Best lower and upper pressure settings - APAP

I think what Link is trying to say is that with CPAP, the pressure is constant all night long and therefore
minimum pressure = maximum pressure = 90% pressure = 10% pressure, or any other percentage pressure you might choose.

In that sense, a 90% pressure number for straight CPAP is meaningless.

Really? All of your studies indicate the definition of 90% includes "eliminates most or all apneas"? It's merely where (or below) you spent 90% of your time. Nothing more, nothing less. If you said it's at the top of the RANGE that "eliminates..." then you might have something.

But the definition does not mention "eliminating apneas". As I correctly said.

jdm-- Yes, I DID make that point early on. He tried to say it was relevant because the OP wanted settings for APAP.

Remember ol' "my way or the highway" Autopapdude? Two peas in a pod, methinks...

Apparently no one actually READS what is posted. I'm not going to rehash it all but why not READ the following:

they mention the PEFF value a lot, which is defined in the below link as: The effective pressure level (Peff) is the one that abolishes obstructive breathing disorders including inspiratory flow limitation and snoring in every sleep stage and body position

http://respiratory-research.com/content/9/1/56

And how is PEFF arrived at you ask, well I'm so glad you asked, from the link above: Then when completing an automatic CPAP titration, Peff value usually corresponds to the 90th or 95th percentile of the cumulative night time pressure response

If people can't understand black and white, that is another matter. According to the studies the 90/95 is FAR from meaningless and again NOT by my definitions by any stretch here folks.

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LOL, Link, its far too late to split hairs, you are out and out wrong and you now know it and it isn't me you have to debate it with, go ahead and email all the doctors that performed the studies.

LinkC wrote:90% pressure applies ONLY to APAP, not CPAP. And it's definition has nothing to do with eliminating the most apneas.

Guess I have to spell it out for you, as per above, Peff is arrived at by using the 90/95 (which duh is a range) and as the bolded statement above says, (Peff) is the one that abolishes obstructive breathing disorders including inspiratory flow limitation and snoring

So yeah, you're statement was wrong, and it can't be any more clear, not going to keep spelling it out.

Like I said before, someday, in a far far far away forum, you might actually win a debate......(maybe after you've done some READING)

Yes, effective pressure is defined by effectiveness in stopping apneas. Yes, Peff "usually corresponds" to 90% pressure. But, of course, not always or he wouldn't have said "usually"..

The definition of 90% pressure is completely time-oriented. The fact that the two are sometimes the same number does not change the definition of either.

I stand by Respironics' definition of 90% pressure (Which has nothing to do with preventing apneas...as I said.

But thank you for playing.

LinkC wrote:Yes, effective pressure is defined by effectiveness in stopping apneas. Yes, Peff "usually corresponds" to 90% pressure. But, of course, not always or he wouldn't have said "usually"..

The definition of 90% pressure is completely time-oriented. The fact that the two are sometimes the same number does not change the definition of either.

I stand by Respironics' definition of 90% pressure (Which has nothing to do with preventing apneas...as I said.

But thank you for playing.

Yeah you clearly are the "my way or highway" one here as you seem to know better than all the docs...

The usually obviously applies to special case people (like BI-PAP,etc), in which they would NOT use the 90/95 to arrive at someone's Peff. Otherwise they are using the Peff, which IS arrived at by using 90/95. READ the studies, you just might learn something (very unlikely given your posting behaviour though)

You stand by your statement, clearly the DOCTORS ARE ALL WRONG and were FOOLISH to use the 90/95 to get the Peff, otherwise known as someone's "Optimal Pressure". You are right, the 90/95 has NOTHING to do with the Peff, the Optimal Pressure that eliminates the most apneas.

Keep trying though, you look sillier each time

So, from all the blathering and name-calling may we assume you haven't found a definition of "90% pressure" as anything more than the pressure at or below which you spent 90% of your time?

Respironics wrote:The percentile pressure is the pressure at which you spent that percent of time at or below. For instance, if the report shows a 90 percentile pressure of 11, it means that 90 percent of the time you were using your CPAP, you were receiving 11 cm/H2O of pressure or less.

I don't see anything about how well it eliminates apneas in that definition, do you?

Not really interested in your twisting of what your sources said. I see nothing in those quotes that changes the definition I gave. It's apparent you don't either or you wouldn't be floundering around so much. You'd provide the expanded definition once and for all.

Time to put up or...you know.

Maybe I can make my point more clearly.

It certainly makes sense to talk about a 90 or 95% pressure during an automated titration, because the titration is done using an APAP, which varies the pressure in response to events. And it certainly makes sense to use that 90 or 95% pressure value to set the pressure on a CPAP.

However, for the patient using that CPAP, looking at a 90 or 95% percent pressure for a night on his CPAP would be meaningless. The CPAP maintains a constant pressure all night, so the 90% or 95% pressure is exactly the same as the pressure the machine is set to provide. The 90 or 95% pressure adds no additional information to the party.

And it would be nice if we could maintain a friendlier tone around here.

jimnsc wrote:In your learned opinions, what would be the best upper and lower settings on an APAP machine for a prescribed pressure of 9?

I look forward to your responses and thanks.

If it was me Id set my minimum as a 9 and leave it wide open to 20. I use my CPAP pressure as my minimum I dont do the regular APAP thing. Worked really well for me for several years. Now I need a new titration, think my pressure needs raising. I might switch back over to straight CPAP for the adjustment if they significantly raise my pressure.

Eric