Pressure settings

I've been using a Respironics Auto machine. The original settings provided by the sleep lab was 5 to 18. From the beginning I've been running AHI's from about 2 to the high 20's. I've tried four different masks at $100 a pop with mixed and inconsistant results which is very frustrating. In any event it's become apparent to me the autopap treatment is only as good as the mask. Now this is an individual thing that doesn't apply to everybody, but I'm a side sleeper and move around quite a bit. Over time I noticed that when I woke (frequently) during the night the darn autopap was blowing a gale, far more air than the mask could handle and making not nice noises. I've also experimented with the different masks to find a max pressure that they can handle with a minimal amount of movement before they "burp" and you have a large leak. For example my full face Ultra Mirage loses it's seal at around 10 cm water unless cinched down to the point of pain, so no point in having a setting of 18. The other masks are about the same.

To make a long story short, I reset the Autopap to 5.5 and 10. The results have been astounding. No more "Large Leaks" and the AHI has been reduced to about 3. While the hypopnea was reduced somewhat, most of the reduction was in the obstructive apnea category. The average autopap pressure runs between 6 and 8. Average leak has been halved and last night I actually slept through the night for the first time that I can remember.

Hope this helps someone. It sure works for me. Seems to me the key, bearing in mind mask limitations, is to get to the lowest possible cpap or autopap pressure that does the job. More is not better in the case of setting pressures. Warning, this is an individual un-scientific observation, and no doubt some folks really need the higher pressure settings so if anyone wants to experiment like I did, be careful and use small increments. I just said to heck with it and went from a high setting of 18 to 14 to 10.

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