Raise the APAP minimum pressure?

Hi All,

So after being on cpap for a month at 8CM, I got this Autopap machine and have been watching the data. I started out with the thing set from 7cm to 20cm and it was a disaster from the get-go with it escalating pressure widely. Backing down to 7-16 and still, a mess and my AHI numbers were like 8-10 over a weeks time. Leaks, lousy sleep, lots of hypopneas, etc.

So I went back to c flex instead of Aflex (which really irritated me) and set my pressure from 8-12 and boy are things looking great. Here are the last 4 days (picture) which were just like the 7 before them...- My question is, after 11 days of data like this - I can see that I always have a higher AHI at 8CM than 9-12cm - it also seems to not be caused by apnea events but by hypopneas.

First I want someone to say - "hey, nice numbers" - ... why thanks! You guys have been a great help!
second, should I just set the thing to 9-12cm and be done with it? Is the difference in the data statistically significant?

here is a summary and a typical night

Hey...Nice numbers!!!

If it were me, I'd bump it up to 9 AND work to fix the leaks a bit better. Actually I'd work on the leaks first...then bump it up a notch if need be. I like my leak line to be straight and low.

Brenda

You are spending 11% of the night at max pressure. I don't believe that is good. While it doesn't show NR's, my thinking is that it sits at max trying to reach some events but is limited. I'm inclined and have mine set to where there are few times it gets to max. When I saw max was being hit more often I bumped it up a notch. The big advantage of an auto is it doesn't go where it's not needed.

Since it spends 23% of the night at 8, I would leave that alone - just increase the max to 13 and see how often it reaches that high. A 6 point spread is perfectly OK, so you can go to 14 if needed.

bdp522 wrote:Hey...Nice numbers!!!

If it were me, I'd bump it up to 9 AND work to fix the leaks a bit better. Actually I'd work on the leaks first...then bump it up a notch if need be. I like my leak line to be straight and low.

Brenda

I have simply no idea how to control the leaks any better. I wash my face and the skin on the mask, tried the 'boil the gel' thing, have adjusted it as best i can.

Could the peaks be from mouth leakage? After all I am asleep and simply cannot tell!!

You could try a full face mask. You might try tape or poligrip strips to seal the mouth. I tape every night, have been for over 2 years now. Not everyone is able to train the tongue to stay where it should!

Brenda

bdp522 wrote:You could try a full face mask. You might try tape or poligrip strips to seal the mouth. I tape every night, have been for over 2 years now. Not everyone is able to train the tongue to stay where it should!

Brenda

If the AHI is low, what difference does it make if I leak a lttle?

Also, what happens in a power failure or if you need to cough?

Leaks can wake you up (arousal), if they are large leaks they can report an artificially low AHI, it indicates a bad fit for a mask.... and you have to define what "a little" leaking is - some is OK, the wild up and down oscillation of the leak line is preferrably avoided.

Taping is a personal decision. Nothing happens if the power goes out - you just keep rebreathing your own CO2. It happened to me once while travelling - I woke up after a minute or so but I wasn't too comfortable with the situation.
You can use the tape as test or trial to check for mouth breathing. If you find that you are, then you can go for the FFM... many do.

Your "Summary" is showing that your best pressure is 10. (anything higher or lower is worse)
I'd be inclined to set it in CPAP mode at 10 and see what things look like after a week.


Den

In case of power outages, I wake up before the machine is even completely stopped. As for coughing, I've learned to cough with the tape (and mask) firmly in place.

Brenda

elader wrote:

bdp522 wrote:You could try a full face mask. You might try tape or poligrip strips to seal the mouth. I tape every night, have been for over 2 years now. Not everyone is able to train the tongue to stay where it should!

Brenda

If the AHI is low, what difference does it make if I leak a lttle?

Also, what happens in a power failure or if you need to cough?

Brenda is correct, You are aparently having trouble with mouthleaking. As far as the AHI being good, the machine can't give true data when you mouthbreath, you can't trust your AHI numbers. Your avg leak rate is OK but a good part of the night it isn't. Raising the max pressure will only cause worse treatment and more leaks.

As far as worrying about power failure or coughing, a FF mask allows you to by-pass that problem, also the comfortGel allows you to get some air if the machine stops, a apnea event will tend to wake you, it's a little panic attact, but it woke me up. You can make a battery solution if the power factor bothers you, we all should, but if it's not raining why fix the roof. ECT... Jim