HOW DO YOU KNOW YOUR PRESSURE IS TOO LOW

Are there any indications the pressure on your machine has pressure is too low? Sometimes my airway tightens and
I can't exhale as clearly as I inhale when I'm wearing my cpap. In other words, my air pipe (esophagus) isn't open.
Does it sound like the pressure is too low?

The usual signs that your pressure is too low is that your treated AHI is still above 5.0. Or that you are still doing a lot of snoring while using the machine. Or that you have nasty clusters of OAs and Hs even if the AHI is below 5.0. Or there are gobs of RERAs and FL in your data.

Some people feel a bit air hungry at pressures that are below 8cm, and in particular a lot of people feel air starved at pressures below 6cm. So there are people whose apnea is well controlled at very low pressures who feel like it is easier to breathe with the pressure set a bit higher than they actually need to set it to control the apnea. But in general, if your data looks good and you are comfortable breathing with the machine at your current setting, there's no good reason for increasing the pressure.

robysue wrote:The usual signs that your pressure is too low is that your treated AHI is still above 5.0. Or that you are still doing a lot of snoring while using the machine. Or that you have nasty clusters of OAs and Hs even if the AHI is below 5.0. Or there are gobs of RERAs and FL in your data.

Some people feel a bit air hungry at pressures that are below 8cm, and in particular a lot of people feel air starved at pressures below 6cm. So there are people whose apnea is well controlled at very low pressures who feel like it is easier to breathe with the pressure set a bit higher than they actually need to set it to control the apnea. But in general, if your data looks good and you are comfortable breathing with the machine at your current setting, there's no good reason for increasing the pressure.

Thanks for your reply Robysue Several different issues:

The tech looked at the ResMed data and said I open my mouth during REM sleep which is almost like not using the machine. Unfortunately, I can't wear a chin strap because I pull it off in my sleep, but maybe I pull it off from feeling air starved? My pressure is set to 5-10. The AHP is below five though. Maybe if the pressure was higher I could use a chin strap and wouldn't have to change to a FF mask?

On SleepyHead, on the row of AHI, when it reads 4.8 to 5.6 is that in terms of minutes in apnea/ hypopnea?


Also, today I saw the data was incorrect on my machine. It said I slept for 21 hours -- my max is about 7 usually. I don't know whether the other numbers are absolutely correct now. Not sure what to do - it may be out of warranty.

You could try "rebooting" your cpap. Just unplug your cpap machine and leave it unplugged for a few minutes. Then plug it back in. That might correct that problem with wrong hours of sleep. Or it might not, but worth a try.

An AHI of 4.8 means 4.8 apnea events per hour. Generally speaking, an AHI of 5 or less is considered "normal". While that's the upper bound for medical practice, I think that it varies with the individual. You may not feel rested even if your AHI is around 5 or less.

As to pressure, without looking at (accurate) sleep data it's hard to set it in a useful way. But it sounds like you could at least increase the lower limit pressure a bit, I didn't really feel like I was getting enough air until I was using the range of 6-10. When I first got my cpap it was set up for a ramp that started with 4. That just wasn't enough, so I turned off the ramp, and moved up my lower pressure limit until I was comfortable, which started at about 6. After looking at my sleep data, I've ended up at the 10-12 range, which works pretty well for me. I wouldn't move the top pressure limit until I thought the sleep data was accurate so I could gauge the effect via the data.

By the way, I just noticed that the forum isn't showing the "Machine" line in my equipment profile, which should be the first line. That seems odd to me, it used to work right *smile*. Oh well...guess I'll throw that in with the other free-form comments...

A soft cervical collar will keep your head off your chest (opening your airway more), and your jaws (if not lips) closed. Many people use it and like it better than straps.

RogerSC wrote:You could try "rebooting" your cpap. Just unplug your cpap machine and leave it unplugged for a few minutes. Then plug it back in. That might correct that problem with wrong hours of sleep. Or it might not, but worth a try.

An AHI of 4.8 means 4.8 apnea events per hour. Generally speaking, an AHI of 5 or less is considered "normal". While that's the upper bound for medical practice, I think that it varies with the individual. You may not feel rested even if your AHI is around 5 or less.

As to pressure, without looking at (accurate) sleep data it's hard to set it in a useful way. But it sounds like you could at least increase the lower limit pressure a bit, I didn't really feel like I was getting enough air until I was using the range of 6-10. When I first got my cpap it was set up for a ramp that started with 4. That just wasn't enough, so I turned off the ramp, and moved up my lower pressure limit until I was comfortable, which started at about 6. After looking at my sleep data, I've ended up at the 10-12 range, which works pretty well for me. I wouldn't move the top pressure limit until I thought the sleep data was accurate so I could gauge the effect via the data.

By the way, I just noticed that the forum isn't showing the "Machine" line in my equipment profile, which should be the first line. That seems odd to me, it used to work right *smile*. Oh well...guess I'll throw that in with the other free-form comments...

Once cpap.com discontinues a model it is dropped from the Machine list in the Control Panel....You will find that the S9 does not show up for anyone. Myself included.

LSAT wrote:

RogerSC wrote:You could try "rebooting" your cpap. Just unplug your cpap machine and leave it unplugged for a few minutes. Then plug it back in. That might correct that problem with wrong hours of sleep. Or it might not, but worth a try.

An AHI of 4.8 means 4.8 apnea events per hour. Generally speaking, an AHI of 5 or less is considered "normal". While that's the upper bound for medical practice, I think that it varies with the individual. You may not feel rested even if your AHI is around 5 or less.

As to pressure, without looking at (accurate) sleep data it's hard to set it in a useful way. But it sounds like you could at least increase the lower limit pressure a bit, I didn't really feel like I was getting enough air until I was using the range of 6-10. When I first got my cpap it was set up for a ramp that started with 4. That just wasn't enough, so I turned off the ramp, and moved up my lower pressure limit until I was comfortable, which started at about 6. After looking at my sleep data, I've ended up at the 10-12 range, which works pretty well for me. I wouldn't move the top pressure limit until I thought the sleep data was accurate so I could gauge the effect via the data.

By the way, I just noticed that the forum isn't showing the "Machine" line in my equipment profile, which should be the first line. That seems odd to me, it used to work right *smile*. Oh well...guess I'll throw that in with the other free-form comments...

Once cpap.com discontinues a model it is dropped from the Machine list in the Control Panel....You will find that the S9 does not show up for anyone. Myself included.

Thank you very much!

I had an exhale obstruction while going to sleep. I kept raising my minimum pressure till it stopped and added 1cm, the max stayed the same.
don't use a ramp, start off on your minimum treatment pressure

ajack wrote:I had an exhale obstruction while going to sleep. I kept raising my minimum pressure till it stopped and added 1cm, the max stayed the same.
don't use a ramp, start off on your minimum treatment pressure

I can try that, but don't know how to use the settings. Are there instructions for the ResMed S9 online?

Thanks

http://www.resmed.com/ja-jp/dam/documen ... ow_eng.pdf
page 17

which s9 do you have? the elite and auto have a sd card and can use the free sleepyhead program, to look at your results

DeeCPAP wrote:The tech looked at the ResMed data and said I open my mouth during REM sleep which is almost like not using the machine.

Get SleepyHead and look at the data yourself. You need to figure out just how bad the leaks are. Increasing the pressure is unlikely to fix a leak problem, but it can make an existing leak problem worse.

Unfortunately, I can't wear a chin strap because I pull it off in my sleep, but maybe I pull it off from feeling air starved? My pressure is set to 5-10. The AHP is below five though. Maybe if the pressure was higher I could use a chin strap and wouldn't have to change to a FF mask?

Feeling air starved is most likely to happen when you are awake and trying to get to sleep while using the machine.

If you pull a chin strap off in your sleep, the problem is more likely to just be a comfort issue. Besides, if you have a lot of events in REM, then the pressure is likely to be at its highest level since the machine increases pressure when OAs and Hs are being scored. Again, looking at the data would be the best way to determine if bumping up the pressure is a good idea, a so-so idea, or a bad idea.

On SleepyHead, on the row of AHI, when it reads 4.8 to 5.6 is that in terms of minutes in apnea/ hypopnea?

The AHI is the average number of events per hour of usage. In other words,

• AHI = (total number of events scored)/(hours of usage)

Your SleepyHead data is showing that you are still experiencing roughly 5 apneas/hypopneas per hour. That means that your current therapy is not fully effective. We'd like to see that AHI consistently below 5, and most people around here would say that it would be best if that AHI was below 2.5ish most days.

But here again, it is important to look at the data: If the events are clustered during periods with high leaks, fixing the leaks is going to be more important than simply increasing the pressure. If the events are clustered during times when you are most likely awake (very beginning of night, right before you get up in the morning, etc.), then the events may not even be "real" since wake breathing can be erratic enough to fool the machine into thinking it is seeing sleep disordered breathing.

Also, today I saw the data was incorrect on my machine. It said I slept for 21 hours -- my max is about 7 usually. I don't know whether the other numbers are absolutely correct now. Not sure what to do - it may be out of warranty.

Again, without knowing exactly what number you are talking about, it's hard to trouble shoot.

Try rebooting the machine before you use it tonight. You reboot by unplugging the machine and then plugging it back in.