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Bad hour every night, should I change pressure range?
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Winterfrost Offline

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Posts: 33
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Machine: Respironics System One 560P
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit 10P For Her
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CPAP Pressure: 8-14
CPAP Software: SleepyHead

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Sex: Female
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Post: #1
Bad hour every night, should I change pressure range?
Seems like every night around 4:30a-5:30a I'll have a series of OA events. Night before last was a great example, see attached screenshots.

Pressure is currently set at 8-14, which seems to have been high enough (pressure didn't quite reach 14 even at the height of it). My fiance says I mouth-breathe sometimes, but the leak rate doesn't seem to be showing that -- it varies with the pressure as I'd expect it to. I do wonder why pressure came down while OAs were still going on. Makes me wonder if they're really being handled properly.

Any thoughts? Should I change my pressure range?


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02-25-2016 12:09 PM
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TonyJ Offline

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Joined: Aug 2013

Machine: System one auto 561CA
Mask Type: Nasal pillows
Mask Make & Model: Airfit P10
Humidifier: system one
CPAP Pressure: 8, 7-14
CPAP Software: SleepyHead EncoreBasic

Other Comments: also use the F & P Eson and Simplus masks

Sex: Male
Location: Winnipeg, Manitoba Canada

Post: #2
RE: Bad hour every night, should I change pressure range?
(02-25-2016 12:09 PM)Winterfrost Wrote:  Seems like every night around 4:30a-5:30a I'll have a series of OA events. Night before last was a great example, see attached screenshots.

Pressure is currently set at 8-14, which seems to have been high enough (pressure didn't quite reach 14 even at the height of it). My fiance says I mouth-breathe sometimes, but the leak rate doesn't seem to be showing that -- it varies with the pressure as I'd expect it to. I do wonder why pressure came down while OAs were still going on. Makes me wonder if they're really being handled properly.

Any thoughts? Should I change my pressure range?

I am no expert but considering that your 95% pressure is over 12 I would be inclined to raise my strating pressure upwards from 8 to something higher to hopefully prevent some of the events.
02-25-2016 12:19 PM
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PoolQ Offline

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Posts: 986
Joined: Jul 2015

Machine: AirCurve 10 VAUTO
Mask Type: Full face mask
Mask Make & Model: Amara View
Humidifier: Integrated
CPAP Pressure: 6.2, 15, PS4.0
CPAP Software: SleepyHead

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Sex: Male
Location: Sillicon Valley

Post: #3
RE: Bad hour every night, should I change pressure range?
Pretty sure you will get some good feedback on something to do. Those snores should not be happening IMHO. I would tend to agree that you low side pressure might be too low, will let others chime in about that. During 4:20 -5:20 the machine is working hard to stop the burst of OA's and eventually does, but it would seem like you could have better settings.

Again there are others around here that will be able to give you some great suggestions.
02-25-2016 12:30 PM
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OpalRose Offline

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Machine: PR System One REMstar Auto 560 with A Flex
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10 For Her
Humidifier: REMStar heated humidifier with heated hose
CPAP Pressure: Auto Cpap 10-13 AFLEX 1
CPAP Software: SleepyHead EncoreBasic

Other Comments: Started CPAP Therapy October 23, 2014

Sex: Female
Location: Northeast Ohio, USA

Post: #4
RE: Bad hour every night, should I change pressure range?
With a 95% reading of over 12, your min. pressure of 8 is too low too tackle the hypopneas, Obstructives, and snores.

Raise it to 9.5 or 10 and leave your max pressure alone for now.

OpalRose
02-25-2016 12:49 PM
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Winterfrost Offline

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Posts: 33
Joined: Feb 2016

Machine: Respironics System One 560P
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit 10P For Her
Humidifier: none
CPAP Pressure: 8-14
CPAP Software: SleepyHead

Other Comments:

Sex: Female
Location:

Post: #5
RE: Bad hour every night, should I change pressure range?
Thanks much! I will try that starting tonight.
02-25-2016 03:21 PM
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Ghost1958 Offline

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Posts: 957
Joined: Aug 2014

Machine: PRS1 Series Sixty Auto Aflex
Mask Type: Nasal mask
Mask Make & Model: F&P Eson
Humidifier: PRS1 with Heated Hose
CPAP Pressure: 10.5 min 16 max
CPAP Software: SleepyHead EncoreBasic

Other Comments: Moderate to Severe SA Obstructive. Rapid O2 desat off the machine.

Sex: Male
Location: KY

Post: #6
RE: Bad hour every night, should I change pressure range?
Machine is responding as designed.
Your min is to low. From the looks of it it should be set at around 10 to 10.5.
02-25-2016 05:07 PM
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Sleeprider Offline
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Machine: Resmed Aircurve 10 Vauto
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Post: #7
RE: Bad hour every night, should I change pressure range?
I agree the minimum pressure should be raised. You are having quite a bit of flow limitation and hypopnea throughout the night that should be improved with higher minimum pressure. I also wouldn't be surprised if this is related to sleeping on your back. Positional apnea often presents as clusters like this.

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02-25-2016 05:46 PM
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woozie38 Offline

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Machine: Fisher & Paykel Icon + Auto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: Integral
CPAP Pressure: 8 to 14
CPAP Software: SleepyHead Other Software

Other Comments: 17 years of CPAP + supp. oxygen @ 3 L/min

Sex: Male
Location: Toowoomba, Queensland Australia

Post: #8
RE: Bad hour every night, should I change pressure range?
(02-25-2016 12:09 PM)Winterfrost Wrote:  Seems like every night around 4:30a-5:30a I'll have a series of OA events. Night before last was a great example, see attached screenshots.

Pressure is currently set at 8-14, which seems to have been high enough (pressure didn't quite reach 14 even at the height of it). My fiance says I mouth-breathe sometimes, but the leak rate doesn't seem to be showing that -- it varies with the pressure as I'd expect it to. I do wonder why pressure came down while OAs were still going on. Makes me wonder if they're really being handled properly.
Any thoughts? Should I change my pressure range?

Your pressure setting & range would seem to be ideal, given the evidence provided by your data.
It's common for sleepers to change their sleeping position around 3:30 to 4:30am & later. By this time bones & joints are telling the brain to move. Most sleepers roll onto their back (supine) & then problems begin to occur.
Also you have significant leak rates which too is common for patients using the nasal route. Speaking from experience I can tell you that therapy air escaping orally defeats your treatment & is not easily remedied. There are quite a number of suggestions on this forum to fix this, but IMHO they don't work. I taped my mouth for six years before changing to an F&P Simplus FFM. Taping works best, but the FFM is a more acceptable approach for most patients.

[Image: signature.png]Keep on breathin'
02-25-2016 07:03 PM
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Winterfrost Offline

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Posts: 33
Joined: Feb 2016

Machine: Respironics System One 560P
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit 10P For Her
Humidifier: none
CPAP Pressure: 8-14
CPAP Software: SleepyHead

Other Comments:

Sex: Female
Location:

Post: #9
RE: Bad hour every night, should I change pressure range?
UPDATE: Last night I changed the min pressure to 10 per advice here, and what a difference! AHI last night was .54, with 1 very brief CA and 2 very brief OAs (spaced far apart). Just a few snores and if I recall correctly, no hypopneas at all! Even the leak rate seemed better - it may have been a hair higher (as you'd expect with higher pressure) but was much more level. Breathing was nice and even all night. Hurray! Big Grin

Thanks
02-26-2016 01:55 PM
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OpalRose Offline

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Machine: PR System One REMstar Auto 560 with A Flex
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Mask Make & Model: AirFit P10 For Her
Humidifier: REMStar heated humidifier with heated hose
CPAP Pressure: Auto Cpap 10-13 AFLEX 1
CPAP Software: SleepyHead EncoreBasic

Other Comments: Started CPAP Therapy October 23, 2014

Sex: Female
Location: Northeast Ohio, USA

Post: #10
RE: Bad hour every night, should I change pressure range?
(02-26-2016 01:55 PM)Winterfrost Wrote:  UPDATE: Last night I changed the min pressure to 10 per advice here, and what a difference! AHI last night was .54, with 1 very brief CA and 2 very brief OAs (spaced far apart). Just a few snores and if I recall correctly, no hypopneas at all! Even the leak rate seemed better - it may have been a hair higher (as you'd expect with higher pressure) but was much more level. Breathing was nice and even all night. Hurray! Big Grin

Thanks

Winterfrost
Happy that the pressure change made a difference. Keep watch on your 95% number, and try to keep your start pressure 1 to 2cm below it.

Just so you know that the 95% number doesn't mean you were at that pressure all night, but that you were at that pressure (and under) for 95% of the night.

Also, if your pressure starts to stay at max setting, let us know so we can help advise. It's all a learning process. You'll get there! Smile

OpalRose
02-26-2016 02:08 PM
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