Newbie - Question about Pressure Setting

I am recently diagnosed with severe obstructive sleep apnea/hypopnea. I had one sleep study. While I was monitored for 7 1/2 hours, I actually slept 3 hours and 48 minutes. REM was delayed 5 hours and 13 minutes. The diagnostic portion of my study was 2 hours and 3 minutes. During that time, my AHI was 50 events per hour. Arterial desaturation was to a low of 86%. I was titrated to 7-cm HWO and my AHI reduced to 14 events per hour most of which were brief central apneas. My SpO@ remained above 90%.

When I mentioned this to a sleep study expert at a public presentation, he was very surprised that my pressure was only at 7 as he indicated that he finds virtually nobody who responds at that low level when they have severe apnea. Any thoughts about that?

Incidentally, I was given a RemStar Plus cpap machine (the most basic).

Thanks.

Hi Ray, interesting stuff!

Just a couple of thoughts. Firstly I noted that your apneas when titrated were central apneas - and these can actually be made worse by higher pressures (although by no means all the time).

Secondly, 7 is fairly low, but by no means unusual, there are plenty of people on this site who are at about that level - if it works, don't worry too much.

However, I too was titrated at about 7.6 and for me that was a disaster! I had been titrated with an automatically adjusting CPAP machine but when I actually used a ordinary CPAP it simply didn't do anything for me except frustrate me. I have since moved onto an auto-CPAP (APAP) again and it has reduced my AHi to less than 3 on an average night. However, my pressures now range from 8.8 - to - 12.6 (with a cold). APAP gives you what you need and as such tends to look at your restrictions and respond with higher or lower pressure as needed.

If you are worried about the 7 being a little low, why not ask to try an APAP - or rent one for a while and see if it makes a big difference. However, I would also talk to your sleep doc about the central apneas to make sure they aren't to serious.

One last note: When I was titrated I to was said to have brief central apneas and my sleep doc took one look at them and said - 'nothing to worry about - ignore them.' He was right - it was probably much more to do with the sleeping environment than anything to do with central apnea problems.
sir_c

Your sleep expert does not seem to be all that much of an EXPERT if he thinks there is a link between severity and pressure setting.

IIRC, many have posted that there is no connection between severity and settings.

It is counterintuitive, I know, and I would like to see any such links.

I could be wrong.

tomjax wrote:Your sleep expert does not seem to be all that much of an EXPERT if he thinks there is a link between severity and pressure setting.

IIRC, many have posted that there is no connection between severity and settings.

It is counterintuitive, I know, and I would like to see any such links.

I could be wrong.

So True! They must have got him cheap.

I second that to the previous posts. No correlation between the two.

I was diagnosed with "severe", and titrated at 7. My auto 90% pressure stayed at 7 for 3 years with the Nasalaire prongs. Now, with my Aura, I'm at 8.

The main question is, how well is it working for you? If you feel good, the CPAP is probably doing its job. I'd go back for another sleep study when you can, though, to see if they can get that AHI lower.