genes(all my families are very healthy guys, ironically) o bad physical condition. though my physical state is such unhealthy, my university life is easy and i owned a lot of time for me to rest and sleep after lunch, and my major is not difficult for me, i didn't have to spend much on my studies, thanks to the clever mind i have, and my idle（i mean not busy, i found that i couldn't handle with very busy things, which consumed me a lot energy） days went on...

in the last few yrs, i went to various hospitals for treatment of fast heart rate, mental depression...i'm diagnosed nothing serious(at least my organs are intact and in good conditions, but i started taking medicines to relieve my daily discomfort, cipramil, pills made in Denmark for mental depression and Bisoprolol to lower heart rate and pressure, the first for 2 yrs, and the secong for 1.5yrs, i went to hospital for treating my depression first, because i felt very nervous when staying with my friends and very tired when talking with others, in one word, i feared i have social contact disorder, and became introvert

until recently,i found an article about sleep disorder, in which the consequences descirbed coincide 80%-90% with my symptoms, i realized inmediatelly that i must have got sleep apnea, so i didn't wait not a single day(hehe, not that exagerated) to purchase a respiratory machine (my parents financed me, i just graduated this yr), it's a Resmed autoset II,
i've used for 15 days, and i felt good (quite improved,and i stopped my blood pressure pills and feel now OK), the data registered : ahi<5, and ai hi in normal range,but i still feel insecure with autoset mode, because i bought the machine without any advice from doctors. and i read in this forum(i found this forum just yesterday) that some forum talkers don't feel very good in autoset mode, now my starting pressure is 4 and maximum is 20, i didn't changed them. and my average pressure is 10, how do i have to moderate the pressure to get the maximum treatment?

i want to hear more advice from u, i know that many have yrs of experiences using this machine, many thanks!! oh, forgot to tell u, i live in a middle-size town of beijing where last yr the Olympic acuatic games took place, it's small and beautiful, maybe one of u has been to my town last yr, i did saw a lot of foreign visitors.

[Gale Hawkins]

I started at a setting of 9 because that was was the former user had it set on since I was treating myself without any sleep study. From my research and other family members using CPAP machines I knew 9 was not that high.

Then I raised it by 1 until all snoring stopped. 11 took care of it most of the time but a setting of 12 on the Remstar Pro stopped all snoring. This past week I got an Oximeter and my oxygen saturation stays around 95-96 all night and the pulse rate is good.

Now after 4.5 years of use I have my first data and it indicates I do not stop breathing in my sleep so as to trigger abnormal oxygen saturation or pulse rates.

Best of luck. Since you are a snorer then my home made approach can be tried by you. Since the oximeters come from China you should find one that will record your readings all night for a lot less than the $160 US I paid for mine. I would use one very month or two to insure your oxygen level is not dropping when sleeping.

[iricoboy]

I started at a setting of 9 because that was was the former user had it set on since I was treating myself without any sleep study. From my research and other family members using CPAP machines I knew 9 was not that high.

Then I raised it by 1 until all snoring stopped. 11 took care of it most of the time but a setting of 12 on the Remstar Pro stopped all snoring. This past week I got an Oximeter and my oxygen saturation stays around 95-96 all night and the pulse rate is good.

Now after 4.5 years of use I have my first data and it indicates I do not stop breathing in my sleep so as to trigger abnormal oxygen saturation or pulse rates.

Best of luck. Since you are a snorer then my home made approach can be tried by you. Since the oximeters come from China you should find one that will record your readings all night for a lot less than the $160 US I paid for mine. I would use one very month or two to insure your oxygen level is not dropping when sleeping.

i wanna know if i use autoset mode, and manually set a range between minimun and maximum pressure, for example, in autoset mode, i would set 9-20, does that mean, the machine will ajust automatically between 9-20cmH20 according to my breathing? is it right?

[cflame1]

The biggest thing to watch when you do that... is that your minimum is up high enough to your 95% that it doesn't take the machine too long to respond.

For example if you set it at 4 but it takes until 10 to respond to your apneas... it's not going to get them all.

[spitintheocean]

A couple of weeks ago I did a formal sleep study and the lab diagnosed a requirement to begin CPAP treatment and set machine pressure at 16. I received an Autoset II from my DME and started using it. The suppliers set the machine for 4 - 20 and and my readings after the first few sessions confirmed the original diagnosis by reporting between 16 and 16.3. That suggests in autoset mode it will find pretty close to the correct pressure necessary for treatment, After that it's just tweaking to reduce your AHI's; my AHI's have scored between 4.9 and 7.8. I have changed my pressure settings 15 - 18.

All this to say that barring significant mask leaks, on its own your equipment should find a close approximation of your needed titration level.

[ozij]

Don't go off blood pressure pills without talking to a doctor, or at least without seeing that your blood pressure measures normal. High blood pressure is not something you feel. And feeling better on APAP therapy is not a promise that your blood pressure in normal now.

Its wonderful that you feel better now. Don't feel inscecure about the Autoset mode and the range- the fact your AHI is so low is an indication that the machine is working for you the way you set it up. When you snore, the machine raises its pressure very quickly - it doesn't wait for an apnea to happen - which is good. You don't have to change it if you feel well.

Welcome to the forum, and good luck!
O.

[rested gal]

i wanna know if i use autoset mode, and manually set a range between minimun and maximum pressure, for example, in autoset mode, i would set 9-20, does that mean, the machine will ajust automatically between 9-20cmH20 according to my breathing? is it right?

Yes, you are correct.

8 - 20, 9 - 20, 10 - 20 ... setting an autotitrating machine for any of those ranges would probably suit most people very well. That's just my opinion, however, and I'm not a doctor.

As ozij pointed out, you are getting a nice low AHI at the present range you're using: 4 - 20.
Leaving your machine set at 4 - 20 seems to work fine for you.

Many people say that it feels stifling to try to breathe through a mask at such a low pressure ( 4 ) , but if you're comfortable starting each time at that low pressure, and you're getting a low AHI, and you feel good... there doesn't seem to be any reason for you to change your setting unless you just want to experiment with raising the minimum pressure.

P.S. I enjoyed watching the Beijing Olympics on TV. Love the "Bird Nest"

[iricoboy]

Don't go off blood pressure pills without talking to a doctor, or at least without seeing that your blood pressure measures normal. High blood pressure is not something you feel. And feeling better on APAP therapy is not a promise that your blood pressure in normal now.

Its wonderful that you feel better now. Don't feel inscecure about the Autoset mode and the range- the fact your AHI is so low is an indication that the machine is working for you the way you set it up. When you snore, the machine raises its pressure very quickly - it doesn't wait for an apnea to happen - which is good. You don't have to change it if you feel well.

Welcome to the forum, and good luck!
O.

thanks a lot for your advice, i've set my machine working in autoset mode pressure 10-16 cmH2o, i felt much better last night than the past 2 weeks using the default autoset mode (4-20 cm H2o), indicating that the default autoset mode couldn't solve totally my apnea during sleep, the only thing is that i'm not used to starting pressure at 10, which made me hard to sleep and wake up early in th morning, (i mean i slept fewer hours, but i feel it enough), but i think with 2 o more days, i'll get acustomed to it.

[dsm]

iricoboy

迎cpaptalk 。我的名字是马贾的。我来自澳大利亚。我一直在北京和昆明。我在香港从2000年至2003年。

We can help you and perhaps even speak PutongHua sometimes but being English it can be very hard
for us to speak Chinese well.

Welcome

DSM

[iricoboy]

iricoboy

迎cpaptalk 。我的名字是马贾的。我来自澳大利亚。我一直在北京和昆明。我在香港从2000年至2003年。

We can help you and perhaps even speak PutongHua sometimes but being English it can be very hard
for us to speak Chinese well.

Welcome

DSM

oh, what a pleasure reading words of welcome in Chinese! are u in beijing now? i think i might pay a visit to u for more advice, and how do you spell your name in English, since i find quite exotic your name translated in chinese.

[iricoboy]

i wanna know if i use autoset mode, and manually set a range between minimun and maximum pressure, for example, in autoset mode, i would set 9-20, does that mean, the machine will ajust automatically between 9-20cmH20 according to my breathing? is it right?

Yes, you are correct.

8 - 20, 9 - 20, 10 - 20 ... setting an autotitrating machine for any of those ranges would probably suit most people very well. That's just my opinion, however, and I'm not a doctor.

As ozij pointed out, you are getting a nice low AHI at the present range you're using: 4 - 20.
Leaving your machine set at 4 - 20 seems to work fine for you.

Many people say that it feels stifling to try to breathe through a mask at such a low pressure ( 4 ) , but if you're comfortable starting each time at that low pressure, and you're getting a low AHI, and you feel good... there doesn't seem to be any reason for you to change your setting unless you just want to experiment with raising the minimum pressure.

P.S. I enjoyed watching the Beijing Olympics on TV. Love the "Bird Nest"

what a coincidence, I visited the Bird Nest just today with my mom, i wasn't in beijing during the Olympic Games, impressive, magnificent though, the bird nest looks coarse and a little rough when i saw it.

my ahi's are lower than 5 during the last 2 weeks when i started to use the Resmed, autoset mode 4-20 default setting, the day before yesterday i changed it to 10-16, autosetmode, last night(the second night, the first night with starting pressure at 10 made me sleep fewer hours, not good) i felt better than before,but the ahi's registered showed "7", and the first night also exceeded 7, my question is:
why the ahi's became higher while i increased my starting pressure??
does that mean, the machine lost data some time? o something wrong with my machine?
do you o does any one have the same experience?

thank u~ my dear lady ^_^

[dsm]

Hi iricoboy,
我住在澳大利亚。我上次访问北京是在1993年。在香港，我为电讯盈科。他们被称为香港电讯。

I am in Australia now. The Chinese name was given to me by my Employer when I worked in HK. They were http://www.pccw.com/chi/

Doug Marker = Ma Jia De 马贾地 (I hope that is the right Kanxi characters)

Cheers

DSM

[jo5525]

I snore at 19 what can I do?

[iricoboy]

Hi iricoboy,
我住在澳大利亚。我上次访问北京是在1993年。在香港，我为电讯盈科。他们被称为香港电讯。

I am in Australia now. The Chinese name was given to me by my Employer when I worked in HK. They were http://www.pccw.com/chi/

Doug Marker = Ma Jia De 马贾地 (I hope that is the right Kanxi characters)

Cheers

DSM

hola,
your chinese name is a little strange for mandarin speakers, but i think maybe it comes from cantonese pronunciation. in Mandarin (Putonghua, official language, like "castilian" in spain)we say "hanzi" instead of "Kanxi", but i understand "Kanxi" comes from the cantonese dialect, it's okay.

by the way, could you answer my questions about adequate pressures? it's a few lines above your post, the question i asked to the lady