Do AutoSets go higher than is necessary?

Is it possible that an AutoSet can reach levels that are over the necessary prescription? We are trying to establish a pressure setting. The AutoSet has taken him to a pressure of 17.6. This seems very high. The last prescription reading (which was 20 years ago mind you) was 12 but this man has not been using a CPAP machine for most of that time. He has decided to try again and is testing the AutoSet. Is it likely he really now needs 17+? We don't have a Clinician anywhere near so I suggested he try an AutoSet.

I had exactly the same thing happen several times before I set both the high and low pressures to about 2 cm from my 95% pressure.
Oddly, it never happened with my Devilbiss when it was set wide open (4-20).
Maybe it has something to do with the programming.

The older technology machines used to go chasing leaks with more pressure but these newer technology machines don't seem to do that now.
In general the machine won't go where it doesn't think it needs to go there for some reason but it might go chasing snores and flow limitations which it will perceive as a reason for more pressure.

What is the minimum that he has been using and what do his reports look like?
If the minimum pressure is too low and not optimally set then often APAPs will go higher trying to fix things and when the minimum pressure is more optimally set then often the maximum pressure actually will reduce and not go so high.
The 95% pressure number will also often reduce if the minimum is more optimally set. I have seen it often.
So going by the 95% pressure isn't always the holy grail of starting numbers. They can be and they can also be easily skewed.

Also just because it went to 17.5 doesn't necessarily mean he needs that all the time. Maybe it was a 30 minute REM stage sleep or supine sleeping that caused the increase in pressure needs.

I'm about to undergo another sleep study; it'll soon be almost 7 years since my last 2 night one; I don't know if my next study will be another 2 night one or a split night one. My current pressure is 18cm; if I'm diagnosed with a new pressure of 19 or 20cm could I tolerate that on a straight CPAP or would I be able to tolerate that increased pressure on an auto-set machine or might I have to start using a BIPAP device if my new pressure increases from 18 to 20cm? Who usually determines the kind of machine a patient will need to be on after having just undergone a new study? Will it be the doctor with the lab who interprets my test results or will it be my primary care doctor who is not a "sleep doctor" who will make the final determination on which kind of machine I will need to be on if my pressure does go from 18 to 20cm?



Stevoreno_55
MS Gulf Coast
04/26/14

I had my pressure set between 8 and 12, and it was nearly always at 12. But last night I did a test and set it between 7 and 10 and it still is very effective, ( about 3 AHI ) - so it seems to me that it might be the case that it can go way higher than you really need.

If your 95% is getting close to 20, you may need a bipap.

Sleepermustawake - why don't you try a test (of a few nights though, not just one) of raising the '12' to e.g. 15, and seeing what happens?

If yours routinely sits around 12, I'd think it's trying to tell you something, and just because a night when you lowered it to 10 did not cause a crisis (though AHI of 3 is not e.g. .5), it doesn't mean you were treated 100%.