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[Diagnosis] Spending long times at APAP top pressure
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jpapnea Offline

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Post: #1
Spending long times at APAP top pressure
I use a Resmed APAP S9. Some of my sleep time is spent at pressures of 12-14 cm-H20. However, I often spend extended periods (~1 hr) at my top setting of 18 cm-H2O. During those times, though I usually only have several hypopneas, the Flow Limitation is at or near the top level.

Does this impair my sleep quality significantly and, if so, do you have suggestions for improvement?
01-05-2013 09:15 AM
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Shastzi Offline

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Post: #2
RE: Spending long times at APAP top pressure
Easiest and cheapest way to get a read out on that is to use a Zeo.
That will log any significant awakening events based on your brainwaves.
If you didn't record an awakening event it probably was not an issue.
***
However, if you are recording awakenings that coincide with your hypopneas then you
might want to start using a wearable logging pulse oximeter to see if you are going into actual O2 desaturations that
are then waking you up...
If that is happening, YOU need to know about it so you can correct for it.

Wink
01-05-2013 09:27 AM
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jpapnea Offline

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Machine: Resmed S9 Autoset
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Post: #3
RE: Spending long times at APAP top pressure
(01-05-2013 09:27 AM)Shastzi Wrote:  Easiest and cheapest way to get a read out on that is to use a Zeo.
That will log any significant awakening events based on your brainwaves.
If you didn't record an awakening event it probably was not an issue.
***
However, if you are recording awakenings that coincide with your hypopneas then you
might want to start using a wearable logging pulse oximeter to see if you are going into actual O2 desaturations that
are then waking you up...
If that is happening, YOU need to know about it so you can correct for it.

Wink


I don't awake during hypopneas, so I think an oximeter is a good way to go.
Many thanks.
(This post was last modified: 01-05-2013 09:41 AM by jpapnea.)
01-05-2013 09:40 AM
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Sleepster Offline
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Post: #4
RE: Spending long times at APAP top pressure
(01-05-2013 09:15 AM)jpapnea Wrote:  I use a Resmed APAP S9. Some of my sleep time is spent at pressures of 12-14 cm-H20. However, I often spend extended periods (~1 hr) at my top setting of 18 cm-H2O. During those times, though I usually only have several hypopneas, the Flow Limitation is at or near the top level.

Does this impair my sleep quality significantly and, if so, do you have suggestions for improvement?

There really is no way to tell if it impairs your sleep quality. It could be interrupting your sleep cycle, you could even be waking up without realizing it. This stuff happens to people who don't have CPAP machines because they have an AHI that's under 5. It's just a fact of life.

There are some things you can try to improve the situation. You could try raising the upper limit and see if it reduces the hypopnea index during those times that you're at the max pressure.

Another thing to consider is that these periods of high pressure occur because you're sleeping on your back. You could try sewing a tennis ball into the back of your night shirt. That, too, may impair your sleep quality. You just have to experiment.

Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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.
01-05-2013 12:05 PM
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Shastzi Offline

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Post: #5
RE: Spending long times at APAP top pressure
(01-05-2013 09:40 AM)jpapnea Wrote:  I don't awake during hypopneas, so I think an oximeter is a good way to go.
Many thanks.

Unless you use a Zeo you cant really tell when you 'wake up' at night.
Your brainwaves will betray this though.
Your electical activity shows you are really awake but in actuality your
consiousness has not 'switched on' yet, so you have no way of remembering these 'waking events'
I had the same problem at the start.
I was getting up dead tired and had not 'woken up' once!
The Zeo showed I was awake most of the night and no REM at all.
It was kind of creepy but it shook me into action.

=^.^=
01-05-2013 02:08 PM
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vsheline Offline

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Post: #6
RE: Spending long times at APAP top pressure
(01-05-2013 12:05 PM)Sleepster Wrote:  Another thing to consider is that these periods of high pressure occur because you're sleeping on your back. You could try sewing a tennis ball into the back of your night shirt.

Hi jpapnea,

Yes, if you are rolling onto your back for an hour while asleep, that could explain it.

To stop me from doing that, I find I need to wear a teeshirt with tennis ball in a pocket or sock sewn high on my back, between my neck and shoulder blades, so it won't shift position and touch the bed and bother me when sleeping on my side.

Take care,
--- Vaughn

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 01-05-2013 02:33 PM by vsheline.)
01-05-2013 02:11 PM
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zonk Offline

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Post: #7
RE: Spending long times at APAP top pressure
(01-05-2013 09:15 AM)jpapnea Wrote:  I use a Resmed APAP S9. Some of my sleep time is spent at pressures of 12-14 cm-H20. However, I often spend extended periods (~1 hr) at my top setting of 18 cm-H2O. During those times, though I usually only have several hypopneas, the Flow Limitation is at or near the top level.

Does this impair my sleep quality significantly and, if so, do you have suggestions for improvement?

I've seen my S9 increase pressure in response to FL and would go as high as allowed
for me its a trade off between comfort and getting apnea treated without pressure going to the top
overtime, FL improved and pressure decreased

hows hours do you actually sleep and how do you feel
if just starting out, going to take some time adjusting (for you and the machine)

whats the median, 95% percentile, max pressure and leak
look at the leak graph ... if leak spiked at some period and not other periods might indicate some mouth breathing. a chinstrap might help
turn EPR off and see if makes any difference, EPR lower pressure at exhale by 1, 2, or 3
01-05-2013 02:51 PM
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