CPAPtalk.com

JohnBFisher wrote:Hmmm... No multiple choice ...

My EPAP pressure is 10. My IPAP pressure varies from 13 to 25 cm H2O. Yup, 25 !!!

Did I mention that using an ASV can be "interesting"? ... But then that's the ventilator part of the machine. And my machine definitely has to ramp up occasionally to provide the pressure I need to sustain my breathing.

So how does one vote for an ASV? Based on the IPAP? Use the median pressure? Min support? Max support?

And yeah, 25 must feel like it'll blow your head apart.

What it can show (Hey, I'm on BiPap, I used the higher number because that's the one that's actually keeping my airway open, the lower one's just relief while exhaling) is "OKay, so my 14 is a little higher than most, but not out of the realm of normality...okay...that makes sense."

Which has value, maybe not for the hyper driven "I'm going to hack my machine so it behaves *exactly* as I want it to and my doctor can stuff it, I know best" crowd, but for the clueless newbie (hi, that's me) who's trying to figure out "OKay, so I have this machine, and they gave me a brief orientation on how to use it, but nothing really on what in the heck is going on...HELP!!!!" person, every little bit of reassurance doesn't suck.

My pressure is at 11, that's what I started out with a year and a half ago and I'm still there. I have my pressure on straight cpap and check it on my auto every so often to make sure I'm still in the zone. Feel better on straight cpap than auto, so that is where I will stay.

Nan, when you check, what settings do you use for auto?

ameriken wrote:... So how does one vote for an ASV? Based on the IPAP? Use the median pressure? Min support? Max support? ...

I suspect one does NOT. Or just use the EPAP pressure. But 10 just does NOT explain what I see every night.

ameriken wrote:... And yeah, 25 must feel like it'll blow your head apart. ...

Of course, that's on the Resmed unit. When I take a nap with my Respironics unit, it ramps all the way up to 30. That's a pretty stiff wind!

I look forward to a new unit in a couple years when I can better track patient triggered breathing, since I suspect it is not as good as it should be. My newer, replacement Resmed ASV unit is starting to squeal by morning. I suspect that indicates it's having to work much harder than it should.

DoriC wrote:Nan, when you check, what settings do you use for auto?

Morning Dori
I just set my auto from 10 to 15 and it usually says my median is 10.6 to 11. At straight 11, I usually have 0.0 to 0.2 ahi......can't complain at that.
My best to Mike.....
Nan

14

Mine is 14. I was diagnosed for 10 but my apneas were still in the teens with that.. so I started the apap from 8 to 14 and my 90 percent pressure was 13.9. So I set it on 13.5 and still getting apneas not as high but I thought it could be better.. so set it at 14 and now apneas are around 2-4 per night.. not bad.. I will take it.

Dr. didn't know where to set mine, so he set it 5-15. I was having still some obstructives and rising number of centrals, they looked at the data and set it to 5-20. It went to 20 trying to "fix" me and damn near blew my face off so I set it back to 5-16 and found a way to sleep on my side/tummy where my sleep study said I did better and... wa-la! Much better stats, lower average pressure, tho that is still around 13.5. On Wednesday I go to the Dr. again, this time with a month of data for the official pressure determination.

Titrated on APAP at 11 cmH2O - 17 cmH2O. Adjusted it to 12 cmH2O - 18 cmH2O about 3 - 4 weeks ago due to increased AHI and not waking up feeling well. I may up the high number by 0.5 or 1.0 soon as I am hitting 18 cmH2O more frequently some nights, according to Sleepyhead, and don't want to limit the machine.

John

Edit on 03/03/12: Pressure now for APAP adjusted to 14 cmH2O - 18 cmH2O. I think I have found my 'sweet spot', as I am waking up feeling rested and have consistant low AHI's from 0.12 - 2.09 for over 2 weeks now... YES

I use my APAP in auto mode, range from 14-18, so none of the choices really fit.

I was prescribed a range of 9-15. Through a series of trial and error tests, I found that 11-15 works best for me with Auto set to 2. Now I am trying the machine on straight cpap at 12.5 and have added a bacteria filter. This is still a work in progress. Have been on straight CPAP for only 2 days. AHI was 1.4 & 1.5. So we will see how it goes. If I don't hit and 0.x in the next week, I will raise the pressure to 13, or I can always go back to 11.5-15 which worked will with the bacteria filter. Without the bacteria filter I got my best AHI at 11-15. As I said, still a work in progress. I'd like to see my AHI consistently in the 1.X-0.X range.

Okay, I'll add my two cents to this purposeless survey. I started with a 7. I was retitrated in late October, Early November to 12. Result: I fell much better!!!

I started at 9cm 5 years ago.

Recently had another study done and now running CPAP mode at 12cm.

AHI's been < 1.5 and I have been feeling great.

16