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Changes to pressure range
#1
I have a few questions about tweaking my pressure range.  My average pressure after two years on my APAP machine is 11.1.  My AHI is regularly under 2. Over the first year, I slowly increased my starting pressure from the originally prescribed 4-20 range up to where I currently have it set at 10-20.  I would like to further narrow the range because I've read on here that a narrower range would be more optimal for treating any events.  Would it be ok for me to move my starting pressure up to 11?   I don't have any issues with starting at that pressure and don't like the ramp feature so that's been turned off long ago.  Is there any benefit to starting at any pressure lower than my average pressure?  I haven't analyzed my sleep data since early on so I have no idea where to set my max pressure yet.  I'll just keep it at 20 for now until I can upload my data.  For now, my question concerns moving up my starting pressure.

Thanks!!
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#2
While the narrower range performing better is true, PR machine are known for a much slower response than ResMed machines.  I wouldn't worry about it until you get more data.
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#3
IMHO the "narrower working better" applies to running the machine full open, ie., 1-20 on auto. I found running open like that didn't do as well as raising the minimum to a more reasonable level. However, I don't see the "better" in lowering the upper limit. If you start within 2 of average and leave the top end open I find that works best. In the event you have a bad night it leaves the upper range open with no adverse effects, and starts near a good value so it doesn't have too much drag to get where it needs to be. Hope that helps, that's just me.
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#4
I have found that, lowering my maximum pressure to one where the mask begins to leak excessively prevents such leaks as it won't then go that high. When I look at all the times my machine has increased pressure, it has never gotten over about 18.2, so I made my maximum 18.6.
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#5
Without knowing what kind of events you are having, the median and 90% pressure, it is hard to advise. If you are seeing pressure increases more than 3-cm in your current therapy, and have residual obstructive events, a higher minimum pressure may be needed. We have also found some people with flow limitation that end up with pressure too high. Balancing pressure should be done with some specific objectives in mind, to minimize pressure changes, address obstructive events, and avoid excess pressure that can give rise to CA or even OA events.
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