CPAP trouble / Self Prescribe APAP?

Last night my 90% pressure was 19. That a problem? My AHI was 1.9. I slept pretty good.

cpapn00b wrote:Last night my 90% pressure was 19. That a problem? My AHI was 1.9. I slept pretty good.

Is it a problem? Not necessarily. Your AHI was (well) less than 5 and you say you slept pretty good. How was the aerophagia? Since aerophagia was what led the doc to authorize lowering the pressure down to 12 in the first place, that's an important question to ask yourself.

And note: Multiple arousals and awakenings can add to an aerophagia problem---there's a tendency to swallow when we're aroused. So if you slept more soundly last night, that might explain why you had less aerophagia even though the pressure was allowed to go much higher than your formal titrated level of 14cm.

Aerophagia was better than usual as well. I sent my doctor a polite fax explaining what I have tried and that it helped and that I would like him to prescribe an auto bi-pap.

I was told that I cannot try another mask until March 6th. She said she would order me the Liberty by ResMed at that time. I told her I wanted a Hybrid. I am still in the first 30 days, but already tried a second mask. They told me I can only try two masks in the first 30 days. They are mailing me a chin strap in the meantime to keep my mouth closed...

What do your leaks look like? Might help to know if they could be affecting the reliability of your data. I'm in favor of going through the process to get a bi-pap. May have to jump through a few hoops, but getting an auto may not suffice if it turns out your needed pressure really is in the upper teens. By the way, take some time to look for trends before making too much out of anything that happens in one night. Your stuffy nose may be related to mask style, but humidification can play a role. Have you experimented much with that? The problem with a lot of changes close together is it can be hard to be sure which change made the difference. Data is your friend. Good luck going forward.
EDIT: If you are having trouble with the stabilization of any mask, an added strap can make a world of difference. Just make sure it can't slip and block the exhaust holes. Sometimes a comfortable but unstable mask can be salvaged.

The machine is saying 0% leaks...

I was getting bloody noses at a humidity setting of 3. At 5, it seemed to make congestion worse. I have been using humidity of 4, which seems to be working.

KTeague brings up an excellent point.

Bipap or bilevel, providing two independent pressures can make a world of difference at the high pressures you are dealing with. The new models on the market "learn" how you are breathing and work with you.

If you feel like you are moving forward, I would encourage you to continue. I have worked with many many people with pressures higher than 16 cm H2O and the CPAP has worked find once they got used to it. If not though, don't hesitate to inquire about a retitration to the bipap.

Good luck!

Lots of nonsense instead of answering the OP.

cpapn00b, I did change my CPAP to APAP mode. But I don't suffer from any of the contraindication conditions specified by the Board Sleep Medicine on it. APAP should NOT be used if you have: Central Sleep Apnea syndrome (including Cheyne Stokes respiration, Periodic breathing, etc) , COPD, Obstructive Pulmonary Disease, Restrictive Respiratory Lung Disorder, and a few more maladies.

APAP mode is BAD for any of these.

penuel wrote:Lots of nonsense instead of answering the OP.

cpapn00b, I did change my CPAP to APAP mode. But I don't suffer from any of the contraindication conditions specified by the Board Sleep Medicine on it. APAP should NOT be used if you have: Central Sleep Apnea syndrome (including Cheyne Stokes respiration, Periodic breathing, etc) , COPD, Obstructive Pulmonary Disease, Restrictive Respiratory Lung Disorder, and a few more maladies.

APAP mode is BAD for any of these.

According to my machine, I have periodic breathing as follows:
1 day: 0%
7 days: 2%
30 days: 1%

Is this a concern for APAP use?

cpapn00b wrote:I've been using CPAP for a few weeks now, but not very successfully. Some nights are awesome, and others are horrible. I think it depends on how well I am able to breath through my nose that night - which ranges from poor to very poor

This is sort of a side note if you can get your nosebleeds in line. I recommend the Snorepin device on this forum pretty frequently. (I have no affiliation with the company) It works for me if you can handle something inserted into your nose. It helps keep the lower and therefore some of the upper nostril open. The manufacturer claims thirty percent improvement and I'd say that's about right. I find it does need a bit of tape to help it from sliding out. PM me if you need some tips:

http://www.amazon.com/Snorepin-Smarter- ... B000BABW5Q