Quick Pressure Question

Hi everyone, a possibly quick question about my pressure settings on my Resmed 11.

I'm currently set at APAP, 8 to 15. For the past couple of weeks, SleepHQ shows my AHI below 3 on those settings. My 95% is 13 to 14 and my 99% is 14 to 15.

I'm still waking up feeling "full" and gassy with some lower back pain that goes away after standing for a few hours. I think this is related to my pressure, so I wouldn't mind lowering it. I not too concerned about getting my AHI below 1, as long as it stays below a 5. Thinking about changing my pressure from 8 / 15 to 8 /14 (or even 8 / 13).

Good idea, bad idea? Any thoughts?

Here's last night's data for reference:

https://sleephq.com/public/725dc8b5-dc1 ... d019f8d147

I would actually try lowering the max to 12 to start with if it were me and see if that helped relieve your problem or not.
You don't really spend all that much time above 12 anyway.

If you are doing any supine sleeping at all you might also try to stay on your side more if at all possible.

decker12 wrote: ↑

Wed Jan 04, 2023 1:26 pm

Hi everyone, a possibly quick question about my pressure settings on my Resmed 11.

I'm currently set at APAP, 8 to 15. For the past couple of weeks, SleepHQ shows my AHI below 3 on those settings. My 95% is 13 to 14 and my 99% is 14 to 15.

I'm still waking up feeling "full" and gassy with some lower back pain that goes away after standing for a few hours. I think this is related to my pressure, so I wouldn't mind lowering it. I not too concerned about getting my AHI below 1, as long as it stays below a 5. Thinking about changing my pressure from 8 / 15 to 8 /14 (or even 8 / 13).

Good idea, bad idea? Any thoughts?

Here's last night's data for reference:

https://sleephq.com/public/725dc8b5-dc1 ... d019f8d147

Just because you HAVE an auto-adjusting CPAP machine, doesn't mean you HAVE to set it to a range of pressures.
I would suggest setting your machine to a fixed pressure of 14 cm, for a week or so and see what happens,
You won't know till you try it........and many times with this therapy, the users have to "think out of the box" and try things that may seem unconventional to others, but may in fact work for the users.

Try it and report back in a week or so. Your AHI may even drop below 1.0.

Good luck and have a Happy New Year.

Den

.

Thanks my friend, I'll give it 7 to 12 a try for a week. Great point about not being above a 12 for very long each night, I didn't see it that way.

Just because you HAVE an auto-adjusting CPAP machine, doesn't mean you HAVE to set it to a range of pressures.
I would suggest setting your machine to a fixed pressure of 14 cm, for a week or so and see what happens,
You won't know till you try it........and many times with this therapy, the users have to "think out of the box" and try things that may seem unconventional to others, but may in fact work for the users.

Try it and report back in a week or so. Your AHI may even drop below 1.0.

Good luck and have a Happy New Year.

Den

.
[/quote]

I very rarely post here as I do not feel qualified to know enough! But I do read here very often.

I have to agree with Den. For 9 years I was set on 8-20…This past fall I got with a certain poloysomnologist who after trying a few things that did not work, moved me to CPAP only at 13. I can say that VERY rarely do I ever get to an AHI of 1 — its always under!!!

Gparr wrote: ↑

Sun Jan 08, 2023 8:02 am

Just because you HAVE an auto-adjusting CPAP machine, doesn't mean you HAVE to set it to a range of pressures.
I would suggest setting your machine to a fixed pressure of 14 cm, for a week or so and see what happens,
You won't know till you try it........and many times with this therapy, the users have to "think out of the box" and try things that may seem unconventional to others, but may in fact work for the users.

Try it and report back in a week or so. Your AHI may even drop below 1.0.

Good luck and have a Happy New Year.

Den

.

I very rarely post here as I do not feel qualified to know enough! But I do read here very often.

I have to agree with Den. For 9 years I was set on 8-20…This past fall I got with a certain poloysomnologist who after trying a few things that did not work, moved me to CPAP only at 13. I can say that VERY rarely do I ever get to an AHI of 1 — its always under!!!

The solution to misconfigured APAP, is not necessarily to switch to CPAP, it's to properly configure your APAP settings.

Another silly question:

Should I use SleepHQ (or Oscar) to figure out my lowest pressure that still gives me less that 5 AHI? I'm at 7 to 12 right now, and my stats show me at about 3 AHI each night. I'm going to change it to 7 to 11 and see if I am still under 5 after a few days.

Does that sound like a proper plan of action? Try to adjust my pressure so it's as low as it can go with still maintaining under 5 AHI?

decker12 wrote: ↑

Sun Jan 08, 2023 10:23 pm

Another silly question:

Should I use SleepHQ (or Oscar) to figure out my lowest pressure that still gives me less that 5 AHI? I'm at 7 to 12 right now, and my stats show me at about 3 AHI each night. I'm going to change it to 7 to 11 and see if I am still under 5 after a few days.

Does that sound like a proper plan of action? Try to adjust my pressure so it's as low as it can go with still maintaining under 5 AHI?

NO! that is a bad idea. the "5" is a very poor level of treatment. If you have an AHI of 5, then that makes you get your sleep interrupted, on average, ever 12 minutes all night long.

A far more better target is to keep your AHI under 2, NOT 5. That gives you a better chance to get actual REST.

So, no, it's a bad idea.

Don't settle for "good enough for the insurance companies", it's your health we're talking about.

palerider wrote: ↑

Mon Jan 09, 2023 12:50 am

If you have an AHI of 12, then that makes you get your sleep interrupted, on average, ever 12 minutes all night long.

I think PR means an AHI of 5 will interrupt your sleep every 12 minutes.

Dog Slobber wrote: ↑

Sun Jan 08, 2023 8:55 am

The solution to misconfigured APAP, is not necessarily to switch to CPAP, it's to properly configure your APAP settings.

I agree in principle (and truly appreciate the "necessarily" qualifier)--unless someone has other PAP issues that straight pressure helps. Some (probably the majority?) may find that APAP lessens aerophagia issues, for example, since pressures may be lower much of the night. But others (at least a few?) may find that using a straight pressure allows their body to adjust to that one pressure in a way that lessens aerophagia, or other issues, for them.

Autotitration, in that sense, can be viewed similarly to ramp. Great tool to have available; that doesn't mean it always needs to be used. In my case, ramp destroys my therapy, since I need sufficient pressure to feel comfortable falling asleep.

I believe in full-time APAP for most, but some sure swear that they feel much better and get better AHI at one pressure all night. To me, that doesn't mean that having an APAP set to CPAP is in any way going to waste; the APAP capabilities are still there available for whenever needed, as indicated by data.

So I would say that although I agree with you, I would personally also qualify that further by saying that there is no reason to rule out using CPAP mode just because you have a machine that can autotitrate.

Use what works well and feels good.

Sometimes specialized tools, even common ones, are just as valuable being left in the tool drawer until it's clear they're needed. I don't feel I have to use every tool in the drawer all the time to get my money's worth, myself.

I don't expect you to agree with me, but I didn't think you'd mind my posting my wordy 2 cents, either.

Respirator99 wrote: ↑

Mon Jan 09, 2023 3:50 am

palerider wrote: ↑

Mon Jan 09, 2023 12:50 am

If you have an AHI of 12, then that makes you get your sleep interrupted, on average, ever 12 minutes all night long.

I think PR means an AHI of 5 will interrupt your sleep every 12 minutes.

Yes, thank you, I fixed the original.

lazarus wrote: ↑

Mon Jan 09, 2023 4:00 pm

Dog Slobber wrote: ↑

Sun Jan 08, 2023 8:55 am

The solution to misconfigured APAP, is not necessarily to switch to CPAP, it's to properly configure your APAP settings.

I agree in principle (and truly appreciate the "necessarily" qualifier)...

Don't disagree with anything you said.

But want to point out something both the Switch to CPAP advocates said:

I would suggest setting your machine to a fixed pressure of 14 cm, for a week or so and see what happens,
You won't know till you try it
...
Try it and report back in a week or so. Your AHI may even drop below 1.0.

The OP's minimum pressure is 8. This guy is suggesting an increase of 6cm, which I don't disagree with. And a switch to CPAP. But, then will attribute benefits to the switch to CPAP, instead of the pressure increase. That reasoning is absurd.

I have to agree with Den. For 9 years I was set on 8-20…This past fall I got with a certain poloysomnologist who after trying a few things that did not work, moved me to CPAP only at 13. I can say that VERY rarely do I ever get to an AHI of 1 — its always under!!!

This guy increases his pressure by 5cm, switches to CPAP and then attributed his improved AHI to the switch to CPAP.

Neither of them understand the relationship of a properly configured minimum pressure to therapy, and should not be offering advise on configuring devices.




An Analogy:
OP:

My car is running rough.

Den:

I would suggest tinting your car windows and having your engine tuned-up, try it for a week or so and see what happens,
You won't know till you try it........and many times with car performance, the users have to "think out of the box" and try things that may seem unconventional to others, but may in fact work for the users.

Try it and report back in a week or so. Your MPG may very well improve.

Gparr:

I have to agree with Den. For 9 years my car had not been tuned-up…This past fall I got with a certain mecahanic who after trying a few things that did not work, tinted my windows and tuned-up my car. I can say that VERY rarely was my milage over 20 MPG — its now always over 30 MPG!!!

Never underestimate the power of window tint.. (especially in the south).

Thanks for the insight here. However everything I'm reading, I thought an AHI of under 5 is considered normal?

What I don't want to do is make myself miserable with an increased pressure range all night long to get an AHI of under 2, waking up several times feeling uncomfortable and of course feeling like I had a Core workout when I get out of bed in the morning. Especially when 5 is still considered within the normal range. I'm currently at a 7 to 12 with nightly AHI readings hovering around 2 to 5, and most nights around a 3.

Decker12, are things pretty much the same for you with the new range of 7 to 12? That wasn't clear to me from your most recent post.

Also, could you provide a link to a typical chart from a night with the new settings? I'm curious whether your events continue to be clustered.