Why Not Higher Pressure than Titration Shows?

FreeLancer74 · Post by **FreeLancer74** » Sat Dec 01, 2007 4:33 pm

If constant pressure is what keeps the airway open and prevents apnea, hypopnea events, why not bump the pressure up 1 or 2 levels above your known level and leave it there? Why do some of you report more HPIs with a higher pressure than some lower pressures closer to your titrated level?

I know there is a reason, I just need it explained so I can better understand for my future self therapy.

DreamStalker · Post by **DreamStalker** » Sat Dec 01, 2007 4:54 pm

For some, higer pressure may trigger central apneas ... a different type of apnea than obstructive.

Also, higher pressure may result in aerophagia ... air in the stomach.

Goofproof · Post by **Goofproof** » Sat Dec 01, 2007 5:09 pm

And more leak related problems, mask and mouth. Added discomfort with treatment. This is why we use APAP, to lessen these things. Jim

Didn't the Doctor warn you how dangerious breathing air was?

Slinky · Post by **Slinky** » Sat Dec 01, 2007 5:12 pm

I've read here in the forum that during titration they take you to the highest pressure that stops or reduces obstructive apneas but doesn't cause central apneas. And that the doctors then tend to script that highest pressure that stops or reduces obstructive apneas. Then in other posts I've read that the doctors tend to script the lowest pressure that prevents most or all obstructive apneas. Go figure. Confuses me!

Maybe some docs are more aggressive than others. Maybe some doctors are more conservative than others. Maybe it is just the choice of words. I figure they most likely pick THE pressure that prevents or stops obstructive apneas without causing central apneas. Makes more sense to me.

rested gal · Post by **rested gal** » Sat Dec 01, 2007 5:14 pm

Higher pressures can also make it more difficult for a mask to maintain a leakproof seal.

One or two cm's (or even more) above the titrated pressure is not going to cause any problem for most people, imho.

I personally don't believe there's one magic number that is always what a person needs. So, if you were titrated at, say, 10, there may be nights that 8 would do you fine all night long. And other nights when you might need 11 or 12 for quite awhile.

I also believe that striving for zero events (apneas and/or hypopneas) is not important. As long as a person is getting an AHI below 5.0, he/she is getting effective treatment. There's nothing magic about an AHI of 0.0. AHI of 1 or 2 is essentially like getting "zero", to my way of thinking. I mean, think about it...ONE apnea or hypopnea per hour...and the rest of the hour breathing fine.

Besides, what the machine software reports happened, and what would have been reported by sleep lab standards can be different. The machine might register a hypopnea or two that would not have been scored at all in a sleep study because there was not a sufficient drop in O2 sats.

wabmorgan · Post by **wabmorgan** » Sun Dec 02, 2007 5:45 pm

rested gal wrote: I also believe that striving for zero events (apneas and/or hypopneas) is not important. As long as a person is getting an AHI below 5.0, he/she is getting effective treatment. There's nothing magic about an AHI of 0.0. AHI of 1 or 2 is essentially like getting "zero", to my way of thinking. I mean, think about it...ONE apnea or hypopnea per hour...and the rest of the hour breathing fine.

Besides, what the machine software reports happened, and what would have been reported by sleep lab standards can be different. The machine might register a hypopnea or two that would not have been scored at all in a sleep study because there was not a sufficient drop in O2 sats.

MAybe so.... but I like seeing that AHI 0 when it happens. At least I know I didn't have any apneas!!!!!!!!!!!!!!! Always a good thing!!!!