What does changing pressure do?

Since I have a brick of a machine and no insurance, I'm kinda going at this blindly... I've had the machine for over a year, but have only been seriously using it the last few months. I have no problems at this point in falling asleep, but I only get a couple hours of sleep before I wake up and then that's it. I get my 8 hours of sleep a day in 2 or 3 chunks of time. I've never in my life really slept solidly through the night. The only difference now is that with the machine my sleep is more restful so I don't fall back to sleep again like I used to.

My sleep study was a waste and I don't trust the folks that did it. They set my pressure to 4cm, but I was wondering if I upped my pressure would that possibly help to keep me down? Are there negative effects to upping the pressure? I figured I might experiment with higher numbers but wanted to get some feedback before I go messing with things.

Thanks for any input!

Devin

Hi, I don't believe the pressure (prescribed by your doctor - the sleep centre doesn't prescribe pressures unless your only doctor is in fact part of the centre) of 4 cm is valid, it's just the default low setting of any Cpap machine and no one can breathe at it - certainly you won't get much therapy from it (and what about a high, ceiling pressure?).

If you didn't get a pressure setting of something else, likely 7 to 10 for straight Cpap mode, and/or a higher setting as well if using Apap, then you need to talk to your doctor, or at the very least talk to the centre again about it.

As your already know your M Series Plus machine is a straight cpap machine with no data available.

Pressure setting of 4 cm is really quite low but it could be the prescribed pressure as some people do not need much pressure to deal with events. If you are waking up every 2 hours or so it sounds like events in REM or possibly on your back are sneaking in and causing you to wake up.

Obviously the best solution is to use data from a data capable machine to evaluate things and it is just as obvious that is not an option for you at this time. You could raise the pressure only slightly to see if it lets you sleep longer. The only real danger from increasing your pressure would be possibly pressure induced centrals and those are really relatively very rare especially at these low pressures. You could try a simple increase to 6 cm to see if it helps. Without data for evaluation you only have how you feel to go by so you would need a couple of weeks to evaluate things and keep a journal so it doesn't elude you.

Also realize that there are often other factors unrelated to OSA that can cause fragmented sleep. Pain. Meds. Bed discomfort. If at some time in the future you are financially able to purchase a gently used data capable machine this would be the best way to go. I would suggest either a PR S1 series data capable machine or the equivalent ResMed S9 machine simply because the older models require expensive data card readers and the new machines use simple SD cards.
Software for both is easily available.

WOW.

So went to take one of my many naps this morning and upped the pressure to 6 and was promptly knocked out! I slept a solid 4 hours, only waking because of bathroom needs. My body really wanted to go back to sleep. I cannot wait until tonight to see what this small change will do!

Devin

Very good, Devin.

There was a study done once -- to see if people who were allowed to adjust the pressure on their machines would let them find an effective pressure on their own. They could. Sounds like you can, too.

Link to a study that concluded, "yes."
"Can Patients with Obstructive Sleep Apnea Titrate Their Own Continuous Positive Airway Pressure?"
http://www.tnlc.com/Lara/laura/osa/CanP ... wnCPAP.pdf

So, Devin, how did it go last night?

You may find that, after reaching your optimum pressure, you will not need to get up to go to the bathroom any more during the night. That is the first improvement that many of us see.

If you want to get really nerdy about this, you can set a tape or video recorder going to record whether you're snoring or gasping periodically. Keep upping the pressure 1 cm at a time until those events go away and you'll be where you need to be. That's about the best you can do without data or an automatic machien.

I can't even breathe at 4 cm. 6 cm is marginal. At 8 I'm comfortable. My machine averages around 10-11 cm during the night and I sleep like the dead. And yes, no need to get up to urinate which means more restful, uninterrupted sleep.

Still waking up after upping it, but I do sleep for an extra hour or so before I do. I figure over the next week or so to slowly up the pressure every couple of days and see where I'm at. The biggest difference with just the little change is that I'm only taking one nap a day (if you consider 3 hours a nap) compared with 2 or 3 and I was only up for about an 1 1/2 during the night before being able to go back to bed.

Pretty sure I'm on the right path to getting there. But it is time to trim the beard. Had some trouble getting that airtight seal. Looks like that face mask is going to help keep my face well manicured!

Devin

I wouldn't be changing the pressure every couple of days.... stay at 6 for a few more nights and then maybe go to 6.5 for about 5 nights.... Your body may adjust to these new pressures, and with that, you may find yourself no longer making potty calls. Most of us used to get up a few to several times a night to use the restroom and no longer do that at all. I now sleep straight through.... You'll get there, but don't be in a hurry. Give yourself time to adjust to each change, and even .5 can make a world of difference!

Do you have a copy of your sleep study results? You are entitled to a full copy of the report so if you can call the doctor who handled it, ask for it. If we can know what your study said, and what pressure you were actually titrated for, it may help us to help you know the best pressure parameters to work within. I agree that 4 is most likely NOT the titrated pressure and whoever provided your machine just didn't set it properly for you. You said the study was a waste of time, but the report may hold some good information. It would be hard for them to fudge a report that is generated by all that equipment you were hooked up to.

Keep us posted!! Good luck......

My cardiologist sent me off to get a sleep study and then washed his hands of it (he is no longer my cardiologist). The problem with my sleep study was the tech himself took a nap during it - I caught him because I couldn't get the remote to work for the TV. They made me sleep on my back so I never really fell asleep, then when they had enough incidents they hooked me up to a machine and again I never really fell asleep. The tech was in a rush to get out in the morning so I was actually only plugged in for about 2 hours. Total sleep time with and without cpap was under 5 hours. When they called to schedule a second study (aka hit me up for another $1000) I raised hell. After agreeing to a freebie, they brought a machine to my home to record data - but as we are all aware getting used to all this stuff does not make for good sleep. I had the machine going for only an hour or two the second time.

All that being said, even if I got a copy from the people who did the study, I doubt the numbers are really valid. I'll ask for a copy and put up the info. I'm hoping that once I get my dad set up on a machine to use his to get new data. At the least I got my mask for free out of the deal....

Devin

If you slept for about 5 hours total, they had more than enough to determine a DX and RX. My sleep tech said they only need 2 hours of data to get what they need, but more is always better.

You are hooked up to all those wires and those, in turn, are feeding data to the computers. The tech probably doesn't have a lot to do during the initial study. The titration part is when they work to find the right pressure(s) to alleviate any and all types of events. So, please do get the report.... I am sure it will be helpful.