Should I up my pressure?

My prescription is for a pressure of 14. Since I've been trying to use CPAP in fits and starts over the last 2 years and was never really successful (until now), my GP suggested lowering the pressure to 10 while acclimating to sleeping with CPAP. I slept 3-4 nights last week successfully at a pressure of 10 with an average AHI of 1.1. I upped the pressure to 12 two nights ago and had one ok night, one successful nap, and one very successful night last night. My AHI last night was 0.81.

Should I try to up to pressure to the prescribed level of 14? Is 12 to 14 a huge jump, should I slowly up it by .5 each night for 4 nights, or just try 14 tonight?

I started noticing a little bit of leaks around my nostrils when I upped to 12, tried the S pillows, but I'm back on the XS because the smalls make my nose hurt after a few hours. If I do up to 14 should I expect more leaking?

I would leave it at 12 and see what the AHI wants to continue to be. You can't really expect to get much lower than 0.81 AHI so unless this AHI is a fluke why use 14 cm when lower gets the job done?
Heck I might have left it at 10 cm.. AHI was still well under 10.

But your choice.
If you do want increase your pressure..yes, go up in 0.5 increments. It will be much easier on you.
I have experimented in this range and the difference begins to get more noticeable. While one does adjust to it..might as well take the easy road. Especially since your AHI is so very well controlled now. There is no pressing need to get to 14 quickly.

Why go higher when even a 1.1 is great at a 10 setting? You're trying to fix something that isn't broke. The goal is to get 5 or under, once you are there you are in the normal range of a person who would not be diagnosed with sleep apnea.

The big question is, Are you feeling better?
The numbers aren't everything.

If it's easier to sleep at 10cm (or 12cm) than it has been when you've tried 14cm, and
If the AHI remains nice and low (and an AHI = 1.1 is fantastic) when you sleep at 10cm, and
If you are feeling well during the daytime when you sleep at 10cm,
Then there's no compelling reason to increase the pressure.

Now, it could be that long term a pressure of 10cm won't be enough. But I'd say give it a week or two at 10cm to see what the longer term trend in AHI at 10cm actually is before concluding that you need more pressure.

'Tis better to sleep well with an AHI in the 1-3 range (heck even the 3-5 range) and function well during the daytime than it is to sleep poorly with an AHI close to 0.0 because you're fighting with leaks, pressure, and discomfort for significant parts of the night.

Agree with the others! Leave it at 10 and check back on it in a few weeks, see what your average AHI is. If it remains low like that I'd just leave it at 10. If 12 makes you feel better that's ok too, but why go any higher? You probably won't get a better result with a higher pressure.

robysue wrote:'Tis better to sleep well with an AHI in the 1-3 range (heck even the 3-5 range) and function well during the daytime than it is to sleep poorly with an AHI close to 0.0 because you're fighting with leaks, pressure, and discomfort for significant parts of the night.

Is there a category for "Best Quotes"? Ah yes, it only took me 2yrs to figure that one out!!

Just my personal opinion, your ahi levels are great and you are being successful. Perhaps 12 is enuff. All you can do is go up to 14 and see how it goes, leaks and all. If its too high, you might not sleep as well and since you are doing so well, why mess with success. Just depends on how you are feeling.

adrianne wrote:My prescription is for a pressure of 14. Since I've been trying to use CPAP in fits and starts over the last 2 years and was never really successful (until now), my GP suggested lowering the pressure to 10 while acclimating to sleeping with CPAP. I slept 3-4 nights last week successfully at a pressure of 10 with an average AHI of 1.1. I upped the pressure to 12 two nights ago and had one ok night, one successful nap, and one very successful night last night. My AHI last night was 0.81.

Should I try to up to pressure to the prescribed level of 14? Is 12 to 14 a huge jump, should I slowly up it by .5 each night for 4 nights, or just try 14 tonight?

I started noticing a little bit of leaks around my nostrils when I upped to 12, tried the S pillows, but I'm back on the XS because the smalls make my nose hurt after a few hours. If I do up to 14 should I expect more leaking?

Thanks everyone for the replies. I only feel compelled to up to 14 because of the prescription. I guess I feel a bit guilty, cause my GP told me to go back to the sleep doc and have the pressure turned down, but I just did it myself.

I guess I just needed reassurance that I was doing ok.

Thanks all!

During your sleep study, were you sleeping on your back? It may be, that for that one night, you needed 14 to have no apneas. If now, you're sleeping on your side, that may account for the lower pressure.

I found that after a year or so, I needed a little more pressure, and I think it's because I started to have more REM sleep and also, would occasionally sleep on my back rather than my side (due to back or shoulder pain).

You're doing great! As others have said, watch it for awhile, and don't rush to make changes. I occasionally have a "bad" night, where AHI is higher, but still under 2, then the next night it's back down again.

Hi Katie! Nice to see you again after so long!

Don't worry too much about what the prescription says... If I'm understanding correctly, that prescribed pressure is based off of a single night's sleep 2 years ago. Lots can change in 2 years.

If you're still having guilt over sticking to the lower settings, run the numbers by your GP and see what he says. I'm sure he'll say that you're fine to stay at 10 or 12, as long as your AHI is good and you feel good.

No, your AHI is excellent.