12-27-2015, 11:53 PM
(This post was last modified: 12-28-2015, 12:29 AM by vsheline.)
First of all, your Min Pressure is way too low. Unfortunately, all too often doctors do not pay attention to the titration results and prescribe pressure settings which are wide open.
The Start Pressure for the Ramp and even the Min Pressure which follows the end of the Ramp are mostly comfort parameters which should be adjusted according to patient preference, unless the doctor wants a higher Min Pressure. But the Min Pressure should never be set a great deal lower than the pressure you need a significant amount of the time.
I recommend having the Min Pressure set not lower than 6 (and preferably not lower than 3) cm H2O below the 95 percentile pressure. The 95% pressure is the pressure your mask was at or below, for at least 95% of the time; it is also the pressure your mask was at or above for at least 5 percent of the time.
Between obstructive events which cause the pressure to be raised, the Min Pressure is treated by ResMed machines as a target which it is always trying to get back to within 20 minutes. The lower the min pressure is, the faster the pressure decays between events, leading to more events occurring because the pressure becomes too low, too quickly.
However, the Min Pressure won't need to be raised to 10 or higher if you can lower how much pressure you need, meaning if you can get the 95% pressure to stay a lot lower than 16. And we can usually lower how much pressure we need (by a lot!) by avoiding sleeping in the supine position. I think most patients find they need to take precautions to make sure they are never rolling onto their back while asleep.
If you need to use the ramp, I suggest having it's Start Pressure raised to like 6 or 8, or whatever is comfortable. If you do use the Ramp and the Ramp is in AutoRamp mode, the machine will hold the pressure at the ramp Start Pressure until you fall asleep (or until it gives up waiting for you to fall asleep) and then will fairly quickly ramp the pressure up until it reaches the Min Pressure, after which it will respond to obstructions or stay steady. Or, you can use the Ramp in timed mode, in which it does not wait for you to fall asleep, it just starts gradually increasing the pressure to reach the Min Pressure within an adjustable time limit.
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Agree bring your min pressure up to 7 or 8.
Your max and 95% will come down.
The mn is way to low. Taking your machine to long to get up where it needs to be.
WELCOME! to the forum.!
Much success to you with your CPAP therapy and getting it fine tuned to meet your needs.
Hang in there for more responses to your post.
Yet another vote to set th minimum pressure to 7 or 8. Then after a week or so look at your max see if you can gradually lower that.
You don't want the machine to be so restricted that it can't reach the required pressure for proper treatment,but you do want keep the range as close as possible to your upper and lower requirements.
I tried minimum of 6 last night and had better results. 5.8 AHI. I will move it to 7 tonight and see if it gets even better.
Thank you for the responses.