Technical Question- Is this even possible???

Quick backstory..Husband went for a sleep study in 2001, diagnosis moderate OSA...he could not tolerate the titration study. The situation became dire, so I lent him my APAP and a Full Face mask, and from Sep 16,2009 to March 21 2010, he used it. (with many bumps in the road, see my posts.) My homemade titration study shows Pressure at 10.2 (95th percentile), Median 9.4, Max 11.0, AHI 4.3, AI 1.1, HI 3.0. I had the APAP set at 13.0 max and 9.2 minimum.

He gave it up in March (hated it) , but went to our new Kaiser sleep apnea clinic a few weeks ago. They sent him home with a nasal mask,(he is a terrible mouth breather) and an APAP ,running wide open for a "home study.".

Today, we pick up the equipment and get the results. They have his pressure at 14!!!!

How is that possible?? Is it because he was leaking air like crazy from the nasal mask? If I had the machine set at 13.0 max and he never got above 11.0, I don't understand how he could be at a pressure of 14.
I guess someone needs to hang up their RT hat. Either me, or the real RT!!

Pressure needs can vary night to night. Besides, they may have titrated at 12 and thrown 2 more cm on top for good measure or something--who's to say?

That's not hard to imagine. In my sleep study, they titrated me to 16 cm......my sleep doctor "thought" I should have more, so he wrote my prescription for 18 cm. After "trying" 18 for less than an hour, I reset it to 10 and used that for almost a year before experimenting with 11 and ultimately 12. The only thing that the higher pressures affected were my snoring numbers......AHI was as good or better at 10.

It seems that many of these doctors tend to over-prescribe pressure.......although I've read many stories on the forum where the users were under-prescribed, too.


Den

My doc prescribed 20 and I've settled in just below 15.

XPAP treatment isn't Rocket Science, but some people in the business, shouldn't even be allowed to play with Sparklers. I'd be more likely to go with your method than his sleep study. In fact, I wonder why the sleep study at all, wasted time and resources to my way of thinging. He had a script written, get him a data capable machine and a FF mask, and have him get with the program.

since you were using a Resmed to test with, and they read high, he was probably being well treated. jim

We'll give 14 a shot, but only because they warned me not to change his pressure. "We don't ALLOW patients to do that sort of thing!" they said with a scary, stern look.
And these people clearly need their sparklers taken away

Lee Lee wrote:they said with a scary, stern look.

Given your knowledge and experience,
why are you even bothering w/these people?
You know what to do.

Just curious.

Lee, I wouldn't let them confuse you, you can get to the bottom of this far better than they can. Do you think nasal masks and mouth-breathing are the answer without taping? How about trying other FF masks sized just for him? Lots of questions to answer about the correct pressure, etc, but you'll get it figured out. Good luck and keep the faith!

I don't know that I agree with doing a home study with an APAP machine. You could use several brands of APAP and get different results. Has he had a sleep study done IN the lab? where the technician can watch for mouth breathing, arousals, positional apnea, etc? I know home studies are starting to make their way back again, but I still think ( bias? maybe ) going to a sleep lab is better than an APAP study.

Kaiser--at least in my region--doesn't do in clinic sleep studies. Everything is done at home and they titrate you on an auto machine.

Lee Lee wrote:We'll give 14 a shot, but only because they warned me not to change his pressure. "We don't ALLOW patients to do that sort of thing!" they said with a scary, stern look.
And these people clearly need their sparklers taken away

Lee Lee, I think you're doing a MUCH better job handling your husband's cpap therapy than Kaiser is.

And that statement from them... laughable. They "don't ALLOW" that, eh?

Do what you think best, I say.