pressure settings question

When I had my sleep study the center set my pressure to 14 but recommended that I use the APAP to verify. My doctor and DME at the time set my old machine to 14 in CPAP mode and discouraged me from changing the machine to APAP mode stating that it was unnecessary. Thanks to the wonderful Squid13 who so generously provided me with a machine when I lost my machine, DME & doctor when I lost my insurance I have been able to use the APAP for the last 18 days. If I am reading the data below correctly my average pressure has been 9.97 and I am confused as to why the number is so different then the sleep center recommendation. I have lost 25 lbs since I started using the CPAP in Aug 2012 could this be a factor? Also can someone explain to me the difference between average pressure and 95% pressure? With my old machine (DeVilbiss IntelliPAP) my AHI was averaging between 8-20 and my leaks were averaging between 15-30 could the fact that my pressure was to high have actually been causing higher AHI and leaks? Thank you in advance for any feed back.

Average pressure is a median average.
95% number pressure just means that for 95% of the time you were at OR below that number...People tend to forget the "Or Below" part.

Regarding different AHI between brands....different algorithms and different definitions for the events. So really not a fair comparison.

Regarding apparently needling less pressure now...might be the weight loss. Might be the titration study recommendation was a worse case scenario...no way to know for sure. Titration study is one night out of a whole bunch of nights and we don't sleep the same way each night. Plus it's a foreign environment. My study recommended a pressure that was too low. It happens.

Your AHI for 18 days has been 0.2! Hey, that's great! How do you feel?
You know, if it ain't broke, don't fix it, right?

As NotLazy asked: how do you feel? For me...your leak rates are high (I know Pugs.... just sayin') but if you feel better, with such a low AHI, you are on the right track... Let us know....

Sheriff

NotLazyJustTired wrote:Your AHI for 18 days has been 0.2! Hey, that's great! How do you feel?
You know, if it ain't broke, don't fix it, right?

I feel good, much better with this machine compared to my other one. I have been really surprised by the differences. The humidity on the old machine could only be set between 1-5 but I could not set it above 3 without the humidifier running dry and every morning I was waking up with a bad case of dry mouth. The first night I used the new machine with the humidity set at 80* and I woke up with no dry mouth and the chamber still at least half full. Yea! It is so wonderful not to have that nasty dry mouth. I am however having to learn how to deal with "rain out" something I had never experienced before. The first time the water started nosily rattling around in the tube it scared me half to death, I though some kind of creature had managed to make its way into the hose. I was so relieved that only water came out when I checked the hose. It is a learning curve but I think I am starting to figure it out. I am noticing as it is getting warmer I am setting my humidity lower and lower (I think I am at 75* now).

Are you using the Climateline Hose?

Sheriff

Sheriff Buford wrote:As NotLazy asked: how do you feel? For me...your leak rates are high (I know Pugs.... just sayin') but if you feel better, with such a low AHI, you are on the right track... Let us know....

Sheriff

I am a bit concerned about my leak rate as well, I was reading another post that was made about using a chinstrap with the same type of mask that I have and I am going to try "create" something similar(I don't have and extra headgear is scavenge from) because most of my leaks are up at the top of the nose around the eyes where the mask rides up when I move in my sleep. Hopefully that will help me get my leaks down some. My AHI's have been a wonderful shock/surprise those "0's" amaze me every time I see one. I never had a zero day with the old machine.

Sheriff Buford wrote:Are you using the Climateline Hose?

Sheriff

yes I am Squid13 gave me one when he gave me the machine. I do have a question about it though, can I use it all year round or do I need to switch to my old hose as it continues to get warmer? I hope not, the other hose I have (from the old machine/DME) is 10ft long and much heavier than the Climateline hose and it used to pull at my mask, get kinked up and/or I got tangled up in it when I moved in my sleep. I have had none of those issues with the climateline hose, yet another point I have enjoyed with the new setup.

Hello memapenquin,

Though I am personally a big fan of downloads and all the wonderful help they can be, I'm leaning toward the sheriff on this one. There really are two sides to this issue. I have seen people with terrible data that felt great and some with perfect data that felt awful.

As far as mask type, the interesting thing about the late model masks is that you are supposed to start at the mid bridge point of your nose and then swing the mask down. Hopefully, the bottom of the cushion bisects your lower lip and your chin. I was really shocked just how important this little swing action is on the quattro fx.

Please keep posting progress, very interesting story. Good luck!

Jim

Here is a good video to watch for using the S9. http://www.cpaplibrary.com/machines.html

Hi - try setting your machine either just level with or lower than your head... water won't run uphill.

memapenguin wrote:

Sheriff Buford wrote:Are you using the Climateline Hose?

Sheriff

yes I am Squid13 gave me one when he gave me the machine. I do have a question about it though, can I use it all year round or do I need to switch to my old hose as it continues to get warmer? I hope not, the other hose I have (from the old machine/DME) is 10ft long and much heavier than the Climateline hose and it used to pull at my mask, get kinked up and/or I got tangled up in it when I moved in my sleep. I have had none of those issues with the climateline hose, yet another point I have enjoyed with the new setup.

I would use the ClimateLine until I got control of the rainout issue. Make sure the machine is LOWER than your head (water cannot travel uphill... unless it's pushed...). For one night, I'd place my machine either on the floor or on a milk crate or phone books to see if that helps on the rainout issues. Placing your hose on a hose hanger will also help on the rainout issues along with getting the hose off your body.

Sheriff

SleepWellCPAP wrote:Hello memapenquin,

Though I am personally a big fan of downloads and all the wonderful help they can be, I'm leaning toward the sheriff on this one. There really are two sides to this issue. I have seen people with terrible data that felt great and some with perfect data that felt awful.

As far as mask type, the interesting thing about the late model masks is that you are supposed to start at the mid bridge point of your nose and then swing the mask down. Hopefully, the bottom of the cushion bisects your lower lip and your chin. I was really shocked just how important this little swing action is on the quattro fx.

Please keep posting progress, very interesting story. Good luck!

Jim

The quattro fx mask I have is a small with a med headgear (my old DME said that there was no such thing as a small headgear, I have since learned that that was incorrect) both the mask and the headgear are actually a bit to big for me. Unfortunately this mask does not come in a smaller size (I wish) so if I put the top of the mask at the mid bridge point of my nose the bottom is actually below my chin and it will not seal at all. So what I do is put it at the top of my nose then hinge it down and the bottom is hitting the bottom of my chin but not dropping below it. I have to ratchet down the straps pretty tight to minimize the slippage not exactly comfortable but I do as best as I can with what I have. The mask does have a bad tenancy to ride up when I move causing the leaks at the top of my nose into my eyes. But I am going to try to make some kind of a chin strap to see it that will help. The only other mask I have is the Amara Full Face Mask with Headgear size petite and it is actual larger than the quattro fx small. The top of the forehead support is up in my hairline and the bottom of the cushion falls below my chin and no matter how I adjust it I can not get any kind of seal with it. It was something my old DME randomly mailed me without even attempting to fit it when her company stopped carrying the the quattro fx. I told her from the beginning that it did not fit and was useless to me, but she refused to exchange it or replace it. She said if I didn't like it I could order something different in 6 months but I lost my insurance so that became a moot point. As I am a serious mouth breather (awake or asleep) I hope to one day to be able to try a hybrid mask but any new mask is just not a financial possibility for me at this time.

squid13 wrote:Here is a good video to watch for using the S9. http://www.cpaplibrary.com/machines.html

Thank you for the link I will be sure to go watch it. FYI just so you know you are still my hero! I hope both you and your lovely wife are doing well. Thank you again for what you did for me I think of you often!

Sheriff Buford wrote:
I would use the ClimateLine until I got control of the rainout issue. Make sure the machine is LOWER than your head (water cannot travel uphill... unless it's pushed...). For one night, I'd place my machine either on the floor or on a milk crate or phone books to see if that helps on the rainout issues. Placing your hose on a hose hanger will also help on the rainout issues along with getting the hose off your body.

Sheriff

Julie wrote:Hi - try setting your machine either just level with or lower than your head... water won't run uphill.

The machine is set about 2" lower than my bed so with my pillow nest it is approximately 6" or 7" below my head. I may be using the term "rainout" incorrectly. What I am experiencing when I set my humidity too high is a buildup of water in the tube at the lowest point of the arch that makes a lot of popping, rattling type noises that startled the heck out of me the first time it happened. If it happens now I get up, empty the excess water out of the hose, than turn down the humidity a couple of degrees.