Testing higher pressure

First of all I would like to say thank to WillSucceed for his useful comments through private communication, and all the wonderful people in the forum that help us to learn so much about the XPAP treatment.

I have been on CPAP treatment (using POB420s) for 2 months starting with pressure of 7cm. For the last two months, I play around with the pressure level (increment by 0.5cm each time for about 10 days and then checked the results). On average, my AHI was always above 7 even the pressure was set up to 8.5cm. Since I didn't see any improvement between setting of 7 and 8.5. I suspect that I need more pressure than 8.5. Last sunday, I had a follow up sleeping study. After the study the technician told me I should use the pressure level of 8cm. I don't know how accurate the result would be since I, like most people, don't sleep well and woke up more often during the study.

About my treatment, I think it goes ok. Most of the time, I feel less tire but
sometimes I feel the same as before the treatment. Since I would like to get the best possible outcome from my treatment, I am think of testing higher setting as before to try to lower my AHI. From this forum, I learn that there may some negative effect with more pressure than necessary. So I am seeking your suggestions/comments about my plan of testing high pressure level.

Thanks in advance for your advise.

From this forum, I learn that there may some negative effect with more pressure than necessary.

There can be negative effects from too high a pressure, but the difference between your titrated pressure of 8 and your selected pressure of 8.5 is actually very small. High pressure can cause central apneas. Changing pressure (from an autoPAP machine) can cause micro arousals.

Your observation that you did not sleep well during the titration study, and your comment that you are not feeling as rested during the day as you would like might suggest that your pressure is not correct.

During the day, are you feeling physically rested? Are you feeling mentally rested? How is your memory and concentration?

As you settle into treatment, and get really accustomed to sleeping with the machine, you may find that your AHI will go down. Also, make sure that your mask is comfortable and sealing well. You have only been receiving treatment for 2 months and, although some folk seem to get immeditate relief, many do not. Stay with it, at the prescribed pressure of 8, using adequate humidity and a comfortable, well sealing mask. Make sure to pre-heat the water in the humidifier (I microwave 200ml of distilled in a measuring cup for 20 seconds BEFORE I put it in the humidifier chamber) so that your first breath of CPAP air is moist and warm.

Avoid all alcohol, caffeine and muscle relaxant drugs in the evening and try to make sure that you are getting out of bed earlier enough in the morning so that you will be tired by time you go to bed at night.

Stick with the treatment -2 months is likely not long enough to get fully accustomed to the treatment and settled into a good regime.

Forgot to login. That last response was me.

Anonymous wrote:High pressure can cause central apneas.

And "high" is a relative term, different for every person. I was titrated at 8 but start showing central apneas as I approach 10. For some people 10 is a low or moderate pressure, but my body seems to consider it high.

Make sure to pre-heat the water in the humidifier (I microwave 200ml of distilled in a measuring cup for 20 seconds BEFORE I put it in the humidifier chamber) so that your first breath of CPAP air is moist and warm.

Doh! Why didn't I think of that? .

During the day, are you feeling physically rested? Are you feeling mentally rested? How is your memory and concentration?

I think there is some improvement with my memory. In terms of the feeling, it varies a bit but most of time better than before the CPAP treatment.

Make sure to pre-heat the water in the humidifier (I microwave 200ml of distilled in a measuring cup for 20 seconds BEFORE I put it in the humidifier chamber) so that your first breath of CPAP air is moist and warm.

I did not pre-heat the water. Is it just for comforting or there is other benefit for it?

I find that if I don't pre-heat the water, I get stuffed up by the blast of cold air that hits my nose. A quick 20 seconds in the micro solves the problem and, as I know that I only use about 200ml during an 8 hour night, I only warm up 200ml.

This way, I'm putting fresh water in the tank every night and, I'm not wasting water down the drain in the morning. At the most, I dump out a very small quantity, let the tank dry during the day and then just put in what I need before bed.

Another advantage is that I'm not using the humidifier hotplate to do the preheating -->my machine is not sitting there attached to a tank full of water, water vapour going into the machine while it is not blowing. I guess I have this notion that I don't want the inside of the machine rusting from the moisture. Ya, I know, I'm being overly cautious.