Conseqences of having pressre set too high?

Brian000 · Post by **Brian000** » Tue Jun 07, 2005 9:10 am

My prescription is for 11 cm. I'm on plain cpap -- not apap. Over the past 6 months I've fiddled with my pressure, taking it to a high of 15. I don't think this has really improved my sleep, but I don't have too much difficulty breathing against 15 cm.

Apart from comfort and compliance issues, what are the consequences of having one's pressure set too high? Are there health risks? Will it make apnea worse or introduce other sleep disorders?

wading thru the muck! · Post by **wading thru the muck!** » Tue Jun 07, 2005 9:29 am

How did you determine you needed the pressure higher? Do you feel that 15cm is working better for you? What machine do you have? Can it record any data regarding how you are doing at 15cm compared to 11cm? The only risk is in potentially causing central apneas.

Brian000 · Post by **Brian000** » Tue Jun 07, 2005 12:47 pm

wading thru the muck! wrote:How did you determine you needed the pressure higher? Do you feel that 15cm is working better for you? What machine do you have? Can it record any data regarding how you are doing at 15cm compared to 11cm? The only risk is in potentially causing central apneas.

Well, after several years I'm still not consistently sleeping through the night, so I wanted to try tweaking the pressure. No, I don't think a higher pressure is making a whole bunch of difference -- but sleep is different. My machine is the basic Remstar Plus: no auto or data collection.

What's a central apnea? (It's not in the 'pedia).

I'm just wondering why some doctors are so cautious about prescribing higher pressures if there is no possible harm (or is there possible harm?).

wading thru the muck! · Post by **wading thru the muck!** » Tue Jun 07, 2005 2:03 pm

A central apnea is one that is not obstructive. Kind of like your brain forgets to breathe. If you are feeling better (and sleeping better) at 15cm, I bet that is what works better for you. I was titrated at 7cm during my sleep study, but my auto-pap shows I need 9cm. The quick snapshot from a sleep study is an in-exact science. The key is that you are sleeping better. That is the goal of this treatment.

bman · Post by **bman** » Fri Jun 10, 2005 5:02 am

I think a high pressure can be dangerous

it is a matter of risk versus the benefit

personally I have since someone's chest x-rays showing emphysema after using cpap

at about pressure of 13 I can feel my eardrum bulging and also my chest muscles aching in the aching

ahujudybear · Post by **ahujudybear** » Fri Jun 10, 2005 6:15 am

Hi Brian!

My Dr's recommendation was for anywhere between 10 & 15. The sleep study concluded 10 or 12. (I use a BiPAP so the EPAP level is always 3). In between these tests I had noticed that the setting of 12 felt better than 10 (felt more like it was actually doing something.) On a whim I asked the RT to increase the pressure of the P-B GK 425 to 13. The nest two mornings I woke up with my heart racing, although it felt like I had slept better,, but I turned it back down to 12.

- JB

pattsie · Post by **pattsie** » Fri Jun 17, 2005 9:37 pm

[quote="bman"]I think a high pressure can be dangerous

it is a matter of risk versus the benefit

personally I have since someone's chest x-rays showing emphysema after using cpap

at about pressure of 13 I can feel my eardrum bulging and also my chest muscles aching in the aching

notbigenuf1 · Post by **notbigenuf1** » Fri Jun 17, 2005 10:49 pm

Muck, how do you tell what pressure you needed from your machine? you said you went from 7 to 9 from an indication from your machine

neversleeps · Post by **neversleeps** » Fri Jun 17, 2005 11:00 pm

bman wrote:I think a high pressure can be dangerous

it is a matter of risk versus the benefit

personally I have since someone's chest x-rays showing emphysema after using cpap

at about pressure of 13 I can feel my eardrum bulging and also my chest muscles aching in the aching

ARE YOU SAYING CPAP CAUSES EMPHYSEMA?? THAT'S INSANE!!!!! (NOT TO MENTION, IRRESPONSIBLE!)

I CAN UNDERSTAND YOUR CHEST MUSCLES ACHING IN THE MORNING IF YOU HAVE DIMINISHED LUNG CAPACITY, BUT MY PRESSURE IS AT AROUND 13 EVERY NIGHT AND I'M NOT HAVING THOSE ISSUES. OTHERS HAVE PRESSURES SET AT 19. HMMMMM.........

twistedcherokee · Post by **twistedcherokee** » Sat Jun 18, 2005 12:13 am

I bumped mine from 7 to 11. The Doc said that when I am on my back it takes 15, so he wanted me to sleep on my side. We are not talking pressure as much as we are talking volume. CFM is not a pressure setting. Yes, it may take more pressure to make the cfm on the machine, but it is the volume of air that fills you up to keep the throat passage open. If it were pressure than you would keep blowing up like a balloon until you pop. But low pressure with a high volume out put is what you are talking about. Put your thumb over the end of the hose, it will overcome the air coming out without alot of pressure. Maybe try to blow up balloon, the volume is there but not sure if the pressure is. Hope it helps.

toby

ahujudybear · Post by **ahujudybear** » Sat Jun 18, 2005 8:18 am

I am a polio survivor. I have weakened oblique abdominal muscles. These are the muscles that we use to breathe with during the night or when we are not upright. Trying to breathe out against any pressure higher than 3 for any length of time will cause my chest wall muscles to spasm so that I cannot breathe at all. (imagine a stretch that lasts for several minutes.) It will also cause my abs to ache, and in the extreme will cause one or more ribs to dislocate.

But I have normal lung capacity.

You might want to visit a Physiatrist (doctor of physical medicine) to find out if anything else is going on.

Also, please read my post under the thread about other ailments we have. viewtopic.php?t=3092

I wish you well.
- JB
P-B GK BiPAP 12/3
F&P FlexiFit HC407
Swift
F&P Ambient Humidifier HC105

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): bipap, humidifier, swift

bman · Post by **bman** » Wed Jun 22, 2005 7:53 am

ARE YOU SAYING CPAP CAUSES EMPHYSEMA?? THAT'S INSANE!!!!! (NOT TO MENTION, IRRESPONSIBLE!)

I am just quoting what I saw. This is the only case that I noticed out of a few hundred osa patients. I am just quoting the CXR showed signs of lung overexpansion as reported by the radiologist. May be the term emphysema is not appropriate but the CXR findings can be quite similar.

I CAN UNDERSTAND YOUR CHEST MUSCLES ACHING IN THE MORNING IF YOU HAVE DIMINISHED LUNG CAPACITY, BUT MY PRESSURE IS AT AROUND 13 EVERY NIGHT AND I'M NOT HAVING THOSE ISSUES. OTHERS HAVE PRESSURES SET AT 19. HMMMMM.........

Well I dont have limited lung capacity but I do feel chest muscle achings in the morning. I am certainly quite impressed with others able to tolerate pressure of 19-20 easily. I am sorry I am not matching your expectation.

By the way I have come across many osa patients who are not able to tolerate the treatment and gave up despite being warned of grave consequences. Most people joining this forum would in my opinion in fact the minority group with lots of motivation and endurance in taming the cpap beast.

neversleeps · Post by **neversleeps** » Wed Jun 22, 2005 8:27 am

bman,

Your are correct when you say, "....Maybe the term emphysema is not appropriate..." Not only is it inappropriate, it is completely false!
You are correct in your observation,

By the way I have come across many osa patients who are not able to tolerate the treatment and gave up despite being warned of grave consequences. Most people joining this forum would in my opinion in fact the minority group with lots of motivation and endurance in taming the cpap beast.

Wearing a mask to bed every night is hard to adjust to.... it is my understanding the difficulty is the mask itself, not the pressure.

Yes, this forum is great for motivation! There's a lot of experience here, sharing techniques, sharing factual information, sharing encouragement. That's why I got angry when I read what you wrote,

personally I have since someone's chest x-rays showing emphysema after using cpap

because it isn't true! It is a great disservice to make such a claim, and if you scared off even one person from continuing their therapy, it is one too many.

wading thru the muck! · Post by **wading thru the muck!** » Wed Jun 22, 2005 9:49 am

notbigenuf1 wrote:Muck, how do you tell what pressure you needed from your machine? you said you went from 7 to 9 from an indication from your machine

I have an auto adjusting machine that shows me data of what the machine needed to do to prevent most of my apneas.

bman · Post by **bman** » Thu Jun 23, 2005 6:19 am

You are correct in your observation,

Observation is always correct. It is a fact.

Wearing a mask to bed every night is hard to adjust to.... it is my understanding the difficulty is the mask itself, not the pressure.

I am confused here. This is a special cpap mask to maintain certain pressure and not like a hat.

Yes, this forum is great for motivation! There's a lot of experience here, sharing techniques, sharing factual information, sharing encouragement. That's why I got angry

You are right about sharing opinions but you are imposing your views on others. I am sorry I dont share some of your views.