What should I set my APAP at?

[Dale92]

I just went down to my DME and picked up an APAP to try for two weeks to see if I have any improvement in my daytime sleepiness and also to see if in fact I do need a variable pressure setting which the doctor will determine by the data from my smart card.

I would like some input on at what pressure I should set the machine.

Some information for you to consider:
My initial pressure set at 18 cm/w in August 2005.
Pressure set at 10 cm/w January 2006 after using dental appliance.
According to software my AHI at 10 cm/w is between 6 - 10 depending on the day.
The unit given me for trial is the RemStar Auto w/cflex and was set between 4 cm/w and 20 cm/w by the DME's office assistant.

My doctor just sent an RX for me to try the unit for 2 weeks and did not specify any pressure settings. I guess he new I would probably mess with it myself

I could leave it at the 4 - 20 setting or change it to say 8 to 18 would be my feeling. What would you all think?

Any feed back would be appreciated

Dale

[Linda3032]

You might find it too stuffy at 4. If so, then you could set it for 6 to 20.

Since your original titration was 18, that's why I said 20. Otherwise, I would have lowered it.

But, in effect, you are basically titrating yourself again, I would leave it pretty wide open.

Hopefully, the doctor has software and runs reports for more than simply compliance ...

Since it's a Remstar, you could send the card to one of us and we will read it for you. I will volunteer if you so wish.

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CPAPopedia Keywords Contained In This Post (Click For Definition): Titration

[Dale92]

Thanks for the offer Linda but I already have the software to read it, at least I think so. I have the Encore Pro software and MyEncore and have been downloading the info from my Remstar Pro 2 w/cflex. I am assuming that is the same software to read the Auto also. Please correct me if I am wrong. If it is not the correct software I will get back to you because I would like to know what the software said before I call the doc to have a conference with him about whether or not I will keep the Auto or stay with my straight CPAP.

Dale

[Guest]

Well, duh on me.

If I had read the bottom, I would have known that.

The software is the same.

[Linda3032]

Obviously that was me.

I had logged out so I could do the spam, spam alerts.

[Goofproof]

Since you have the software find your 90% rate and set it 2 cm above that and 2 cm below the 90% rate. 4 to 20 is the stupid DME setting. Jim

Give it 3 days and let us know the results.

[Guest]

On my 4th day of a loaner apap set at 5-20cm.
current as of end of april prescription of 15cm.
Median pressure 7.0
95% 9.6cm
Max 10.4

Its hard to get to sleep without that reasuring gust of air expanding my chest but software shows 4.4 ahi.
My sleep study split decided on 15cm beacuse longer rem sleep.
The machines are quiet but a leak at 15 sounds like a jet engine.

[Dale92]

Thanks Jim and Guest.
I will get my 1st reading tonight and then follow your instructions Jim for the 90% up and lower limits. I am interest to see what kind of data the APAP shows compared to CPAP. Obviously it must give data over the course of the night I am guessing pressure vs Apneas but I am unsure about the 90% stuff you mentioned but I am sure that it will be easy enough to figure out once I get a days data under my belt.

I am hoping that this APAP will help lower my apneas and hypopneas to a lower level so I get some restful sleep.

Thanks again.

Dale

[rested gal]

I would like some input on at what pressure I should set the machine.

Some information for you to consider:
My initial pressure set at 18 cm/w in August 2005.
Pressure set at 10 cm/w January 2006 after using dental appliance.
According to software my AHI at 10 cm/w is between 6 - 10 depending on the day.
The unit given me for trial is the RemStar Auto w/cflex and was set between 4 cm/w and 20 cm/w by the DME's office assistant.

My doctor just sent an RX for me to try the unit for 2 weeks and did not specify any pressure settings. I guess he new I would probably mess with it myself

I'm not a doctor. If it were me, I'd set it at 10 - 20 and see how that goes for several days. If the AHI doesn't drop down to 5 or below, I'd change the range to 12 - 20.

[Ric]

I will echo what has been suggested about the lower limit setting, that 6cm is about the "break-even" point for just plain breathing. There is a lot of additional aerodynamic resistance with the air having to pass through the humidifier (optionally) and through the gnarly kinky twisty hose with all those little spiral bumps and turns. Any pressure below 6cm feels like one is slowly suffocating.

RG had a pretty good point setting it well above that, say 10. In a few days with the data you will have a whole new titration, and you can come back for a second opinion. Same low price. .

OK, there's my 25¢ worth.
(sorry, inflation)

[nodding off]

I'm not a Doctor, but I discussed my settings with my GP. My sleep study titrated me at 15, with an AHI of 14 at that pressure (AHI 94 untreated). I noted on my sleep study that REM sleep did not occur below 11, so I made that my min. I left the top wide open at 20. My average pressure is runs between 12-13, depending on if I am stuffed up, with an AHI of 3.7 (12 month avg) and I sleep and feel great, so it works well for me. Good luck with your settings! Don't be afraid to tweak them a little until you feel great.

[DME_Guy]

I have mine set between 6 and 20. Works great for me.

[Guest]

I would ALWAYS check the pressure so you know for yourself exactly what it is. If you think your last pressure was 18cm, then you need to set the High pressure to 20cm so it has room to increase pressure if needed. The Low/bottom pressure is whatever is comfortable for you to tolerate and still fall asleep, yet you want it as high as possible.

If you are used to 18cm pressure, 10cm on the Low-end should be easy for you and that is what I'd use. I would try a Cflex setting of 2 to start off with, but you can try 3, should you feel like your hyperventilating then lower the setting. So after you enter setup mode on your machine I would set it to the following:

mode=AFLE (autopap mode w/cflex feature enabled)
cflex=2 (cflex comfort setting, try all 3 but 2 works for most).
Low Ramp/Pressure=10cm (6cm to 10cm should work, higher the better).
High Ramp/Pressure=20 (set at 20cm, if you only need 18cm, it will stop there, but don't limit the machine since your pressure is so high).
Timer: 00:00 (must be at zero:zero for autopap mode to work).
Patient Alert: On=1, Off=0 (it's up to you).
Lights=1

This would leave you with a range of 10cm to 20cm and Cflex comfort setting of 2. With the Low pressure at 10cm, it should eliminate a majority of your sleep events so you may not have to go up to 18cm very often.

If you find the machine is constantly blowing at 18cm pressure (check LCD display should you awaken), then you may want to talk to your doctor about a bi-pap machine or an auto-bipap.