"On the one hand, the maximum pressure setting needs to be high enough to effectively prop the airway open during the times when the airway is most likely to collapse. If the maximum pressure is not high enough, the airway will continue to be prone to collapsing off and on throughout the night.
On the other hand, the minimum pressure needs to be high enough where the machine does not need to increase the pressure by a significant amount during the first cluster of events. Sharp rapid increases of 5-8 cm of pressure in 10 minutes might not allow the airway enough time to stabilize and settle down. And unstable breathing can cause further events, which leads to more pressure increases and more unstable breathing."
My mom's Auto Bi-PAP is set for min. of 9 and max of 18 (IPAP). Sometimes when I put the mask on her, I watch the pressure steadily rise from min to max within less than a minute. Most of the night it stays at/near the max. even if she wakes up. The mask is not leaking and it happens with different masks. After about 2 hrs. of use, there are times when the EPAP is at max. and IPAP is at max or above and it wakes her. At these times, her AHI is also very high (40-50). I turn off machine, let air out of mask, turn machine back on and it's good for the next 2 hrs (but again the pressures typically increase fairly quickly- sometimes she is in a sleepy state, sometimes awake).
She just had a second sleep study and the tech told me that her AHI was below 10 at an IPAP of 14 but she did not have any REM sleep during the study. If that is true, why does the machine just keep going up to the max?
And, is the quoted text correct, that a quick rise like what occurs creates unstable breathing?