Can you help me adjusting pressures?

[simoneXCX]

Hi everyone,

my name is Simon and I'm new here
I had my first CPAP a month ago and now I wold like to ask you all how to improve the quality of my settings.

I'm 33 years old 1,87 mt hight and 110 kg weight
I have a Respironics PR System One REMstar Auto with A-flex in AUTO MODE with 10-15 cm H2O pressure setting and I use a Mirage Liberty

These are two data sheet extracted from the PR ONE


http://www.flickr.com/photos/60824142@N ... /lightbox/
http://www.flickr.com/photos/60824142@N ... /lightbox/


How could I improve my spleep quality? Any sugestions?
I have a problem with the mask for pressure highter than 16 cm H2O because I have Large leaks


Thanks to all

[archangle]

Be careful about increasing pressure on your own. You are showing some clear airway apneas, which may very well be central apneas.

Central apneas aren't necessarily more dangerous than obstructive apneas, but increasing the pressure may make them worse.

If your central apneas are bad enough, you may need a more expensive bilevel or ASV CPAP machine.

[Pugsy]

Your minimum pressure is showing 4 cm both on the stats and the graphs. Not 10 cm.

Do you have frequent awakenings during the night? Some of those clusters look a lot like awake artifacts or events. Did you have any history of centrals in either of your sleep studies?

First thing I would do is make sure the minimum is 10 cm which is the prescribed setting (maybe the DME made a mistake). Perhaps the wide variations are disturbing your sleep and perhaps the machine can do a better job with 10 cm minimum. Give it a bit more of a head start and things may settle down and perhaps give you more restful sleep.

You might like to read this thread. It is a short thread.viewtopic.php?f=1&t=39869&st=0&sk=t&sd=a

Do you know how to get to the clinical menu to change your pressure? Do you have the clinical/provider manual? If not, send me a private message and I will get one to you.

[VikingGnome]

You should not be adjusting the pressure on your machine unless your doctor has specifically instructed you on when it is indicated AND given you permission to do it. Especially since you have only been on it for one month.

The pressure setting for your treatment is a PRESCRIPTION written by a doctor that was determined to be the pressure that is best for you specifically. You cannot take a doctor's prescription for say oxycontin and decide you want a different dosage or take it more often than prescibed..

It is very DANGEROUS for somebody to change their own settings without fully understanding both OSA and potential hazards of changing the pressure. You are not a doctor. You've only been using the machine for one month. If you need a change, you need to go back to your doctor and explain specifically what physical symptoms you are having. NEVER change your pressure based solely on the data from your machine.

Some people on this forum may have led you to think that changing pressure is the patient's freedom and privilege. It is NOT. Some fully understand what is going on and the ramifications of making their own changes BUT they also have the permission from their doctor.

[nanwilson]

You should not be adjusting the pressure on your machine unless your doctor has specifically instructed you on when it is indicated AND given you permission to do it. Especially since you have only been on it for one month.

The pressure setting for your treatment is a PRESCRIPTION written by a doctor that was determined to be the pressure that is best for you specifically. You cannot take a doctor's prescription for say oxycontin and decide you want a different dosage or take it more often than prescibed..

It is very DANGEROUS for somebody to change their own settings without fully understanding both OSA and potential hazards of changing the pressure. You are not a doctor. You've only been using the machine for one month. If you need a change, you need to go back to your doctor and explain specifically what physical symptoms you are having. NEVER change your pressure based solely on the data from your machine.

Some people on this forum may have led you to think that changing pressure is the patient's freedom and privilege. It is NOT. Some fully understand what is going on and the ramifications of making their own changes BUT they also have the permission from their doctor.

Your note about an rx for oxycontin is sort of off the wall isn't it?? When you take your prescription home what's to stop you from taking more or less of that rx........are there prescription police out there??? Its the same thing with your prescription for cpap ..its your therapy, along with your machine. There's no cpap police either. Good luck telling us we can't tweek our own pressure....

[Pugsy]

Check your private message box please.

If your prescribed pressure is 10 cm minimum and 15 cm maximum...your machine is set at 4 cm minimum and that could be part of your problem. Narrow the range and your leaks may settle down also along with maybe you will also sleep better with less variations.

[DrBucky]

Check your private message box please.

If your prescribed pressure is 10 cm minimum and 15 cm maximum...your machine is set at 4 cm minimum and that could be part of your problem. Narrow the range and your leaks may settle down also along with maybe you will also sleep better with less variations.

Second this. You need to be at around 9-10cm minimum or you risk apneas form the CPAP not going up fast enough. You also might be hitting a ceiling with the 15 maximum. From the data it seems like your CPAP might actually be set to 14.5 maximum. I'd think about raising it to 16 or even 18. I don't know much about REMstar devices, but I do know that my S9 is good about not ramping up the pressure inappropriately (with is why you limit it with the max), so if you can tolerate higher pressures I think that would be a good idea.

So the settings I would have:

10 cm minimum
16 cm maximum

Then see what your data looks like. If your cpap is hovering at about 10 cm maybe you lower it to 9 cm (as that would show you could get by with a lower pressure). If your APAP keeps maxing out then raise the max a bit. However if your numbers keep being as bad as they are I would definitely meet with a doctor again. It could be you need a BPAP or something more advanced.

//Not a medical doctor
///ask your doctor if this is okay if you have concerns.

[jnk]

What was your complete diagnosis?

If you had any sleep studies, is there any chance you can post them (minus any personal/medical identifying info) like you did your machine data?

Some simple-OSA patients have found that raising the minimum to within one or two centimeters of what was needed to prevent apneas during their titration has made a big difference for them.

I personally do not consider raising the minimum on an auto to be contrary to the doc's Rx. Raising the max would be, but raising the min would not, since the doc has already approved your receiving that treatment pressure by allowing the auto to reach it whenever it chooses to.

Is that the machine you will be keeping? Some docs hand over an auto for a month and then check the data to make further choices as far as treatment pressure and then switch the patient to a different machine, such as one without auto feature or data. Try to keep what you've got if you can. But if you often need more than 15 cm, a bilevel might be a better machine for you.