What is your C-PAP setting?

Just out of curiousity, can ya'll (remember - I'm from Texas!) give me some data:

How long have you been using C-PAP or Bi-PAP or whatever PAP you're using?

What is your setting? (Is "titration" the correct word?)

They started me out at 20cm - which the technician told me is the hightest setting! She set my RAMP to start at 7 - she said it won't go any lower - but I'm up to 20 in 45 minute. That's a HURRICANE - and I'm seeing complaints from posters who say they're at 8 or 9? Come on!

I'm new.....this is just my 4th night, and I'm not coping very well with it. My mask leaks and I, truthfully, sleep better WITHOUT the C-PAP than WITH it! It seems like a setting of 20 is awfully high. I must have it really bad!

Thanks for the input!

I do not envy you. When I complain about my CPAP, I'm really not complaining about the pressure. As you've noted, it's really not that high. My problem is that I just can't seem to get used to having the thing on my face, and I can't seem to stop CONCENTRATING on it.

I do not envy you your higher pressure. Do they have you on BiPAP? It would seem to me that at 20cm, either biPAP or autoPAP would be right for you. (And Auto only if it turned out that it could effectively treat you while keeping you significantly under 20 most of the time).

By the way, I thought 20 was the highest as well, but I was recently told that some biPAPs go up to 25 or higher on the high end.

Anyway, I've been at for a month at my 9, and I'm just not making it work. Tonight, my swift is really bugging my nose (not sure why), so I'm gonna go back to trying the Ultra Mirage, but since I've been on the swift for a week and a half now, I'm afraid the change will just give my conscious mind one MORE thing to focus on.

(I'm rambling here, but since you seemed interested) I think my problem is that apnea was only one of two problems I have, sleep wise. The other is insomnia. Getting my brain to calm down and stop churning so I can get to sleep can prove problematic. So I think my problem with the CPAP is it's a focal point on which my brain energy can, well, focus.

Anyway, keep your chin up, there are definitely people who have mastered 20cm. I wish you the best of luck!

Liam, wimpy man at a wimpy pressure.

Been AutoPAPing for 1 month now.

Use the ResMed Auto Spirit Heated Humidifier set at 3-4

5 minute settling time. 7cm low with 16 cm high. Usually runs at 10 tp 13 cm though.

ResMed Breeze Nasal Pillows most of the time otherwise use a Respironics Gel Nasal Mask.

OOPS I guess I meant the ResMed Swift Nasal Pillows.

Gotta use AYR Nasal Gel and Allegra D each night.

Get about 6-8 hours of good sleep a night unless I am on duty at the Ambulance.

Interested in trying Provigil to help out during the day with EDS from Chronic Fatigue Syndrome.

Hi TexasGal

I'm a relative novice, now in my fourth month. I was originally diagnosed as needing a pressure of 11cm and started with a plain vanilla CPAP (Drager Luna) set at 10cm. Whilst no-where near your pressure, I too found it quite intrusive, had lots of mask leaks and frequent headaches. I have a Resmed Mirage Vista mask.

I then switched to an AutoPAP (ie variable pressure, I have the Remstar Auto with C-flex and heated humidifier) and, wow, what a difference.

Heated humidifier = no more stuffy nose and dry mouth/throat

C-flex = much more comfortable because the pressure reduces as I breathe out

Auto = I now spend much of the night at lower pressure, only goes up to 10cm when I need it and it has never gone above 10cm. Some nights it doesn't go above 7cm or 8cm, and even when it does it is only for a few minutes. Mask leaks and headaches are no longer a problem.

That's what worked for me, though the first couple of months were difficult and I had setbacks.

The secret in this seems to be to find the right combination of machine & mask for each individual and for most people, providing they persevere, there will then be good results.

Good luck

Well I was titrated for 10, but my auto says I need more. I am set at 8 - 16 and often I end up at 15 or 16. But thankfully with my auto w/cflex it is much more tolerable...

See if you can get them to let you try an autopap or bipap. I have been using a pap since June of 2003. I was titrated at 16, which I thought was pretty high. I got a straight cpap, and did ok, but not great for a year and a half. Bought myself an autopap in January, and am doing better. I found out that the vast majority of the time I only need 10-12 pressure (some nights even less) and only need the higher pressure for a few minutes a night. When they decide on one straight pressure, they put you at a pressure high enough to keep your apnea/ hyponea index down below 5. But you might only need that high a pressure for a part of the night. Some people for instance, only need a high pressure during one stage of sleep, like only during REM or only during deep sleep. Since you're only in that stage for maybe a quarter of the night, you only need that pressure for a quarter of the night, and could use a lower pressure the rest of the time. There are some people who need a specific pressure all night long - one of my friends was titrated at 12, and found when she used an auto that she spent the entire night, every night, between 10.5 and 12.2, With that small a pressure change, she really doesn't need an autopap, and a straight cpap at 12 was just fine for her.
But do see if they will let you try an autopap and find out if you really need the pressure that high all night.
Debbie

Hi Texas Gal from another Texas girl. I've been on cpap since November 17 of last year. I have a plain cpap Fisher & Paykel. I was put on a pressure of 12 and I don't exactly know what it starts out as but I have a 20 minute ramp. I use Breeze Nasal pillows and love them. I recently readjusted the top head strap like Rested Gal showed in one of her posts and it works even better. The setting of 12 doesn't bother me at all but I'm sure 20 would be quite another story. I'm feeling better than before cpap. The first 3 weeks of cpap were a nightmare trying to get used to something stuck on your face all night. Then after I finally was able to sleep all night with it on, I felt absolutely fabulous for about 3 weeks and then became tired and sleepy again in the afternoons. I would take naps again in the afternoon with the cpap on. Now I don't get sleepy in the afternoons and experience just mild fatigue. It seems like I run in 3 week cycles. I didn't even know there were autopaps when I got my machine and the DME billed my insurance company for the full purchase price 3 weeks after I got the machine without me knowning it so I'm stuck with it for a couple of years or until I can save up enough money to buy one outright. About the only good thing is that I had 100% coverage so the machine didn't cost me anything out of pocket but I could have had an autopap for the same price if I understand what is said about insurance coding on this board. I hope you find a more comfortable machine. I imagine a pressure of 20 is like trying to breathe in a hurricane! I've learned more on this board than I ever did from any of the doctors. I just wish I had found it earlier. Best of luck to you.

I was told my setting should be 8-14. (auto pap PB 420E). I
lowered nitial pressure to 4.0. Felt too suffocating starting at 8, so then after initial 4, I've upped to 5, may up to 6. But with the software, I can download my #'s, and I've not gone over 11 max. So the 14 would've been too much, and I've averaged about a "1" or "2" ea. day. My aps are down to 7, and pop's to 2 per night. . So from the titration study I had 133 total. So it's obvously working. I do not like the feeling of the higher pressure, and at times, I do feel pressure in my chest at higher pressure # . Of course, while sitting up, no pressure feeling. It is something I guess we have to adjust to once we lie down and airway flattens.
Any higher pressure settings initially would be too uncomfortable, at least for me. IMHO.
It's what I like about the auto, it's not set to shoot you up too high, cause problems, and eventually compliance issues due to discomfort, etc.

.

Hi Texas Gal,

I started on 1/10/05 with a ResMed S7 Lightweight set at 14cm/H2O with heated humidifier. I purchased a PB420e (with heated humidifier) recently, and have settled on a range from 10-16.5 cm/H2O. My average pressure is 10-11 and only occasionally goes up to 16-16.5 during the night. It is much more comfortable and I am sleeping better. I don't use the ramp, although it helped at first. Now I feel like I am suffocating with less than 10! I use the NasalAire II interface.

My sleep study was in early December '04, and my AHI was 78 -- no wonder I was tired all the time! My longest apnea during the study was 111 seconds, and my desaturation got down to less than 60% for a while. Yikes! I feel so much better on the hose, and especially since getting the auto!

Your pressure has to be hard to get used to -- I feel for you. I have heard some on the board with high pressures be gradually ramped to the desired pressure to get used to it (i.e. a few days at 10, then when that is tolerated up a few more notches). That might be something to suggest, unless it is lifethreatening to have less than 20 for you. I am not a doctor and relatively new at this!

I would talk to my doc, sleep lab, RT or whomever you are working with about this. Many have good luck with C-flex -- I can't speak personally about that -- rested gal could help with that! Also many with very high pressures like yours are on a bi-pap.

I know that non-compliance is not an option for me, so even though it is strange and annoying to have this stuff strapped to you blowing up your nose, I just do it. This disorder has probably been damaging my body for years -- I am not going to allow further damage to occur when I can prevent it!

Sorry that this got too long -- I feel strongly about this!

Sleep well and good luck,

Jane

Txgal, You must be from west texas with a setting that high. All that wind ya know. If you set up a windmill in your bedroom you might make a little $$ producing electricity.

titrated at 11, usually much less .


Chris

Chrisp, I'm just a bit south of you, in Portland, just north of Corpus Christi. I hadn't thought about setting up a windmill in my bedroom! Not a bad idea!

Glassgal said:

Now I feel like I am suffocating with less than 10!

I have to completely agree. During my fitting the DME actually raised my lower setting to allow easier exhalations and it worked great. I don;t understand it, but it worked great.

Now if I wake up during the early morning hours when my ResMed Auto Spirit has titrated up to my usual pressures around 10 to 13 I actually notice less resistance to almost none on exhalation compared to when I went to bed at a pressure of 7 CM. Don't understand it, but it works.