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[CPAP] Pressure Limited on Auto CPAP
#1
Pressure Limited on Auto CPAP
Yesterday I took delivery of a new Dreamstation Auto CPAP which had the default pressure range set between 4mm min. and 20mm max.  I used the CPAP last night and when I looked at the data today the actual  max pressure was flatlined at 5mm.  The AHI was 53.  Needless to say, I had a lousy nights sleep.

I'm thinking when I was crashing around trying to get familiar with the menu settings, that I accidentally set something that overrode the default 20mm max. 

Any suggestions about how to get my unit operating at the default max.?   My settings till show the default limits at 4 - 20mm.

Thanks for any help.

Dana
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#2
RE: Pressure Limited on Auto CPAP
Welcome to the forum,

Click on CPAP Setup in the black banner at the top of the page, follow the instructions and the manal will be emailed to you. It is a manual process so it will not be immediate.
While you are at it set the min pressure = 6 because most adults find 4 too low.

Also, and here is where you get the bang for the buck, download OSCAR and post your daily charts, see the Organize in my signature for what to include. And you will need a 2-32GB SD card for your machine.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#3
RE: Pressure Limited on Auto CPAP
G'day Dana, welcome to Apnea Board.

The pressure range of 4 - 20 cm is just the way it comes from the factory, it's not a setting you'd use in real life. Having said that, some docs and therapists use this wide open setting initially, with a view to narrowing the range later.

So a couple of things you'll need to get things under control:
  1. Get the clinician manual for your machine - see the link "CPAP Setup Manuals" at the top of this page. This will allow you to check / adjust the settings on the machine.
  2. OSCAR software. OSCAR will show you in great detail exactly what's happening with your respiration on a breath-by-breath basis. Click on the word OSCAR to download
  3. SD card to go in your machine to record the data (may already be one there)
  4. Copies of your prescription and sleep study report. We need the full report with charts and graphs, not just the summary. Remove any personal details (name, address, phone number etc) and attach the report to your next post.
  5. Any background information you can give us - age (approx), apnea symptoms, other illnesses (especially respiratory or cardiac).
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#4
RE: Pressure Limited on Auto CPAP
When you get the clinical manual you may find the DME has enabled opti start if they have turn it off as this will limit the machine max pressure rising by a small amount every night
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#5
RE: Pressure Limited on Auto CPAP
Thanks for this.  I turned off the Opti Start and narrowed the pressure range to 10-15mm.  Doing this reduced my AHI from 53 to 12, a big improvement.
So, the CPAP is giving me therapy now but I don't know if it is optimal.  Any suggestions for fine tuning the machine?

Cheers,  Dana
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#6
RE: Pressure Limited on Auto CPAP
post a copy of daily charts from OSCAR
That provides a solid basis on which to base advice.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

Download OSCAR
New to Apnea? Helpful tips to ensure success
Soft Cervical Collar
Mask Primer
Dealing with a DME
Organize Charts
Attaching Charts

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#7
RE: Pressure Limited on Auto CPAP
Attached are two files.  The first (ending in ...135) is from Feb 10 when I used the CPAP with the default settings.
The second file (ending in ...155) is from Feb 12 when I turned off the Opti Start function and narrowed the pressure
range to 10-15mm.

My CPAP is the Respironics Dreamstation Auto.

I appreciate all the help and I will make a donation.

Cheers,  Dana        
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#8
RE: Pressure Limited on Auto CPAP
I don’t have the expertise to advise you on further revising your pressure settings, but I just wanted to say what a dramatic demonstration your pair of charts gives of the ability of CPAP to address obstructive apnea. You went from an obstructive index of 29 to less that 1–wow!
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#9
RE: Pressure Limited on Auto CPAP
Seeing your CA's and your hypopneas, I think you may be better served if you turned off the Flex mode.  This would reduce any CO2 washout which can cause the CA's.  Also, it will increase your exhale pressure which may reduce your hypopneas. You can turn off the VS2 event flag.  You can get a VS2 flag by simply running the air hose rib against the edge of your nightstand.

How do you feel?
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#10
RE: Pressure Limited on Auto CPAP
Increasing pressure from 4-5 to 10-15 eliminated most of the obstructive events, but brought quite a bit of CA. As Crimson Nape suggests, you need to turn off Flex or use a Flex setting of 1 and see if CA events can be dropped. At this point, I think your pressure settings should be 9-10 and we can observe where this goes. It may take some time for you to adapt to the therapy and for CA events to dissipate. That is considerable progress and I think your results should continue to improve.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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