Increased anxiety from high pressure...

I have a noticed a big correlation between high pressures on my machine and increased anxiety, higher blood pressure and increased cortisol levels that I feel. I reduced the minimum pressure on my machine to 12 last week instead of 16 and feel so much better. My AHI numbers are pretty much the same and I am also not full of air and gas in the morning. My doctor said a while back that my oxygen numbers were crazy out of wack when I was using high pressures and I think that it makes sense. Has anyone else experienced anything like this?

Not me; but it makes complete sense.
Just do what works--FOR YOU.

Sub-optimal use of your CPAP is better than no use at all. Do what you need to.

Glad to hear you're feeling better. That's the most important thing, in my humble opinion.

D.H. wrote: ↑

Wed Jun 27, 2018 1:47 pm

Sub-optimal use of your CPAP is better than no use at all. Do what you need to.

You think that having pretty much the same AHI with a lower minimum automatically means sub optimal therapy?

From what he said...I think that the therapy is probably optimal and he's feeling better because of less aerophagia and anxiety.
Makes perfect sense to me.

joeljjk11 wrote: ↑

Wed Jun 27, 2018 1:18 pm

My AHI numbers are pretty much the same and I am also not full of air and gas in the morning.

I have increased anxiety sometimes too. I do know sometimes when I have NO leaks and good airflow all night, I've had anxiety in the morning.

It has been reported that higher pressures can induce central apneas, so it could be lowering the top pressure is better therapy for you. How are your leak, AHI, etc numbers?

Muse-Inc wrote: ↑

Tue Jul 03, 2018 1:40 am

It has been reported that higher pressures can induce central apneas, so it could be lowering the top pressure is better therapy for you. How are your leak, AHI, etc numbers?

People keep trotting out that old horror story, but complex SA is really only something that happens in 6-12% of people, so it's fairly rare.

And, according to the first post:

joeljjk11 wrote: ↑

Wed Jun 27, 2018 1:18 pm

My AHI numbers are pretty much the same and I am also not full of air and gas in the morning.

Not having bloating is more likely to be the issue, anxiety wise... would be my guess..

palerider wrote: ↑

Tue Jul 03, 2018 1:57 am

Muse-Inc wrote: ↑

Tue Jul 03, 2018 1:40 am

It has been reported that higher pressures can induce central apneas...

People keep trotting out that old horror story, but complex SA is really only something that happens in 6-12% of people, so it's fairly rare.

Not initiating complex apnea. The way my sleep doc explained it (confirmed by studies posted in PubMed/NIH) was that for some people, the brain just doesn't respond as reliably to the chemical signal to breathe during those periods of high pressure, similar to what happens with severe untreated hypothyrodism. He also explained that is why sleep studies increase pressure beyond what is needed to significantly reduce apneas to see if centrals were induced. He helped me figure what APAP range to set moving from CPAP at 11, my manual notes of my ResMed Escape's daily data, data from my previous sleep study, and data from a 4-day trial with a loaner APAP. I grant you that this was in late 2009 so new studies may have invalidated that theory.

Muse-Inc wrote: ↑

Tue Jul 03, 2018 2:15 am

palerider wrote: ↑

Tue Jul 03, 2018 1:57 am

Muse-Inc wrote: ↑

Tue Jul 03, 2018 1:40 am

It has been reported that higher pressures can induce central apneas, so it could be lowering the top pressure is better therapy for you. How are your leak, AHI, etc numbers?

People keep trotting out that old horror story, but complex SA is really only something that happens in 6-12% of people, so it's fairly rare.

Not initiating complex apnea.

"Complex SA" is the condition that 6-12% of people experience wherein they have purely obstructive apnea under room air, but when they are put on cpap, at some point, possibly even at low pressures, they start to develop central apnea. Some people experience that at low pressures.

Muse-Inc wrote: ↑

Tue Jul 03, 2018 2:15 am

The way my sleep doc explained it (confirmed by studies posted in PubMed/NIH) was that for some people, the brain just doesn't respond as reliably to the chemical signal to breathe during those periods of high pressure, similar to what happens with severe untreated hypothyrodism. He also explained that is why sleep studies increase pressure beyond what is needed to significantly reduce apneas to see if centrals were induced. He helped me figure what APAP range to set moving from CPAP at 11, my manual notes of my ResMed Escape's daily data, data from my previous sleep study, and data from a 4-day trial with a loaner APAP. I grant you that this was in late 2009 so new studies may have invalidated that theory.

And, yes, this affects a minority of people. I've had my pressure up in the mid 20's at times, and I have *no* central apnea as a result, most people don't have pressure dependent central apnea (CompSA) but a few do.

palerider wrote: ↑

Tue Jul 03, 2018 2:37 am

..."Complex SA" is the condition that 6-12% of people experience wherein they have purely obstructive apnea under room air, but when they are put on cpap, at some point, possibly even at low pressures, they start to develop central apnea. Some people experience that at low pressures...

Thanks, new info!

Muse-Inc wrote: ↑

Tue Jul 03, 2018 3:45 am

palerider wrote: ↑

Tue Jul 03, 2018 2:37 am

..."Complex SA" is the condition that 6-12% of people experience wherein they have purely obstructive apnea under room air, but when they are put on cpap, at some point, possibly even at low pressures, they start to develop central apnea. Some people experience that at low pressures...

Thanks, new info!

Sure thing... the reason I addressed this is that one of the common misconceptions is that "higher pressure WILL cause centrals" and "centrals are uber scary"... this plot point is used to try and scare off people that are thinking about treating themselves... "ooooh, you'll get centrals (and what? immediately die??? no..)

A few centrals here and there are far less disruptive than all the obstructives that the person is having without the cpap...) In fact, I think if you look at enough pressure traces from people having the occasional central, you'll usually see that the central wasn't disruptive at all... it's only when you've got bucket loads of them that it's a problem, because SpO2 starts dropping.