Consequences of setting too high?

mindy · Post by **mindy** » Mon Mar 03, 2008 6:46 am

Hmmm ... my AHI drops when I increase pressure until I get to 14 and then my OAI increases dramatically but no non-responsive events show up on the report (this is in straight cpap mode). So what would cause that?

Mindy

Wulfman · Post by **Wulfman** » Mon Mar 03, 2008 7:09 am

mindy wrote:Hmmm ... my AHI drops when I increase pressure until I get to 14 and then my OAI increases dramatically but no non-responsive events show up on the report (this is in straight cpap mode). So what would cause that?

Mindy

Non-Responsive events and Flow Limitations will not show up in Encore Pro/Viewer from machines set in CPAP mode......even if they're an Auto.

Den

mindy · Post by **mindy** » Mon Mar 03, 2008 7:12 am

Den,

Is the theory that pressure should be high enough to eliminate apneas (mostly)? I can't get my pressure high enough to get OAI below 1 without apparently getting centrals....

thanks!
Mindy

Wulfman · Post by **Wulfman** » Mon Mar 03, 2008 10:20 am

mindy wrote:Den,

Is the theory that pressure should be high enough to eliminate apneas (mostly)? I can't get my pressure high enough to get OAI below 1 without apparently getting centrals....

thanks!
Mindy

Mindy,

Is your total AHI below 5.0?
What is your typical "average" (per week/month)?
I admit, it's nice to see numbers BELOW 1.0, but sometimes we just have to accept the "That's as good as it MAY get" frame of mind......and especially if you're dealing with Centrals.
I could probably keep mine consistently "low", but I sleep very well where I'm at, even though I sometimes spike between 1.0 and 2.0......and without having to use a higher pressure.

Den

mindy · Post by **mindy** » Mon Mar 03, 2008 10:34 am

Wulfman wrote:
mindy wrote:Mindy,

Is your total AHI below 5.0?
What is your typical "average" (per week/month)?
I admit, it's nice to see numbers BELOW 1.0, but sometimes we just have to accept the "That's as good as it MAY get" frame of mind......and especially if you're dealing with Centrals.
I could probably keep mine consistently "low", but I sleep very well where I'm at, even though I sometimes spike between 1.0 and 2.0......and without having to use a higher pressure.

Den,

My total AHI is below 5.0 if I keep my lower pressure (or single pressure) at least 11. I have more apneas than hypopneas. Over the past 7 months I've worked with various pressures, both ranges and single pressures, between 8 (titrated pressure) on up to 15 (I've never used a single pressure of 15). When I use ranges, my actual pressure will spike up to 14 some of the time. At a single pressure 13 my best AHI was about 1.9 with OAI 0.9, HI 1 with average AHI around 2.5.

I'm currently using a range from 9-13 and it does bump up against the top, AHI 3.5-4. I've recently started monitoring SAO2 periodically. Last night I didn't use CPAP since my cat swiped a couple of pieces of my quattro and I was too congested to use nasal pillows. I did monitor last night and haven't yet seen results but I do feel noticeably worse today.

O2Sats from pressure at 13 and from 9-13 still show some desaturations down to 85%.

Thanks!
Mindy

Wulfman · Post by **Wulfman** » Mon Mar 03, 2008 10:51 am

Mindy,

At your current range of settings, are you seeing any Flow Limitations or Non-Responsive events on your reports?

Also, are most of them happening at the lower pressures or are they still occurring all the way through? Which types of events are predominantly causing the pressure increases?

Did your sleep study indicate Centrals?

Den

mindy · Post by **mindy** » Mon Mar 03, 2008 10:59 am

Wulfman wrote:Mindy,

At your current range of settings, are you seeing any Flow Limitations or Non-Responsive events on your reports?

Also, are most of them happening at the lower pressures or are they still occurring all the way through? Which types of events are predominantly causing the pressure increases?

Did your sleep study indicate Centrals?

Den

Den,

I typically see very few flow limitations - FLI<1
I've only seen 1 NRE

Not sure if they're all the way through. I'll need to look back to see which are causing the pressure increases. I seem to currently have mostly apneas.

I had rotten sleep during my sleep study. It showed no apneas, 1 central and the rest were hypopneas. Apparently I did have some apneas during titration and those didn't completely disappear until pressure hit 8. I did sleep somewhat better during titration (due to Ambien!).

I have tried going back down to 8 but when my bottom pressure is below 9 (range or single pressure), my AHI tends to go to 5 or 6. It doesn't seem like adding pressure makes a huge difference although it does make some. The two key things for me are that although I'm feeling noticeably better than before, I still sometimes wake up with mild headaches and am still getting mild desaturations. Since I have heart failure (very mild at this point), those desaturations are definitely not good for me.

Mindy

Wulfman · Post by **Wulfman** » Mon Mar 03, 2008 11:15 am

Keep in mind that with an Auto, most anything can trigger a pressure increase.....leaks, snores, flow limitations, hypopneas and apneas.

http://sleepapnea.respironics.com/techn ... rithm.aspx

http://sleepapnea.respironics.com/techn ... logic.aspx

Den