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Do I need to raise my max pressure?
#1
Do I need to raise my max pressure?
For the flow limits?


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#2
RE: Do I need to raise my max pressure?
My opinion would be to raise the min as much as you feel comfortable with. The EPR IS what helps flow limits. Your max is set to stop the pressure from going to high driven by flow limits. If you increase the max I think your pressure will just go up to the new max pressure you set.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#3
RE: Do I need to raise my max pressure?
Gotcha, thank you Stacey. Smile
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#4
RE: Do I need to raise my max pressure?
To clarify, Max pressure won't be the setting that affects flow limits. Min pressure and EPR would be the ones to control these as 1. Min pressure is your base. It needs to be high enough to combat FL and Apnea. 2. EPR is PS on a BPAP and this too affects FL. And if you look at your OSCAR above, your Max is 15.8 in setting but also on the chart. And you can visualize it bouncing on that ceiling because given the ability, the PAP would go higher if Max were set higher.
Dave

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#5
RE: Do I need to raise my max pressure?
Thank you for that Dave, I understand now.

Regards
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#6
RE: Do I need to raise my max pressure?
The real question is, with AHI under 1.0, how do you feel?
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#7
RE: Do I need to raise my max pressure?
I was using a DS1 auto bipap prior to this S10, I felt more rested using that machine, my average AHI was .4 and it was more comfortable, since I had dialed in the epap/ipap and PS..
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#8
RE: Do I need to raise my max pressure?
Of course I agree with Dave Stacey and Gideon (wouldn't dare not too!)

but would also to add something else to consider.

I have seen the same pattern in my charts, look at this one here:

   

Note I have set the Max at 10.20
Note the 95% Max is already at 10.18
See where I am hitting Max Pressures around 3AM to 4:30 AM?
See the FLs stay high?
And there are more Events during this time?
And how the Tidal Volume becomes erratic? 
My notes from that sleep session said I felt Bruxism, Air Starvation, Heart Pounding not a happy chappy.
For me, having the Pressure bounce off the ceiling for extended periods of time causes some sort of physiological stress, I don't like it.
I don't like it at all.
Since then I have upped my Max Pressure setting to 14.0 and seldom get there. 
I feel much better for that. There seems to be more "space" for things to move around in.

Now, let's look at your chart:

   

See how at the blue arrow your snoring and FL push up the pressure.
and how quickly this controls the FL and the pressures drop down again (orange box)

At the Brown arrow your snoring and FL push the pressures up higher and you reach Max Pressure, and stay there for half an hour.
The machine cannot go higher to control things, it would if you let it, but it cannot.
So you have a  longer period of dwindling FLs.

At the Green Arrow the same thing happens and you are at Max Pressure for well over an hour. The FLs are not being controlled and you carry on snoring.
The Blue Box highlights that many of your events are in this time period. 
Because your FLs stay high that long your 95% FLs score is high at 0.21 (pink line)

At the next Orange Box your FLs drive the pressure up to around 14+, the FLs are treated and quickly fall back down, and the pressure drops.
And again at the 3rd orange box.

Of course, if you are sleeping well, fine, no need to do anything.

If you have some issues or side effects, it might help trying to up the Max Pressure for a few days. 
Keep a diary of how you feel, how well you slept, any problems you had.
It's possible that have the pressure rise too fast or staying up that long can be uncomfortable

Your mileage may vary, we are all different, just something to consider in between drinks!

Coffee
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#9
RE: Do I need to raise my max pressure?
Yes in cases where Max pressure is hit fairly frequent, it would make sense to increase the Max setting a couple of points up..
Dave

OSCAR
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Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#10
RE: Do I need to raise my max pressure?
What were your settings with the DS BiPAP? It is pressure support that helps you minimize flow limits, not maximum pressure. You are limited to a difference of 3-cm between IPAP and EPAP with the Autoset, and to further reduce flow limitations, we would like to increase pressure support and lower pressure. My best advise for the moment is not to focus on flow limits. Your Autoset will chase them with pressure because it interprets that as obstruction, but you should simply set the maximum pressure for comfort and assume you will spend most of the night at that pressure. I'd really like to see you back on a bilevel if possible.
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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