What am I doing wrong?

Thanks for the reply John really appreciate it. I am quite overweight so hopefully losing some weight will help bring the need for pressure down. I really do not want to go spending more money on another machine. Luckily in Aust our sleep studies are free so I will schedule my follow up titration test to get a formal prescription as well.

If I am maxing out the machine at 20 apparently I can increase the level in the clinician menu. Can anyone confirm this?

Joshaldo wrote:If I am maxing out the machine at 20 apparently I can increase the level in the clinician menu. Can anyone confirm this?

Josh,

Your machine can only produce a maximum of 20 cm of pressure. BiPAP machines typically go to 25 cm, and ASV machines typically go to 30 cm. I don't think you would want to use a single pressure machine too much above 15, even with exhale relief turned on. A BiPAP can make these high pressures much easier to deal with.

-john-

Again....hitting the max or getting close to the max of 20 cm may be a by product of the minimum pressure being a bit low.
We need to see a pressure line graph...from sleep onset to when you wake up. Not a zoomed in pressure line graph. So Pressure line graph and its corresponding event graph and leak graph.
And yes, a bilevel machine is easier to use at higher pressures but even they have to have a minimum set appropriately.
APAP wide open 4 to 20 with pressure needs above 10 most of the night is not an optimal setting.
Not to mention the fact that the wild variations can be especially disturbing to a newbie not used to these pressures anyway.

Ok thanks guys. Here is last nights data:



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Your minimum pressure of 4 is too low. How was this setting obtained? Are they using this to find optimal pressure settings or is this what you were supposed to have forever?

Please read this thread here. Perhaps seeing what I have been trying to say will help..
viewtopic.php?f=1&t=39869&st=0&sk=t&sd=a

Ok checked the thread out, makes sense. Should I set minimum to 10 or higher you think?

First of all. Are you comfortable making any changes yourself? If the 4 to 20 settings was an experiment to find the best settings and not meant to be forever...I would sure change it but I am not you.
That is why I asked if there was a special reason for the wide open range. Will your health care providers have a screaming fit? Are you okay with it if they do?

That said...I don't know where you would need to be to level things out but I wouldn't jump right in at 10cm first thing.
A jump to 10 (or higher) may or may not be needed but it will sure feel like a hurricane compared to what you are using now.
I would go up in stages and watch the reports as I go up with the minimum. It will be easier adjusting and you might get lucky and find that you don't need as much minimum as it first appears to.

If it were me...I would do 8 minimum for 3 or 4 days...watch the reports...do 9 minimum 3 or 4 days..then do 10 cm....etc. So twofold...easier to adjust and you will get a better idea where you need to go by going up slowly.

Ok cool, I will set it to 8 and see how it goes. The only reason for the original wide gap is that is how the machine came to me from secondwind. I originally had an overnight sleep study done where I was diagnosed with having severe OSA. I didn't do the follow up titration test thinking the autoset would be ok to do the job. The instruction manual you PM'd me, will that be able to show me how to change the minimum pressure for the s9 autoset? Once again thank you for your help.

Joshaldo wrote:The instruction manual you PM'd me, will that be able to show me how to change the minimum pressure for the s9 autoset?

Yep. It sure will and if you need further assistance there is a video.
http://www.cpaplibrary.com/machine-education

And now that I know you are self titrating...I am comfortable with offering you ideas. I just hate to step on doctor/s toes...well maybe not hate to...but some people aren't comfortable with taking charge of their own pressures so I never know till I ask.

You probably will need a higher minimum but there is no harm in going up slowly...it will make adjustment easier and give you a chance to perhaps get lucky and won't need something near that 16 cm mark that it wants to stay at.

BTW...are you using EPR? If so at what setting? It's okay to use it..we just sometimes have to allow for its use.

Ok, am about to change the start pressure to 8 and see how it goes. EPR is set to full time at a level of 2 if that affects anything. Ok changed minimum pressure to 8 and start pressure to 6. Anything else you would suggest to trial? Cheers

Well last night was the worst night with my mask being the problem for some reason. It felt like it was leaking heaps and I had to tighten the straps real tight to stop it which made everything really uncomfortable. I ended up using the machine for only an hour and a half due to the leaks and how uncomfortable it was. Increasing the pressure though was good for keeping my AHI down though for that short duration.

Leaky nights happen. It is a war that we never quite win totally.
EPR is fine at what you are using.
Get some more hours with 8 cm minimum and then we evaluate things again.

Ok, not much seems to be changing with the 8cm minimum. My AHI is still around 7-8 and at the start i feel like the pressure is not enough. Also the top of my nose is getting sore from the mask, any way to fix this?

I am pretty much zero help with over the nose masks. I have never used one.
If you are tightening things too tight it actually defeats the mask and will cause more leaks and more discomfort. Also a mask liner might help. Perhaps someone has some specific hints for your mask type.
I am pretty much solely a nasal pillow girl.

I didn't really expect 8 cm to do much except let you get used to the pressure. Try 9 cm and see what happens.