Prescribed Pressure

For those of us that have taken ownership of their own therapy, I was wondering what you have found regarding your actual prescribed pressure vs. the pressure you actually end up using?

So far, I've found that I really need about 2cm more than what was prescribed to be more effective.

I'm interested to hear what others have found.

My doc made a decision based on average whole numbers at my 90 day visit. I've tweaked that number several times based on the software, ending with a sweet spot of 0.4 less than his recommendation. This is where I see the lowest ai/ahi numbers, and feel the best.

In my sleep study, I was titrated to 16 cm. (with a few lingering events)......sooooo......my sleep doctor wrote my prescription for 18 cm.

I got my machine and software from CPAP.COM.

I "tried" the 18 cm. setting......for about an hour......and thought......WHOA!!!......that's too much to "start" with.

So, I reset my machine to 10 cm......and after four days, I downloaded my card.

Hmmmmm.......not too bad......think I'll let it ride for awhile and see what happens.

About a year later, I finally ended up at 12 cm........and that's where I've had it set ever since.

The main difference between the 10 cm. and 12 cm. was the reduction in the snore index.


Den

I, too, was titrated at 16cm. When I switched to an auto, it confirmed my 90% was 16. I have since put on a few lbs and it slowly creeped up to 17. I currently run 17cm CPAP, with 1 week of self-titration on APAP every 6 months or so. It's held steady at 17.

To answer your question, it appears my initial titration was spot on.

I was originally titrated at a pressure of 15 after a 3 nights home titration. But the mask I had then was terrible and I woke up often during the night with mask leaks and a high pressure "blasting" in my face. My doc finally prescribed an APAP (after I insisted on one) set to a very wide range of 4 to 18 (numbers came from him). I got the PR System One with heated humidifier and we set the A-Flex to 3 at the DME.

I've now been using this machine for close to 2 months. Less than a week into my therapy I realized that 4 as a minimum was too low so I upped that to 6 (and my doc modified my prescription a couple weeks ago). That is now far more comfortable and my 90% pressure usually varied between 7 and 8 and rarely peaks above 9 (highest it went to was 11). With my Activa LT, I get no leaks at all so it looks like my original titration was way off... My average AHI for the last 7 days is 1.4 so I'm doing very well... and feel better than I have in years!

My sleep study showed that I needed 15 for my max pressure. At my one month appointment the sleep doctor moved it up to 17 because I was bumping up against the 15 too much. Today is my 3 month aniversary with the therapy. When I went to my appointment last Monday the 15th I had lost over 10 pounds since the 1st of March and all of my pressure requirement readings are coming down, they said that as I continue to loose more weight they will probably need to lower the pressure some a little at a time.

I was diagnosed at 16, but after analyzing the results, I decided to try lower pressure. I am at 11and feeling great.

I used CPAP machine with preset pressure at 8. I frequently woke up at 2AM due to a mild nasal blockage. I bought S9 APAP machine and it helped me to sleep through the night. It worked so great. I just wonder why we want to use CPAP machine instead of APAP machine. Why we have to worry about the setting since the APAP machine can take care the pressure for us already.
Am I missing something? I asked my doctor but his answer confused me more.

TDN wrote: Why we have to worry about the setting since the APAP machine can take care the pressure for us already.
Am I missing something?

Yes, you are. I don't want to hijack this thread for a subject that's been cussed and discussed to death here, but here's the Cliff Note version:

APAP works by detecting events and bumping the pressure a bit. If that doesn't work, it bumps up another notch...until the events stop. If no more are detected, it eventually begins stepping down until it either reaches the lower limit or events begin again. That's a simplistic view of the process, of course. But the bottom line is, by it's nature, APAP allows unnecessary events. They are part of the mechanism. Another issue is that the constantly-changing pressure disturbs some people's sleep.

Because of those two factors, many (I won't say "most" even tho I believe it) patients get better numbers using CPAP at an appropriate pressure. I know I do. So I run CPAP normally, with a week or so of APAP every 6 months or so to ensure my pressure is the optimal, then I return to CPAP.