How much pressure is too much?

drubin007 · Post by **drubin007** » Tue Jun 23, 2009 7:17 am

Question for the vets on the board... As the subject line reads, how much pressure is too much?

A little background to the question, and then I will post up some numbers that I pull from my machine every morning, and hope I can improve upon them. Usually the first question is do you feel better? Truth be told, I feel the same as I did when I was first put on a cpap around 45 days ago give or take?

I was prescribed a rate of 9.0Cm. Numbers were, average I guess... I come into this forum and do a lot of reading and have tried experimenting as a result. First I tried adjusting my EPR settings from 3 to 2. I had to fight the machine to get a breath out, so changed it back that night before going to sleep.

I then changed my rate from 9.0Cm to 9.6Cm to see if that would decrease my AHI rates... There was minor fluctations, however nothing dramatic. 5 nights ago I changed it to 10.2Cm, and again, no noticable difference to me. 2 nights ago I noticed I was blowing up like a blowfish (my mouth was filling with air). It seemed to me that the machine was tring to force me to breathe faster or more then my body wanted me to I dismissed it thinking it may have been an isolated incident.

This morning, I noticed it again. I do not use a chin strap, (may have to start, not sure?) I use some cheesy headgear that has a support around my chin, but thats it... With my leak numbers, I tried taping one night, failed. I had to yawn constantly when I taped, and could not adjust to yawning behind a closed mouth. I have always been a mouth breather (bad snoring) but since cpap (nasal mask then nasal pillows) it stopped. Following a post I read in here yesterday, I used my tongue to form a seal to my throat and it worked great! I coudl hear this morning (once again) the excessive air (exhaust?) coming out of the headgear... It is hard to explain, and I hope I am doing it clearly... at the higher pressure it seems to be forcing air into me at a rate higher then my body wants to take. 2 Nights ago it was filling my mouth, last night with my tongue at the roof of my mouth it just sounded like an excessive exhaust if that makes sense?

My question is would this be an indicator of too much pressure? Besides a chin strap, any other suggestions based on the numbers I posted below? I am going to post a random sampling of my numbers at all 3 settings to show the pattern if there is one to be determined....

thanks!

Dave

Night Leak AHI AI HI Comments
6/5/2009 0.18 8.4 2.0 6.4
6/6/2009 0.08 7.2 1.5 5.7
6/7/2009 0.10 7.1 2.7 4.4 This and the ones above is at 9.0Cm
6/14/2009 0.14 6.7 1.0 5.7
6/15/2009 0.24 8.1 2.0 6.1
6/16/2009 0.14 7.5 2.4 5.1 This and the ones above is at 9.6Cm
6/20/2009 0.24 9.2 2.0 7.0
6/21/2009 0.20 6.1 1.7 4.4
6/22/2009 0.20 6.6 1.9 4.7 This and the ones above is at 10.2Cm

jdm2857 · Post by **jdm2857** » Tue Jun 23, 2009 2:11 pm

Unfortunately the board software compresses multiple spaces so that columnar data gets messed up.

Putting the table between code tags avoids this. Code tags were meant to preseve spacing in displayed computer programs.

I fixed up your data so others can review it more easily.

Code: Select all

  Night      Leak     AHI     AI      HI     Pressure
6/5/2009     0.18     8.4     2.0     6.4      9.0
6/6/2009     0.08     7.2     1.5     5.7      9.0
6/7/2009     0.10     7.1     2.7     4.4      9.0
6/14/2009    0.14     6.7     1.0     5.7      9.6
6/15/2009    0.24     8.1     2.0     6.1      9.6
6/16/2009    0.14     7.5     2.4     5.1      9.6
6/20/2009    0.24     9.2     2.0     7.0     10.2
6/21/2009    0.20     6.1     1.7     4.4     10.2
6/22/2009    0.20     6.6     1.9     4.7     10.2

drubin007 · Post by **drubin007** » Tue Jun 23, 2009 2:31 pm

appreciate that. now hopefully I can get some feedback

Paul56 · Post by **Paul56** » Tue Jun 23, 2009 3:32 pm

I notice you don't spend too long at each pressure.

It takes time for your body to adjust to the machine pressure and pressure changes.

When you make a change it is best to leave it for a week while you gather data that can be used to gauge the results at the end of the week... then make a decision about what adjustments to make if any.

As well, when you use EPR you will need to adjust your pressure upwards to compensate. If you use EPR 1 then you need to increase your pressure by 1... so on and so forth.

It takes time to get it all dialed-in and working as you would like. Don't be discouraged as your AI numbers are reasonable. Your leaks look reasonable as well but keep in mind that is average through the night. Do you have ResScan so you can get a better picture of what is happening with leaks through the night?

RipVW · Post by **RipVW** » Tue Jun 23, 2009 3:54 pm

Paul56 wrote:When you make a change it is best to leave it for a week while you gather data that can be used to gauge the results at the end of the week... then make a decision about what adjustments to make if any.

Ditto!
Re "How much pressure is too much?" I think that any pressure beyond what is needed to keep one's airway open is possibly too much, since higher pressures can trigger central apnea events (I believe that's accurate--hoping some our wiser members will chime in here as well).

drubin007 · Post by **drubin007** » Tue Jun 23, 2009 4:13 pm

thanks for the responses so far... I have used at each setting for about 7 nights.. I only posted a sampling of the results.. took the days in the middle to post up so it would be a little more fair...
I use the EPR setting at 3.
I will keep it where it is at now, but it is wierd hearing what I think of as extra air blowing out...

BeanMeScot · Post by **BeanMeScot** » Tue Jun 23, 2009 4:22 pm

How much pressure is too much is an individual thing. Just like some people have a pressure of 7 and others have one of 18. Each person is different so too much pressure is different for each person. Too much is more than is needed to keep YOUR airway open. Too much pressure can increase your AHI in the form of central apneas so you don't want too much or too little. Looking for goldilocks here.

drubin007 · Post by **drubin007** » Tue Jun 23, 2009 5:42 pm

*ping* Goldilocks?

I do not think 10.2 is too much pressure (not sure?) for me... Hard to say. I ramp up to that across a time span of 30 minutes, so it does not bother me. I have been at this pressure for 5 nights now.... For the past 2 nights I have noticed
that it seems to be trying to force more air into me then I am ready to take in.. if that makes sense. I know, its hard to explain. Without a card reader and software, all I have to go by is my averages, so I am looking to try and improve on them (without causing central apenas of course).

timbalionguy · Post by **timbalionguy** » Tue Jun 23, 2009 9:01 pm

Your data from the end of each trial period may be more instructive.

There seems to be (I didn't run the numbers) to be a slight downward trend in AHI and HI. I suspect that that the increased pressure is a step in the right direction.

I don't have EPR or anything like it on my machine (IntelliPAP Autoadjust). But many people here report better results when they reduce or eliminate the use of EPR. I am not sure of this, but some gut feeling tells me that part of your problem may be due to too much EPR. So, you might try going from 3 to 2 (keeping the pressure adjustment mentioned in an earlier post in mind), and then 2 to 1, etc. You may find you quickly get used to not having it. You may also find that your therapy improves if you do not reduce the pressure with reduced use of EPR. Every person seems to react to pressure differently.

I have been doing this for about 60 days now (with steadily improving results), and I am still amazed by what I am learning! My biggest challenge has been that I am by nature a light sleeper.

How much pressure is too much?

How much pressure is too much?

Re: How much pressure is too much?

Re: How much pressure is too much?

Re: How much pressure is too much?

Re: How much pressure is too much?

Re: How much pressure is too much?

Re: How much pressure is too much?

Re: How much pressure is too much?

Re: How much pressure is too much?

Mask	Humidifier

Mask	Humidifier

Mask	Humidifier

Mask	Humidifier