what is the highest pressure people have? and then what????

[williamco]

what is the highest pressure Apnea patients can have on their BiPAP? and if someone hit that ceiling then what?
are there apnea sufferers who can' get full treatment by CPAP/BiPAP? (based on pressure needs)

[memyself and i]

well.. be fore cpap, they sometimes trached people

[williamco]

Don't

don't scare me more please

[jules]

you asked what - you got an answer -

[millich]

Williamco -

I think that you are scaring yourself needlessly at this point. From what you've posted, 1) you aren't in bad shape on your current pressure and 2) you still have some "wiggle room" with your pressure.

To answer your question, my doctor mentioned others being on bipap with as high a pressure as *25*. The more knowledgable ones of this board can tell us if that is indeed the max. You are a long way from maxing out.

HOWEVER, your other posts indicate that with a pressure range of 16 - 18, your AHI is around 3. Right? While some here are able to get theirs lower than that, not everyone can. Remember, an AHI less than 5 is considered normal; it isn't even considered to be sleep apnea. I doubt that you could even convince your doctor that your pressure needs to be raised with an AHI of 3. Much less would he consider drastic alternatives.

Relax, buddy. You are scaring yourself for no reason!

[williamco]

millich , the reason I am scared is not that I am at pressure 16, but it is the speed I am going at
3 months ago when I started, the machine was topping at 10-11 cmH20
then gradually the machine started to creep up till 15 in a matter of 2 months
last week my AHI started to creep up from 2.5 to 3 to 4.5 and the machine started to creep up on the pressure to 17

prior to trying APAP: I was relieved by sleeping with a ball in my back, it lasted 2 months only and symptoms returned
then I got relieved by blowing the Didgi, it lasted 2-3 months only and symptoms resurfaced
and then my APAP journey is going on the same rate

that is a long history of progression at an alarming rate !

[DoriC]

Just a thought, have you tried a straight cpap pressure? The reason I ask is that when I set my husband's machine on auto at 11-13 or 11-14, he hits the max quite often and with higher AHIs and leaks as well. On cpap=12cms he does much better as it seems even the minimal pressure fluctuations bother him, so he has more restful sleep and lower AHIs. He was titrated at 13cms. I know this adjustment period is the hardest part but you'll get there, don't worry! Dori

[williamco]

Thanks Dori. I need to try CPAP yes, although I hate to leave A flex feature (available only in Auto) but for the sake of trial I will use only C flex with CPAP and see what happens

[jules]

I don't know your machine but can you set the apap with max = min or set them half a unit apart (half for remstar, .2 for resmed - minimal distance allowed)- then you basically have cpap with aflex?????/

[ozij]

Dori, you're very knowledgeable, do you realize that?

Have you ever tried fixed pressure, as Dori suggests? At which level?

O.

[williamco]

No I haven't tried fixed pressure yet but I will
the minimum pressure difference allowed in my machine inorder to be able to use Auto with A flex is 2 cmh2o
so my stting rightnow is 16-18
but I will abandon A flex for the sake of trying CPAP instead of Auto

[ozij]

Did you ever have a sleep study? Is your sleep apnea self-diagnosed?

What pressure are you planning to use as fixed? What do you base that on?
How much time did you stay on a "rising" AHI before you decided to jog the machine higher?

O.

[millich]

Williamco -

I still think it's possible that your "progression" may be fixed when you find your sweet spot for optimal pressure settings. The suggestions you've been given are excellent.

But, let's look at this differently. If in fact your apnea is worsening, let's search for causes.
a) What medications - prescription and otherwise - are you taking?
b) What changes have been made to those meds in recent months?
c) How is your weight? Has it changed in recent months?
d) What is your alcohol intake?

[Wulfman]

A few thoughts (repeating some that have been previously stated)

I agree......you need to try CPAP mode. (maybe 16 cm. for starters) and (Dori is VERY knowledgeable)
It's been reported that using A-Flex doesn't suit everyone. (and may require a higher minimum pressure)
You need to try to determine WHY your pressures seem to be increasing. (positional sleeping, leaks, "adult beverages", etc.)
You're worrying needlessly at this point. (and you haven't maxed out on CPAP/APAP pressures yet.)


Den

[jules]

to again repeat - meds - especially sleepers and benzos and booze can all raise havoc with this

I would also wonder how comfortable the mask set up you have is and how much that is affecting quality sleep