Limiting max pressure?

Any "reasonable, intelligent person" would have seen that "billbolton" was spot on with his advice, too. He's been a long-time member of this board, lives in Australia and has been VERY knowledgeable about ResMed and their machines and this therapy.

This forum used to be a "fun" place to be, but so many visitors and members have been chased away by the attitudes of some.
I'll admit that I've had my moments of nastiness, too, but I made a conscious decision to be better and more helpful than that.

palerider wrote: ↑

Mon Nov 11, 2019 2:03 pm

Wulfman... wrote: ↑

Mon Nov 11, 2019 1:44 pm

But, you left something out......the most important.......as usual. My point has ALWAYS been to get the users to find out what works best for each of them. I found out long ago what works best for ME. I used exhale relief for years, then decided I didn't need it. Tried APAP ranges of pressure, too........decided it didn't work for ME.

Bottom line is.......YOU need to find out for yourself by studying the reports from the software what events you're having and how YOUR machine may or may not respond to them.

This is also why setting the minimum pressure to eliminate MOST of the events is so important. We don't know how many of the events the minimum pressure prevents from happening, but if you can eliminate the majority of them, then you've gone a long way to improve your therapy.

Any *reasonable*, intelligent person would realize that I 'left that out' because I wasn't disputing the importance of people becoming involved in their treatment and learning how to evaluate their data.

palerider wrote: ↑

Fri Nov 08, 2019 11:34 pm

billbolton wrote: ↑

Fri Nov 08, 2019 6:19 pm

LSAT wrote: ↑

Thu Nov 07, 2019 8:13 pm

In most cases it makes no sense to limit max pressure.

In fact, in very few cases does it make any sense to do that.

The proposition that anyone should let a machine fully auto range all the time is popular with marketers, but it actually works fairly poorly in practice.

Auto operation over a limited range is generally useful, but autoranging over a large range is generally not.

If you're implying that the Max pressure should be limited as a matter of course, you're completely wrong.

The Auto machine will only raise pressure when there is a need to raise it.

The only *valid* reasons to lower the max pressure are if you suffer from aerophagia... then you have to do a delicate balancing act between getting enough pressure to treat your apnea, and having too much pressure that causes stomach pain.

In the rare event you have pressure emergent centrals, then possibly, lowering max *might* be worthwhile, but again, at the cost of more obstructive apnea.

Den

.

Wulfman... wrote: ↑

Mon Nov 11, 2019 2:56 pm

This forum used to be a "fun" place to be, but so many visitors and members have been chased away by the attitudes of some.
I'll admit that I've had my moments of nastiness, too, but I made a conscious decision to be better and more helpful than that.

Just as "helpful" as you usually are, Den.

palerider wrote: ↑

Mon Nov 11, 2019 2:59 pm

Wulfman... wrote: ↑

Mon Nov 11, 2019 2:56 pm

This forum used to be a "fun" place to be, but so many visitors and members have been chased away by the attitudes of some.
I'll admit that I've had my moments of nastiness, too, but I made a conscious decision to be better and more helpful than that.

Just as "helpful" as you usually are, Den.

Sorry I can't say the same about YOU.


Den

.

Wulfman... wrote: ↑

Mon Nov 11, 2019 3:01 pm

palerider wrote: ↑

Mon Nov 11, 2019 2:59 pm

Wulfman... wrote: ↑

Mon Nov 11, 2019 2:56 pm

This forum used to be a "fun" place to be, but so many visitors and members have been chased away by the attitudes of some.
I'll admit that I've had my moments of nastiness, too, but I made a conscious decision to be better and more helpful than that.

Just as "helpful" as you usually are, Den.

Sorry I can't say the same about YOU.

No worries, Den, I'm perfectly happy with the number of people that've told me that I've improved their lives.

You've repeatedly said that you're all dialed in, and happy with your fixed pressure, so there's obviously nothing for me to do to help YOU, so obviously, I'm no help to you...

cheers, happy fishing.

Thanks.
Over the years, I've had many tell me that I've helped them, too. Both on the forum and by PM.
I think the fishing may be over for this year......the water is getting "hard" and I'm not into drilling holes in the ice and sitting there freezing my ass off. My last (fishing) trip on Oct. 25th was productive with a limit of cutthroat trout.

Have a good one.


Den

.

Sorry, newb here. My wife had noticed me clearly suffering from sleep apnia, over the span of a few years. I am a 230-240# weight lifter. Regardless of my weight, from 210-250#, irregardless of body fat, I snored and stopped breathing a few times a night. I went on Amazon and bought a Resmed Airsense 10 with full facemask (I breathe with my mouth open, and "nose pillows" didn't cut it). It took a little time to get use to (the whole CPAP experience), but soon I was sleeping the night away, having never manifested problems sleeping. I sleep good, for the most part, each night, falling asleep in a minute or two. I left the unit on AUTO, but I would wake up a few times a week, feeling like drowning, with the pressure so high, I had an incredibly difficult time sleeping. I contacted the seller, found the "special" menus, and decreased the max pressure a tenths of a point, a few times a week, til I slept perfectly. It's been 2 years and I sleep perfectly each night, never snoring and having great sleep. Please note, I am here to learn, and only got my prescription from my wife noticing my sleep habits over 10-15 years. The past 2 years have been awesome for her (and me), as I sleep quietly without ever stopping my normal breathing. But I did have to turn down the max pressure just a bit. I assume that is what I should have done, as I was just winging it. I do have a BS in nutrition science, worked in a genetics lab, went to a few years of med school, and am now an electrical engineer, so learning is not something I take lightly.....I just didn't want to go sleep in some odd environment, when I clearly knew I suffered from apnia, and the machine would help remedy the situation. Hopefully I can learn more than I have, from the informed people here in this forum. Thanks.

I'm pretty sure my max pressure is set to 16 right now, for the past 18 months or so. It was 18 or 20 before, when it was on "auto". I'll have to check to be sure, later tonight, after work.

thefigurehead wrote: ↑

Mon Nov 11, 2019 4:46 pm

I'm pretty sure my max pressure is set to 16 right now, for the past 18 months or so. It was 18 or 20 before, when it was on "auto". I'll have to check to be sure, later tonight, after work.

Top of home page, under Post a new Topic.

Start by reading this:


Sticky: Newbies PLEASE READ BEFORE POSTING
by Pugsy » Fri Jul 27, 2018 5:36 am

Get:

https://www.sleepfiles.com/OSCAR/

Start a new thread, just for your future questions and post there for immediate future. (For your personal therapy questions)
That should get you started.

You are at the right place for the information you need.

Good luck

JPB

thefigurehead wrote: ↑

Mon Nov 11, 2019 4:37 pm

Sorry, newb here.

may i humbly suggest starting your own thread? people are more likely to help you that way.

please see my link in my sig regarding newbies.

welcome to the zoo and good luck!

billbolton wrote: ↑

Fri Nov 08, 2019 6:19 pm

...
The proposition that anyone should let a machine fully auto range all the time is popular with marketers, but it actually works fairly poorly in practice.

Auto operation over a limited range is generally useful, but autoranging over a large range is generally not.
...

Wulfman... wrote: ↑

Mon Nov 11, 2019 1:14 pm

...
If the minimum pressure is set too low, it may not have time to respond.......and then the event it's supposed to prevent happens anyway.
...

Couldn't help but notice that both people promoting fixed pressure over auto-adjusting are basing their arguments on mis-configured auto-adjusting machines.

Nobody here is suggesting that auto machines be fully auto-ranged, or set too low.

Reading individuals therapy threads here on the forums, the first course of business is almost always to establish a minimum pressure to take care of the majority of the events and then allow the auto-adjusting to take care of the exceptions.

Just as a misconfigured fixed pressure machine is not a valid reason to not use CPAP, a misconfigured APAP is not a valid reason APAP.

My Sleep Doctor is of a similar mindset as you two, she prefers CPAP. She prescribed me a CPAP machine and here in Ontario, one cannot get a [designated APAP] unless your prescription specifically requests one.

Fortunately for me, there is a loop-hole that allows one to get an AutoSet for Her with a CPAP prescription. Which I insisted on getting.

My Apnea is worse in REM. Using CPAP my choices are:

• use a lower fixed pressure that won't address all my events
• use a higher pressure that is less comfortable and more prone to leak
• find a fixed compromise that sometimes helps both issues, but sometimes has both sets of problems.

Sadly, she was content leaving me with fixed options. Had I not found these boards, I would have accepted her prescription and her machine had been tolerating a much poorer therapy.

Dog Slobber wrote: ↑

Tue Nov 12, 2019 9:58 am

Couldn't help but notice that both people promoting fixed pressure over auto-adjusting are basing their arguments on mis-configured auto-adjusting machines.

I take exception to that statement. (I'm not aware that Bill Bolton advocates/promotes one or the other)
MY point is for the users to find what works best for THEM.
And, if they've only used ranges of pressures or only used straight pressure.......and still have "problems"........TRY the other one.
Improperly configured machines (of any flavor) can/will give inadequate or uncomfortable therapy.
Studying the reports is vitally important to see what happens during the night and how the machine responds to or treats whatever happens during that time.
Some people have the precursor/triggering events and some do not. If they do not, pressure ranges are not very effective.
And, if they DO have those precursor events but they do not precede apneas or hypopneas, then all they're doing is just changing pressures for little to no purpose.......and maybe they will disturb the user's sleep.

Again........STUDY THE REPORTS.......and become intimately familiar with what happens during your sleep.
And, try to find what works best for YOU.


Den

.

Wulfman... wrote: ↑

Tue Nov 12, 2019 4:05 pm

Some people have the precursor/triggering events and some do not. If they do not, pressure ranges are not very effective.

Not true. The machines respond to hypopneas and apneas, some better than others.

Wulfman... wrote: ↑

Tue Nov 12, 2019 4:05 pm

And, if they DO have those precursor events but they do not precede apneas or hypopneas, then all they're doing is just changing pressures for little to no purpose.......and maybe they will disturb the user's sleep.

ALSO not true. Your "precursor events", (otherwise known as "flow limitations" and "snores") are, in and of themselves, disturbing to sleep, the extra effort involved in trying to breath through the restrictions ends up causing sleep disruptions, knocking people out of the sleep stage they're in.

While you vehemently ignore this fact, it is, nevertheless, a fact.

Wulfman... wrote: ↑

Tue Nov 12, 2019 4:05 pm

Dog Slobber wrote: ↑

Tue Nov 12, 2019 9:58 am

Couldn't help but notice that both people promoting fixed pressure over auto-adjusting are basing their arguments on mis-configured auto-adjusting machines.

I take exception to that statement. (I'm not aware that Bill Bolton advocates/promotes one or the other)

You can take exception all day, you both promoted (look it up: encouraged acceptance, advocated for) CPAP and you both supported your arguments with mis-configured auto-adjusted machines.