Should I lower the minimum pressure on my Autoset?

I was reviewing the summary data for the past year from my S9, and wondering if I would benefit at all from lowering the minimum pressure. The pressures are set at 10 min. and 15 max. The 12 month summary shows, Pressures ranges are 10.1 median -- 10.8 95th percentile -- and 11.4 maximum. The AHI is 0.3, with obstructive accounting for 0.3.

Is there anything to be gained by lowering the minimum (or even maximum) pressures? Thanks in advance.

yawnny wrote:I was reviewing the summary data for the past year from my S9, and wondering if I would benefit at all from lowering the minimum pressure. The pressures are set at 10 min. and 15 max. The 12 month summary shows, Pressures ranges are 10.1 median -- 10.8 95th percentile -- and 11.4 maximum. The AHI is 0.3, with obstructive accounting for 0.3.

Is there anything to be gained by lowering the minimum (or even maximum) pressures? Thanks in advance.

Yawny, I wouldn't change my minimum pressure. In fact considering your AHI, I would leave both pressures alone. You wouldn't want to lower the max by much and it's working as you have it set.

If you aren't having mask leak problems or aerophagia problems, there's no particular benefit to using a lower minimum. I'd leave it like it is. Looks like you're getting excellent therapy with the minimum pressure setting right where you have it. No need to change the max pressure either, since you're not hitting anything even near 15. I wouldn't change a thing if it were me, unless I simply wanted to play around with lowering the minimum, just for curiosity's sake to see what the data shows.

How do you feel? That's the most important thing.
I think the averages can be very misleading, at least for that long. How did the 1 year compare with 3 months?
I would look at the summary graphs and see what the pressures look like there. I think that will give you a better idea. Were the higher pressures 6 months ago? Do you still occasionally go to 14? What's the highest pressure you have hit in the last 6 months? Then decide.
If I hadn't been using the higher pressure for several months, I would drop both numbers by 1 and see what happened.

Yawnny.... Your numbers look very good. If your AHI and Centrals are less than 1 for the past week it looks like you are getting very good therapy. Someone here posted that it's best to bracket your 95% pressure by no less that 1 cm below it and up to 2 cm above. Lowering your minimum pressure may increase your AHI numbers.
But Lizistired has a very good point... How are you feeling? If you have good energy, and don't feel like you did prior to getting your machine, there's no reason to change the settings... unless you enjoy experimenting. If you do, keep a journal of your settings, your AHI, AI, and central numbers, leak rate, AND how you feel each day. Change one thing and record your numbers and how you feel for at least a week before you make another change. If you like Excel spreadsheets you could track your numbers there. After a while you can look at your data and see what worked and what didn't.
Have Fun,
Cindy

Sounds like you're dialed in perfectly!

Oh come on! Where's y'alls' sense of adventure? I agree your therapy is working fine, but if you don't venture out and explore the regions of the chart marked, "Here there be dragons," you'll always wonder what lies over the horizon. Prove it to yourself and only then will you be sure you have done all you can.

Try lowering the minimum pressure to about 8 and see what happens to your data over several nights. Most everyone agrees that the lower the pressure the better, from a comfort standpoint. If you notice your obstructive events have increased at 8, then try 9 and see what happens. Then maybe 9.5. And if your numbers are better at 10, then you can leave it there.

Have fun with this. Explore!

Slartybartfast wrote:Oh come on! Where's y'alls' sense of adventure?

I was thinking this myself.... I explored and I found it satisfied my "what ifs". In my case I went up in minimum to see if it brought any changes in AHI or how I felt.. From 10 min to 13 in stages.. no change at all in AHI or how I felt.

Not long ago I did go back down on the minimum to 9.5 from my usual 10.. I did see a marked increase in the clusters that I know I usually have in REM. When I use 10 cm min I don't get any clusters. So I found the line where I can't go any lower without increase in events and I also know that any more minimum doesn't really help so might as well use the lowest minimum that gives me the best results.

Bear in mind that I have the "let's do an experiment" mentality. I think it is fun to push things to the limit just to see how far I can push them. I do know it isn't for everyone though. I have had some disastrous experiments but I have also learned something along the way.

That's the spirit! It's not like you're a brittle diabetic experimenting with your insulin dose, where if you miscalculate you can end up in a coma -- or worse! Worst case you'll not feel as good and you can go back to 10. Best case you'll feel better and you'll know why.

The S9 Autoset is smart enough to keep your therapy working. There's lots of people who run their machines wide open at 4 and 20 cm at their doctor's direction and they do fine. Others have problems. Find out which camp you sleep in.

I am tempted to start a new thread, but since the topic of the leaky elephant in the room has been broached here already, I'll continue here for a bit.

Of all of the elements on the software report, mask leakage is one of the more confusing to me. I have searched for and read probably 100s of post on the topic, and I'm still not sure how it applies to me. My leakage rate seem high to me, yet some posts seem to indicate that a percentage can be compensated for and is acceptable.

First of all, I've tried many masks and the Swift FX style is the only one that I can tolerate, so other styles are pretty much out of the question. Over the past 3 months, my leakage rates have averaged, median 9.6 -- 95th percentile 32.2 -- max 42. During the same time pressures have been 10.1 -- 10.7 -- 11.2. AHI=0.4. Do the high leakage rates counter the other relatively good scores?

Speaking strictly about how I am feeling is kind of difficult. Sometimes I feel that I could use some more energy, but who couldn't. One thing for sure is that I no longer ever nod off in the middle of a conversation or decide that a micro nap while driving might be an acceptable idea. In this regard, I am 100% better than I was before CPAP, even with the leakage.

So, what say ye? Is this leakage acceptable? I am doing my best to adjust my mask and head gear to minimize leaking, but am also not certain that I am not sneaking mouth breaths during the night. I dunno. Thoughts, suggestions?

If you got the leak data off the 1 year report it may not be accrurate. What does the 1 month say? The leaks will interfere with your therapy. The machine can't tell you are having an apnea if all the air is going out your mouth.
How about posting an average nights detailed data. Show the Events, Flow, Minute Ventilation, Pressure, and Leak. Snore too unless it doesn't show any measurable snoring.
Nobody can give you advice based on 1 year averages.

You really used to decide that micro naps while driving were acceptable??

Lizistired wrote:If you got the leak data off the 1 year report it may not be accrurate. What does the 1 month say? The leaks will interfere with your therapy. The machine can't tell you are having an apnea if all the air is going out your mouth.
How about posting an average nights detailed data. Show the Events, Flow, Minute Ventilation, Pressure, and Leak. Snore too unless it doesn't show any measurable snoring.
Nobody can give you advice based on 1 year averages.

You really used to decide that micro naps while driving were acceptable??

Hi Liz, the most recent post was actually 3 months rather than a year. One month shows slightly better results than 3 but still pretty high on leakage.

I searched every permutation of "how to post rescan detail" with the search feature and came up with nothing. I know they are out there, but I can't find them. If you will point me in the right direction of how to extract and post chart details, I'll put a days worth up for closer examination.

Decide to take micro naps? No more so than "deciding" nod off in the middle of a conversation. Actually the word "decide" may be a bit of hyperbole, but I was certainly to the point of beginning to fade out of it enough to scare myself into pulling over and engaging in a bout of self face slapping and a few laps around the car to wake up. This was about 20 years ago, I had no idea that sleep apnea existed, nor did most of my doctors. It took some searching to find one that knew what was going on and what to do about it. I fear that there are still many out there in the same condition that I was in.

yawnny wrote:...pressures are set at 10 min. and 15 max. The 12 month summary shows, Pressures ranges are 10.1 median -- 10.8 95th percentile -- and 11.4 maximum. The AHI is 0.3, with obstructive accounting for 0.3...

If leaks are good, I'd try lowering it. The median means 50% of the time the pressure is 10.1 or less...since you're starting at 10, that's not much room (10--10.1). I'd try lowering to 9.6 and see what changes occur in your numbers.

Now, if leaks are high (you are setting the mask type right?), then it makes it hard to rely on the numbers.

Here's a resscan tutorial if you haven't seen it. It might help you get the screenshots the way you want them.
http://montfordhouse.com/cpap/resscan_tutorial/

Take a screenshot with your snipping tool, I use ScreenHunter(free).
Upload it to a site like PhotoBucket.com
Copy the location URL to your post here.
Hit Preview to make sure it looks the way you want.
Hit Sumbit to post.

Slartybartfast wrote:Oh come on! Where's y'alls' sense of adventure? Have fun with this. Explore!

I've had more than enough cpap "adventure", thank you! Too much fun and games seems to get me in trouble!