420E Settings Question

Has anyone experimented with the "Max Pressure for Command on Apnea" setting?

The default is 10 cmH20. I currently have the following settings:

Max 10.0
Min 5.0
Init 6.5
IFL1 Off (to eliminate the "runaway" pressures I've experienced with it "on")
IFL2 On
Max Command on Apnea 10.0

I've noticed that when I have an apnea, the pressure increases by 1 cmH20. However, the Apnea is often preceded or followed by Acoustical Vibrations (snore), which often creates at least one more 1 cmH20 rise. The result is that the pressure tends towards the high side for the night and my flow limitations seem to increase due to higher pressure (as indicated by "%Normal Cycles".) Since the flow limitation runs remain high, the pressure does not go back down, but I think that the higher pressures (often 2 to 3 cm above my titrated pressure) are actually the cause of some of the flow limitation runs.

I tried lowering the Command on Apnea to its lowest setting (effectively shutting it off) for several nights. The results seemed positive, and I seemed to have fewer "flow limitation runs", but am wondering if this is cause and effect, or coincidence.

It makes sense to me to not have any pressure commands based on apnea, because machine should raise the pressure based on other parameters before most apneas occur. After all, you can't always predict the future very well based on the past.

I'm interested in other opinions. . . Has anyone else out there tried lowering this setting some or all of the way? What are your experiences?


Thanks,
-John

Try changing the pressure increment to .5 cmwc . I looks like you have it at 1 cmwc. It won't seem so harsh when it kicks in.

When you change from 1.0 to 0.5 increments, the only difference is that you can set the machine to half-centimeter increments. There is no difference in the way (or the amount in this case) that the machine responds, unfortunately--I've tried.


-John