Pressure of 20!!

Janelle · Post by **Janelle** » Wed Feb 09, 2005 3:49 pm

Anyone know of anyone who is actually on a "therapeutic" pressure of 20? Yes, the "top of the mark"! I just got an email from a friend of mine who has been on straight CPAP for several years and she is currently on a pressure of 20. It think the RT has just been setting it higher and higher because she was having some problems taking her mask off in the middle of the night without waking up, don't know.

bozmon · Post by **bozmon** » Wed Feb 09, 2005 4:20 pm

WOW!!! Sign her up for the Macy's Thanksgiving Day parade (as a float) at that pressure! Doesn't seem to make sense (and may be even causing health damage) to go higher because the person is removing a mask at night! Geez, it's no wonder the mask doesn't just blow off their head at that pressure!

johnnygoodman · Post by **johnnygoodman** » Wed Feb 09, 2005 4:23 pm

Howdy,

I'd ask my friend to get a second opinion or try another provider. It can only help.

gailzee · Post by **gailzee** » Wed Feb 09, 2005 4:58 pm

does she have any sinuses left?
Wow, pressure of 20, can blow leaves in the driveway with that number, whew...............

Janelle wrote:Anyone know of anyone who is actually on a "therapeutic" pressure of 20? Yes, the "top of the mark"! I just got an email from a friend of mine who has been on straight CPAP for several years and she is currently on a pressure of 20. It think the RT has just been setting it higher and higher because she was having some problems taking her mask off in the middle of the night without waking up, don't know.

Janelle · Post by **Janelle** » Wed Feb 09, 2005 6:54 pm

I'm loaning her my APAP 420E overnight in March when I see her, so we can see what pressure she should really be at. Might even download the results so she can flash them at the doctor who prescribed the 20!

She hasn't had a sleep study since summer of 2003 and she had to pay for that one because they were between insurance companies. She doesn't like the Clinic she is dealing with but it is the only one their insurance approves in her area.

Should she call the insurance company and tell them they are not properly treating her?

CJoePap · Post by **CJoePap** » Wed Feb 09, 2005 7:21 pm

I wonder if the body can develop a tolerance to cpap pressure. If your body gets used to 20, will less pressure do any good?

jdschooler · Post by **jdschooler** » Wed Feb 09, 2005 8:56 pm

My sleep tech told me my pressures woud gradally go down some and then stabilize....I am diagnosed as severe and the tech got me up to 13.5 in my split study so she set my auto pap at 7 on the low side and 16 on the high end....I doubt you need 20 but then again I am sure 20 is theraputic for some people.

Dave Hargett · Post by **Dave Hargett** » Wed Feb 09, 2005 11:08 pm

Yes pressures can be that high. I've heard of someone having a pressure setting of 25 (very thick neck with lots of tissue to hold open).

In some instances, ripping the mask off may be a sign that you need more pressure. If apneas are still occurring, possibly in REM sleep that wasn't seen in the lab but is now occurring, the patient may rip the mask off to grab air because he/she subconsciously recognizes the apneas are occurring. But most docs will only go 1 or 2 cm above the tested pressure to test the theory, without coming back for another study to be more sure.

On the other hand, I do know a gentleman who was at a pressure of 19 and was using the original type of nasal pillows, something everyone said could not be done. (Ten years ago, the consensus was that nasal pillows were tough to use if the pressure was over 10 cm -- that's why I never even tried them!) He was quite happy because his apnea was being treated effectively.

Janelle · Post by **Janelle** » Thu Feb 10, 2005 3:30 am

But what kind of a machine would someone who needs more than 20 get? Don't all the machines only go to 20 as a high?

She says the mask ends up in her mouth with her chewing on it! I'm wondering if nasal pillows might be a "mask solution" for her.

christinequilts · Post by **christinequilts** » Thu Feb 10, 2005 10:00 am

Janelle wrote:But what kind of a machine would someone who needs more than 20 get? Don't all the machines only go to 20 as a high?

A lot of BiPAPs go to 25 or 30, some as high as 35 for top pressure. Of course with that high of a pressure a lower pressure on exhale is pretty much a necessity which is probably why most CPAPs stop at 20 and BiPAPs can go higher.

Gilda · Post by **Gilda** » Thu Feb 10, 2005 10:58 am

I have just been put on a bi-pap machine for and have a pressure setting of 18/14 and am having a terrible time with the mressure. I am using nasal pillows and it feels like someone has a leaf blower stuck up my nose! My mouth, nose and throat get so dry it hurts. I am awake every hour drinking water to get some moisture. I got more sleep without the machine. Any suggestions? Have had the bi-pap less than a week.

wading thru the muck! · Post by **wading thru the muck!** » Thu Feb 10, 2005 11:04 am

Gilda,

Do you have a heated humidifier? This will help with the dryness.

mommaw · Post by **mommaw** » Thu Feb 10, 2005 11:22 am

Yes I do and last night increased the temperature, thought maybe the warmer air would be better. Didn't seem to help. I tried a nose mask for 3 days and it leaked all the time so they put me on the nasal pillows. They are more comfortable but the air pressure is awful! The dryness is much worse with the pillows.

wading thru the muck! · Post by **wading thru the muck!** » Thu Feb 10, 2005 11:28 am

mommaw (Gilda?)

Have you tried the Resmed Mirage Activa nasal mask. It has a cushion that inflates from the cpap pressure and seals against your face without the need for tight headgear straps. They are suppose to come out witha full face version of this mask later this year. If you can give it a try, many have had success with this mask.

Guest · Post by **Guest** » Thu Feb 10, 2005 12:42 pm

Thanks for the info. I will talk to my doctor and DME provider about the mask. How do you get to try different masks? My DME provider said they have a 3 day return policy. Does your insurance company pay for the different masks or do I have to pay out of pocket? Also have done some research on the web regarding different masks but I cannot purchase them. It says they must have a prescription and does not give the prices. Just getting very disgusted right now.

Pressure of 20!!

Pressure of 20!!

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Pressure of 20

Pressure of 20

Pressure of 20

Pressure of 20

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