Upping the pressure, an experience

My initial experience with CPAP started about 3 or 4 months ago when I got my M-Series Auto. It started out good. I was extremely lucky to get a mask that fit AND sealed on the first try. I figured out I was a mouth breather so I started taping. I tried a hybrid mask which worked but I decided I hate nasal pillows so that mask is for bad allergies/colds only. Things were good but I am a tinkerer and I was always looking for improvement. After about three weeks I had the machine set to where my AHI was always below 4 and usually below 2. I think I had the min pressure set at about 10 and the max pressure at 14. It had been set there for about a week and a half. I was feeling good again but I woke up during the night once in a while gasping for air.

I needed to lower my AHI even more. So I continued playing with pressures. The first thing I did was set the Max at 20. I left it for a week and my numbers didn't get any better. So I started upping the min pressure. I followed the normal procedure of setting it and using it there for a week. I was setting it to the most common 90% pressure after recording it daily for a week (I reset the stats each day). The thing is, when I set it to the most common 90% pressure and recorded for another week the common 90% pressure was higher. So I upped it again. I did this until my Min pressure was 13. My AHI numbers were slightly better, more consistently below 2. Somewhere along this path I forgot that I was doing this because of the waking up gasping. I was focused on the numbers. I'm not sure when was the last time I woke up because of an apnea.

Now my minimum pressure of 13 matched my 90% pressure. I tried the min pressure at 14 briefly but it was really hard to breath out at that pressure so I lowered it back to 13. I thought OK, this is good enough. Well, after a couple of weeks at this pressure I noticed I was feeling tired again. That confused me because my AHI was now consistently below 2. I wasn't really having any allergy issues or anything that would make me sleep poorly. I wasn't waking up during the night either. My leak rate was fine for that pressure according to the mask manual. Nothing had changed to disturb my sleep... except the pressure changes.

I figured the higher pressure must be disturbing my sleep. It wasn't causing Centrals for me because my AHI was good. It must have been difficult enough for me to breath that it was disturbing my sleep, preventing me from getting the deep sleep that we all need. After thinking about it for a week and ruling out any other possibilty I finally decided to lower my pressure to Min 11. I felt much better again after the first night at the lower pressure. I have now been at the lower pressure for 3 nights and I'm again gaining my energy back.

Lesson learned. I was feeling good at the lower pressure and while trying to solve a minor issue I made things worse for myself. Sometimes good is good enough. And for all those who are thinking of upping their pressure to chase that 0 AHI, are you trying to solve a real problem or would it do more harm than good?

I have been sleeping on my side for over a year with cpap at 8-9 and AI below one. I decided to try again sleeping without a backpack so I raised the pressure to 13 and then 13.6 and then 14 with the top number always being 20. In the past my 95% number was typically from 12-14...last night it shot up to 16.2...so I must not have the lower pressure high enough as my AI is still over one and AHI still above 4. It's tough breathing out at 14-16...but I suspect one gets used to it over time.

Hmmm.... It logged me out before it posted it. That was weird. I'm the original poster for this one.