Do You Set Your Pressure Or Let The Machine Adjust

Hey Guys....This May be a silly Question, but I'm really still trying to figure out what really works...I have airsense Auto 10....I have been using the machine on auto for everything.....I have also been using EPR....it was at 3 and then I took it down to 1......But I'm really still struggling to get the setup right.....Still not sleeping well and not feeling rested at all.....So I have started to question my settings and wonder if I shouldn't experiment with picking a straight pressure and see how that does.....My original auto settings was 5 to 10.....I always thought that it felt at times, very weak....to the point I would pull the nasal mask off to make sure it was working, because I just didn't feel the air and I felt like breathing was a bit of a struggle at those times......I have read a lot of different posts on here with respects to settings and EPR....EPR is another interesting thing to me.....It does feel a bit more comfortable to have it engaged, but it also seems like it really pairs down the airflow.....What I mean by this is, I started to increase my min pressure from 5 to 7 to 8, and using EPR at 1......But I noticed that even increasing the min pressure, if EPR is on of course, the perceived pressure seems to still be very little.....I just find this odd, because even with EPR at 1, I would think I would feel a difference in the mask as min pressure is increased, but I really don't.....Now I have experimented with EPR off.....And wow, I can tell a difference....If I go back at a min pressure of 6, and no EPR, I can feel more air flow for sure.....and as I go up in min pressure, it does become a little more difficult breathing out, but I think I just need a little more practice.....But If EPR is on, I feel like no matter what level the MIN pressure is, it feels way to easy compared to no EPR and lower min pressure.....It makes me wonder if the Machine in EPR mode really reduces the air when exhaling more than necessary.....I know this sounds silly, but its amazing to me the difference between EPR and Non EPR......And then my last thought, is the pressure changes the machine does in auto mode......So If I start out at 7 min pressure in auto mode and EPR 1 mode, within 5 min or so of using the machine, the pressure jumps to something like 8 or 8.5.....Now why I find this odd is, because I'm still awake.....so if I laydown, turn the machine on, I sometimes may think about day, work etc before drifting off......and if I look over to see what pressure is after, lets say 10min, the pressure is up from 7 to the 8 range....I don't know why that would be.....I am relaxed, my breathing is fine and i'm not asleep, but the machine is already increasing pressure....(I do not use any kind of ramp), so I find this odd that the machine would increase like that.........So I guess in general, I question the whole auto setting of the machine and wonder if just using a set constant pressure is the better way to go.....Of course I Know guys, that I need to figure that one out on my own......just curious if any other members have felt that therapy really started to get better with using set constant pressure or if there a lot of members feel like the machine in auto mode has been great for them......

Some people like fixed pressures better.
Some people like auto adjusting pressures better.
You won't know what you like until you try it. What I like is really not relevant to what you like.

As to EPR...quit worrying about the setting...use it at whatever setting is simply more comfortable for you in terms of letting you get to sleep and stay asleep....so try all settings including off and choose the one that simply feels better in terms of comfort...and use it no matter what the setting.

I control my machine, that was I get the treatment I need. Many using XPAP, are given machine settings that promote failure. Jim

I use a set pressure. Using the APAP seems to cause me to wake more often and more fully than when I use fixed pressure. I also have fewer leakage problems.

I use a narrow range on auto so it makes very little difference to me whether I use a constant 12 or 11-15 range. It was said before..try each for a while and use whichever works best for you. Sleephead will help you decide.

I started out with a (data-capable) fixed-pressure CPAP machine. I used it for over a year before I bought my first APAP. I tried a range of pressures ( 10 - 15 ) for a week and found out alot about my sleep, breathing and that I didn't like the changing pressures. But it did confirm that I had already tweaked my fixed pressure to the optimal setting. So, that's what I've used for the most part for over 12 years. For one thing, it gives the user a "constant" to compare their data over periods of time. If things ( numbers/events ) change, it's not the air pressure and it's easier to pinpoint what the culprit or cause may be.
I'm all for users having APAPs, but they need to try both modes and various options/settings to find what works best for them.
For some people the changing pressures don't bother their sleep and for some it does.


Den

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Both, in a manner of speaking. Auto, set on a tight range.
That way, I am covered, no matter which side I sleep on.
---(Except when the bullfrog makes himself a blanket burrito--using ALL the covers)

chunkyfrog wrote:Both, in a manner of speaking. Auto, set on a tight range.
That way, I am covered, no matter which side I sleep on.
---(Except when the bullfrog makes himself a blanket burrito--using ALL the covers)

Carefully applied Hot Sauce, will unwind that burrito.... Jim

But he thrives on that stuff!
He calls it his "rocket fuel".

Mine is set for 13 to 25, with pressure support of 4, but it very seldom goes over 14. My original prescription called for 20 to 25 with pressure support of 5.

robz wrote:just curious if any other members have felt that therapy really started to get better with using set constant pressure or if there a lot of members feel like the machine in auto mode has been great for them......

I started out with a constant pressure machine, and did ok, 'till I noticed I was feeling like crap, looked at the data (which I hadn't for a couple of months), and saw that my AHI had been steadily climbing.

I went out, got an auto, set a sufficient minimum pressure, and haven't looked back.. I get better sleep because the machine adjusts to my needs throughout the night.

I bought an auto after several months of renting a fixed CPAP. Thought problem solved. Instead my problems skyrocketed at higher pressure. That happens in rare cases. After a couple months went back to fixed pressure. It takes a couple weeks to develop a true baseline for any setting.

Thank you guys for the feedback.......decided to try no EPR, min pressure at 7 and max at 9......that seemed to work better.....so I can see zeroing in on a fixed pressure number is going to be the way to go.....

TASmart wrote:I use a set pressure. Using the APAP seems to cause me to wake more often and more fully than when I use fixed pressure. I also have fewer leakage problems.

Who's supposed to determine what causes the leaks? DME? Doctor? Patients?

My doc's tech was so bad he didn't fix the pressures on my machine when he gave me a full face mask.
Sleepyhead showed during the last hour of sleep on the first nite, I spent 17 minutes (not sequential or
I'd be dead) of apneas and hypopneas. I didn't know someone over 50 could survive that!

Musica wrote:

TASmart wrote:I use a set pressure. Using the APAP seems to cause me to wake more often and more fully than when I use fixed pressure. I also have fewer leakage problems.

Who's supposed to determine what causes the leaks? DME? Doctor? Patients?

My doc's tech was so bad he didn't fix the pressures on my machine when he gave me a full face mask.
Sleepyhead showed during the last hour of sleep on the first nite, I spent 17 minutes (not sequential or
I'd be dead) of apneas and hypopneas. I didn't know someone over 50 could survive that!

If you have Sleepyhead, you should see if there are leaks. Some deductive reasoning will help find the source. If you're using a nasal mask and you have dry mouth, it's probably the therapy air leaking out your mouth.
If you're using a full face mask (which you are), it's probably a leak around the seal of the mask. You can still have dry mouth using a full face mask......mouth breathing.......but unless there are massive leaks, you're not losing your therapy air.

Getting the right mask, including the proper size and adjustment......and using a bed pillow which doesn't cause the mask to be moved out of alignment will go a long way to minimize leaking.


Den

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