I have Results from last night!

I have my results from last night.

Pressure 13.4
Leak Rate .38/s
AHI 5.5
AI .1
HI 5.4

From what I've learned here, I'm thinking these numbers are fine, but not great. Since my Doc didn't include a min and max pressure range on my prescription, and my sleep report showed 14 as my obtimal pressure, the DME set the range on my APAP from 6 to 20.

After finding out how to change the settings, I initially raised the min pressure to 10 last night, but after reading many posts regarding air getting pushed down the wrong way when a weak LES allows air to enter the stomach, I decided to first see data from the 6 to 20 range as set by my DME. I have a history of GERD and had laproscopic fundoplycation some years ago. Since then, my symptoms have returned, but not as severe as they were before the surgery. I can generally avoid a reflux episode by taking Prilosec OTC twice a day and avoiding spicy foods after lunch and avoiding any food after 7:00 pm.

Having said all that, I'm concerned about suffering from aerophagia if I raise my min pressure too high. I would like to avoid that if possible.

As always, any input is appreciated!

There are those much more experienced at pressure settings than I am on this forum. But all I've read here indicates that USUALLY 1-2 cms below your titrated pressure and 1-2 cms above your titrated pressure is a good pressure range to start with.

That being the case I would set the pressure range as 12 cms and 16 cms. Of course, there is always the EPR option to take into consideration that can give you up to 3 cms pressure relief on expiration too. I don't blame you about being concerned about aerophagia given your history and surgery!

So far, yeah, your numbers look pretty darn good. Mine didn't look that good my first night on an Auto!!! (Yeah, it was set at 4-20 cms - your RT was more considerate than my sleep doc!).

Have you raised the head of your bed? Doing so can really help put gravity on your side with GERD. You apnea level seems pretty low which helps with the mechanics of GERD.

I had some problems with this issue when I first started. My doc had set a 4-20 range on my APAP. I first raised the pressure to around 7 just to be able to get enough air moving so I didn't have that breathing through a straw feeling. Then I started tuning based on the data I was getting nightly. I should have been at at 10-14 range. But when I raised the pressure to 10, the GERD flared with a bit of aerophagia. I backed down to 8.o and over a period of months slowly raised the pressure to 10. I increased the pressure 0.5/onth over 3 months aiming to reduce the apneas in particular and then the hypoapneas. My AHI is around 0.8 now and the GERD and aerophagia are minimal. LIke you, I'm very careful with trigger foods and timing. I also reduced the exhale relief called Aflex so there was a little less drop in pressure. there are only 3 settings on this APAP machine. Maybe some of the Resmed users can help you adjust the EPR if you are using it so you can see if that helps as well.


Hopefully a few more folks will jump in here.....

silver