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[Equipment] what are repercussions of capping max pressure?
#1
what are repercussions of capping max pressure?
The first and only mask I've received is https://3bproducts.com/masks/siesta-full-face-mask/ along with a Resmed 10 Autoset and a very basic hose.

The mask seems to have issues when the pressure gets to high...if it's not leaking from the part that connect to the hose (until I fiddle with it) it's blowing air across my eyes or leaking from one of the sides loud enough to wake me up.  I'm not sure why my machine tries to take off like a rocket...I'm assuming some kind of major leak but all I know is I'm waking up alot.  Last night was a good example..I finally got wore out enough to cap the max pressure at 13 around 7am and go back to bed.    What possible negatives will I see with this?  Typically my machine doesn't go above 12-14 unless it's spiking like it did last night.  I'm already using ear plugs to be able to ignore the minor hissing but these are loud enough or annoying enough to get past those.  See attachment.


What's the most popular full face mask?


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#2
RE: what are repercussions of capping max pressure?
capping the pressure at 13 just makes the machine stop trying to elevate pressure, beyond that, which would also likely wake you, so it isn't negatively impacting your sleep to cap it.

If this were my chart, I would raise my starting pressure a bit, to 6, and also turn on the EPR full time and set that level to 1 or 2. You can reduce the maximum to 12 as well, and likely won't see much additional apnea and might stay asleep right thru it.

QAL
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#3
RE: what are repercussions of capping max pressure?
Not sure if it's relevant but my AHI's on my sleep study were 42 before I began treatment.  Does that change your suggestions?
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#4
RE: what are repercussions of capping max pressure?
An untreated AHI of 42 is severe apnea, but whether your untreated AHI is 15 or 100, the gold-standard treatment is CPAP therapy, and your specific untreated AHI number (assuming it indicates OSA) isn't particularly relevant to machine settings. 

What's more relevant is found on the chart you posted -- specifically, the fact that treatment is reducing your AHI to below 2 events / hour (which is great). Further, your 95% pressure is 13.00 -- this means 95% of your events are controlled at or below a pressure of 13 cm. Given this, if pressures above 13cm are impacting your ability to sleep, I think capping your pressure at 13 is a very reasonable change to make, which shouldn't materially impact your treatment efficacy while allowing you to sleep through the night.
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#5
RE: what are repercussions of capping max pressure?
Thank you both for your input! I'll give the suggested changes a shot tonight. I was to the point I was considering contacting the DME and requesting a new face mask although I'm not sure if the mask is the issue.
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#6
RE: what are repercussions of capping max pressure?
I would say the mask FIT is an issue. A standard, well-fitting, mask should be able to handle up to max xpap pressure. 
The machine is only able to compensate for a little leak, after that you're no longer getting full treatment or accurate data.

Masks are very individual and it often takes some trial and error to find one that works for your facial structure. 

Read this for more information on masks: 
http://www.apneaboard.com/wiki/index.php/Mask_Primer
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#7
RE: what are repercussions of capping max pressure?
I will put in my 2 cents.  I think your main problem are flow limits. The Flow limits IS why your pressures are going up. Compare the flow limits chart with your pressure chart. 

To help with flow limits you use EPR. your min pressure needs to be at least 7 and EPR set full time 3.

If you will set it this way your pressure will stay lower and with that your leaks will be less.
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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#8
RE: what are repercussions of capping max pressure?
Ok...I've tried to combine all the suggestions to give me something to start with and work from there...gonna try 7-13 EPR 3 tonight and see how it goes then fine tune from there.  I had the DME mark on the velcro where the velcro should line up when they fitted me so I reset it back to that since it's probably a little to tight to compensate for all the leaks (which I now know causes MORE leaks).

I'm currently wearing an anti snore headpiece I plan to lose as soon as the soft cervical collar I ordered comes in...this and not shaving for a few days has probably not helped with the fit either.

I was really lucky to have one of my doctor's notice my hemoglobin was up because of low oxygen levels and I did a mail in sleep study where they send you a device to wear and you then mail it back.  The machine has already improved quality of life because I was ALWAYS tired and thought it was due to some of the medicines I'm on that do say being tired is a side effect.  I'll have a teledoc appt with the doc from the mail in place sometime soon to discuss how things are going so up till now I've been kinda winging it with the help of a friend who also uses cpap.  I REALLY appreciate all the input!
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#9
RE: what are repercussions of capping max pressure?
The 7-13 EPR 3 seems to have worked well.  I woke up twice because the o2 ring said my o2 was 88.   Not sure I want to get rid of that but also not sure if 88 is best number to watch for?


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#10
RE: what are repercussions of capping max pressure?
Those appear to be artifacts, based on the speed they return to your baseline. I believe in O2 Insight Pro, there is a setting for the alarm level and/or its activation. This may be available in the "Settings" setting on the ViHealth as well.

- Red
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
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