Pressure settings?

A question about changing pressure settings yourself. I have a Resmed S9 Escape Auto. (NOTE I know now that I got a brick and it offers very little information. I don't need any replies as to "You got a brick".) When I did my titration test it was set up for 8cmH2o. I've been using the machine since August of this year. The DME had it set to APAP. To make a long story short, I changed the machine back to CPAP and have adjusted my pressure settings to start out at 8 and when ramping up using the EPR level at 1, for a 10 min ramp period. I have the max pressure set at 12cmH2o. My AHI has been running around 0.2 - 0.8. Once in a while I'll have a bad night and it might get as high as 2.? I'm using a chin strap and a Mirage SoftGel nasal mask. I have my humidity level set at 2. I'm starting to feel pretty good in the mornings and I don't wake up at night near as often as I use to. Ok now the question? Should I leave well enough alone or should I try setting the machine back to 8cmH2o and see what happens. The times that I start getting the higher AHI is usually when I start having a COPD attack. When the COPD attack occurs all bets are off for the rest of the night, cause I have to try and get that under control. Another note after spending a lot of money on CPAP bed pillows of different kinds I finally wound up going back to the pillow that I had when all this started. Just can't seem to get comfy on the CPAP pillows or the buckwheat pillow.

In the interest of science it would be enlightening to see what happens if you gradually adjusted your pressure back to the original setting.

However, if what you have now is working, I would suggest you put the science experiment off until you are fully recovered from any sleep debt that you have built up. After you are totally healthy, you will be in a much better position to "play."

You've got it a little backward Tim, cpap mode is straight pressure at one setting, auto is a range of pressures. You are using auto if you have a range from 8 to 12 and I would leave it there as your ahi is good. As long as you keep the leaks to a minimum, you will keep the good numbers. The big question is...at which level do you FEEL better, cpap or auto? Its all about keeping your ahi below 5 and having little or no leaks and FEELING GOOD!
Your decision to make, but if I was feeling good at the setting its at...I would leav e it alone.

nanwilson, I have the machine set in cpap mode. It has a feature that allows me to set a lower number for a certain amount of minutes before it ramps up to the higher setting. Suppose to be a comfort feature. In APAP mode it's suppose to sense what my needs are. I tried that mode and it allowed the pressure to build all the way up to 19.6. That morning it felt like my lungs were bruised. In the CPAP mode once it gets to the higher setting it stays there all night and doesn't move unless I turn the machine off and then back on. At that time it starts all over.

Do you mean you are starting the ramp at 8 for 10 minutes so you are at 12 on cpap all night?

If the DME set it up on APAP, what was the pressure range? You said it was set at 8?

How did you decide on 12 for your cpap pressure?

Did you get copies of your sleep study reports?

In any case Tim1956, your AHI is great the way you have your machine set up now. I would leave the machine as it is- good job.

Mary Z wrote:In any case Tim1956, your AHI is great the way you have your machine set up now. I would leave the machine as it is- good job.

But AHI numbers can be misleading. I had a 0.2 AHI last night, but my leaks were such that my O2 dropped below 90% for 2 hours and at one point to 81%. I felt like crap when I woke up.
AHI isn't everything. There is still confusion about his machine settings. I can see running in AUTO 8(titrated)-12cmh2o, but that's not what he's saying.

Lizistired wrote:Do you mean you are starting the ramp at 8 for 10 minutes so you are at 12 on cpap all night?

If the DME set it up on APAP, what was the pressure range? You said it was set at 8?

How did you decide on 12 for your cpap pressure?

Did you get copies of your sleep study reports?

Lisistired yes it starts out at 8 for 10 minutes and then stays at 12 the rest of the night.
When the DME set it up on APAP the range was from 4 - 20
I got the setting of 12 by just trying different settings on my own. Along with different types of masks.
and finally no I didn't get a copy of my sleep study report.
I'm finding out that there's a lot of information that I don't have. Should I ask the DME for a copy of the sleep study or ask the Doctor?

Tim1956 wrote:

Lizistired wrote:Do you mean you are starting the ramp at 8 for 10 minutes so you are at 12 on cpap all night?

If the DME set it up on APAP, what was the pressure range? You said it was set at 8?

How did you decide on 12 for your cpap pressure?

Did you get copies of your sleep study reports?

Lisistired yes it starts out at 8 for 10 minutes and then stays at 12 the rest of the night.
When the DME set it up on APAP the range was from 4 - 20
I got the setting of 12 by just trying different settings on my own. Along with different types of masks.
and finally no I didn't get a copy of my sleep study report.
I'm finding out that there's a lot of information that I don't have. Should I ask the DME for a copy of the sleep study or ask the Doctor?

Contact the sleep lab where your study and titration were done and request full reports and condensed graphs for both studies and a copy of your prescription if you don't already have it. Your DME just got a copy of it from your doc or the lab and they prefer that you don't have it.
It sounds like your titration wasn't successful if they started you out on 4-20. But you said your titration set you at 8cmh2o? Do you know what your prescription said? Or why the DME didn't set it at 8? Did you have a follow up after 30 days on 4-20?
sorry for all the questions but something doesn't make sense.
Stick with the pressure that makes you sleep the best and feel the best. Have you tried an auto range of 8-12?