08-04-2015, 09:05 PM
(This post was last modified: 08-04-2015, 09:12 PM by TyroneShoes.)
My original prescription was 5-20. Wide open ranges are often prescribed for new patients, until the APAP data can reveal what the range should be, especially if titration does not occur in the PSG or is inconclusive.
I found that the machine "ran away" a couple of times and went up to about 18, which would wake me. I then looked at voluminous SH data and determined that on other than those two occurrences, my pressure never rose above 13, so I lowered the top limit to 14, and it has not risen above 12-13 since, and not awakened me.
Raising the low limit also can help. The APAP (ResMed, anyway, they are all similar) raises 1 cm at a time, 1 cm per obstructive event or FL event, so if the pressure you need at a particular time of the night is 12, and your low setting is 6, it will take a minimum of 6 events that you must endure first to reach that pressure. If the low limit was 10, it would take just two events to get there, so you've lowered your AHI for that stretch by as much as 66%.
But raising the low limit too much is not good either; it can cause more CA events and more preponderance for leaks.
Leaks, in fact, may be why my S9 "ran away". Sometimes leaks confuse it and it raises thinking there was an event to respond to. So the first thing to do is look at your leak rate during these periods, and try to get that under control going forward.
Thanks for the advice thus far. I have been on the phone to my sleep tech and with some persuasion they agreed to make some adjustments. So low pressure has been increased to 7 for the next few days to allow some adjustment (small steps) and in the next phase they will start to decrease my upper pressure from 20 to reduce the sudden pressure increase which is also waking me up. My 95% pressure is around 8-9. Leaks are very low overall but there have been some leaks that coincide with apneas and pressure increases in the AM hours. I have an appointment late next week and am hoping that there are some positive changes prior to that.