Is it possible to over pressurize yourself?

[Mount Snorius]

In the sleep study done in Oct. 2007, it was determined that my pressure setting should be 8. That is what I used since then on a Goodknight 420. That is, until a few months ago when I started to feel groggy again. At the end of March of this year, I decided that I really needed data to see what was going on. The insurance company only allows a new one every 5 years, so I put the money out for a Resmed S9 Autoset with Climateline and a Swift FX mask.

I tried it for a few days in just a straight setting of 8, and found a little relief. Then I started to get carried away with it in a desperate attempt at make things right. I went a few days with a minimum pressure of 6 and a high of 9. Then I went to a high of 10. Then went a couple of nights with an EPR of 1, then a couple at 2, then a couple at 3, then off again. Still feeling the same way, not good. A couple of nights ago I went to a minimum of 8 and a high of 10. As you may see from an earlier post, I was having a tremendous leak problem.

It was suggested that maybe the leak was due to mouth leakage and not mask issues. For a couple of nights, I used a roll of toilet paper tucked under my chin and that seemed to cut the leakage in half. For the last 4 nights, I have used the headstrap of one of the multitude of masks that I have gone through to keep the yap shut. I couldn't do the tape thing, and am waiting for a chin strap that I ordered the other day. But, in the meantime, the leak issue is about 20% of what it was.

The pressure reading over the last few nights has been pretty much around the 10 mark, and very rarely around the 8. The AHI reading last night was .3, with only 1 hypopnea and 1 obstructive event of 13. I still feel terrible though. Can't drive the car (and my business is 75 miles from the house), I want to lie down and sleep just about all the time.

Should I raise the the upper limit to 11 or 12, go back to straight 8 or what? Have I over pressurized? Any thoughts would be appreciated.

[rosacer]

With an autocpap you can't overpressurize yourself.

The machine will give you only what you need as maximum pressure.

What can happen is you can set the maximum too low and limit the functioning of the machine. Let's say some times you need 12,5 and you set the machine at 12, you ill not have the 0.5 extra you needed in some period of the sleep. That will forbid the machine tho chase some events in the night.

If you put your low pressure too high you will be sleeping with an excess of pressure you don't need.

What we normally do is we set the pressures in a range of around 3CM/H2O higher and lower from the pressure you where titrated. Then you check what that does and you can adjust and tweak it later with your data on hand. Nut you will see the pressure changes in the night and goes up and down in a different range for everyone.

Good success!

[DreamDiver]

I understand that when you over-pressurize, you turn blueberry-flavored and that you have to be rolled off to the pressing room before you pop.

Actually, if you can afford it, it might be worth going back to your sleep doctor and getting retitrated, especially if you're too sleepy to drive. (Please have someone drive you, of course.) If you cannot afford it, other members of the forum have successfully self titrated themselves with an auto.

EDIT: If I were self-titrating, I'd follow Den's advice: go to straight CPAP and titrate at a single pressure. There are a number of posts about self titration on the list. Good luck.

Violet turning into a blueberry as the Oompa-loompas sing their cautionary tale...

[Wulfman]

In the sleep study done in Oct. 2007, it was determined that my pressure setting should be 8. That is what I used since then on a Goodknight 420. That is, until a few months ago when I started to feel groggy again. At the end of March of this year, I decided that I really needed data to see what was going on. The insurance company only allows a new one every 5 years, so I put the money out for a Resmed S9 Autoset with Climateline and a Swift FX mask.

I tried it for a few days in just a straight setting of 8, and found a little relief. Then I started to get carried away with it in a desperate attempt at make things right. I went a few days with a minimum pressure of 6 and a high of 9. Then I went to a high of 10. Then went a couple of nights with an EPR of 1, then a couple at 2, then a couple at 3, then off again. Still feeling the same way, not good. A couple of nights ago I went to a minimum of 8 and a high of 10. As you may see from an earlier post, I was having a tremendous leak problem.

It was suggested that maybe the leak was due to mouth leakage and not mask issues. For a couple of nights, I used a roll of toilet paper tucked under my chin and that seemed to cut the leakage in half. For the last 4 nights, I have used the headstrap of one of the multitude of masks that I have gone through to keep the yap shut. I couldn't do the tape thing, and am waiting for a chin strap that I ordered the other day. But, in the meantime, the leak issue is about 20% of what it was.

The pressure reading over the last few nights has been pretty much around the 10 mark, and very rarely around the 8. The AHI reading last night was .3, with only 1 hypopnea and 1 obstructive event of 13. I still feel terrible though. Can't drive the car (and my business is 75 miles from the house), I want to lie down and sleep just about all the time.

Should I raise the the upper limit to 11 or 12, go back to straight 8 or what? Have I over pressurized? Any thoughts would be appreciated.

Based on what pressures you're talking about, it's highly unlikely that you're "over-pressurized". It also sounds like you don't really have a plan to figure out what your problem is......although it also sounds like mouth-leaking to me......which you're working on. It won't make any difference what pressure you set your machine at if the air is exiting your mouth. Chin straps are not very reliable to prevent mouth-leaking. Taping (which doesn't seem to be your cup of tea) or full face masks are the most reliable methods.

If the leaks are too big, it can compromise the data.

If I were you, I'd stick with straight pressure......8, 9, 10......whatever......and then monitor the leak stats. Fixed pressure will give you a "constant" with which to gauge your other tweaks and leaks. If you know what your expected "Vent Flow Rate" is for the mask, then you can monitor whether it's too high or not.


Den

[Wulfman]

I also forgot to mention that you should be able to get your doctor to order a "free" overnight pulse-oximetry to see what your blood oxygen levels are while you sleep.


Den

[ozij]

With an autocpap you can't overpressurize yourself.

You can.

The machine will give you only what you need as maximum pressure.

The machine can misinterpret your breathing pattern, and go to higher pressures than necessary.
Very unpleasant.

O.

[ozij]

I'd do what Den suggested.

[Mount Snorius]

If I were you, I'd stick with straight pressure......8, 9, 10......whatever......and then monitor the leak stats. Fixed pressure will give you a "constant" with which to gauge your other tweaks and leaks. If you know what your expected "Vent Flow Rate" is for the mask, then you can monitor whether it's too high or not.


Den

I have the S9 set to pillows, based on using the Swift mask. Am I correct to assume that the red line that shows up on the ResScan Leak graph is the upper limit for that mask, and that if the graph reads below that line, then it is within acceptable range?

Thanks for the help.

[ozij]

If I were you, I'd stick with straight pressure......8, 9, 10......whatever......and then monitor the leak stats. Fixed pressure will give you a "constant" with which to gauge your other tweaks and leaks. If you know what your expected "Vent Flow Rate" is for the mask, then you can monitor whether it's too high or not.


Den

I have the S9 set to pillows, based on using the Swift mask. Am I correct to assume that the red line that shows up on the ResScan Leak graph is the upper limit for that mask, and that if the graph reads below that line, then it is within acceptable range?

Thanks for the help.

Yes, that is correct.

[Wulfman]

If you don't have the manual for your mask (which shows the "Vent Flow Rate"), you can download it with this link.

http://www.fphcare.com/userfiles/file/O ... ctions.pdf


Den