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Fixed vs auto pressure ?
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SleepyWabbit Offline

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Machine: DS560S (PRS1 REMStar Auto)
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CPAP Pressure: 12cm
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Sex: Male
Location: descensus in cuniculi cavum

Post: #11
RE: Fixed vs auto pressure ?
(06-11-2015 08:32 PM)Mosquitobait Wrote:  Do you have heart problems? Do you have blood pressure issues? These are the two where it MAY be in your best interests to have a set pressure. One member indicated that a set pressure would reduce the changes in blood pressure she would experience during sleep. I would guess that this would come from her sleep study, but they didn't do blood pressure during my sleep study. How would you know if the blood pressure is changing? These are things to ponder. Some people simply feel better at a set pressure.

I have High Blood Pressure and my PCP has suggested I get one of the automated cuffs where I can keep track of my Blood Pressure. I had an appointment with my sleep therapist last week and she suggested the same thing. Of course this wouldn't be all night long, but would give me an idea if CPAP therapy will have an affect on my Blood Pressure in the long run.

I don't remember if the measured my BP when I did my sleep study as it's been about 18 months ago. I wouldn't be surprised one way or the other. I had so many things hooked up to me, but it's not listed on my study report. She did take my BP at my followup last week.
06-13-2015 06:26 PM
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tedburnsIII Offline

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Machine: 3B RESmart APAP
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Other Comments: Dx moderately severe OSA. Overnight pulse oximeter-CMS50D Plus

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Location: San Diego

Post: #12
RE: Fixed vs auto pressure ?
It's a matter of personal preference.

Titration study by definition comes up with one 'cover all' pressure to handle all sleep positions/scenarios adequately.

My preference, thus far, after 3.5 months on Auto, and 1.5 months on CPAP, is to go straight CPAP. Titration study optimum pressure came to 12cm.

I am now at 11.5cm. I have higher sats, less desats, longer and better sleep with fixed pressure. My AHI is consistently less than 0.7. The other night it was 0.0.

Notwithstanding the above, I've also had AHI of 0.0 with Auto.

Best wishes,
(This post was last modified: 07-12-2015 12:57 PM by tedburnsIII.)
07-12-2015 12:53 PM
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zonk Offline

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Location: Australia

Post: #13
RE: Fixed vs auto pressure ?
(07-12-2015 12:53 PM)tedburnsIII Wrote:  Titration study by definition comes up with one 'cover all' pressure to handle all sleep positions/scenarios adequately.
Not sure about this, my pressure vary during the night
Whether sleeping on my side or back, during REM sleep, and even when had a glass too many

But in any case scenario, I trust my AutoSet to come to the rescue ... YMMV
07-12-2015 10:16 PM
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wxmcpo Offline

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Machine: ResMed AirCurve 10 VAuto
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Post: #14
RE: Fixed vs auto pressure ?
For the first six weeks after my study my pressure was set at 5 to 9. I had AHIs as high as 46 and the average was around 28. I visited my doc and she set it to auto and it's been that way for the last six weeks. My highest AHI has been 28 while the lowest was 2.6, but the avg is down to 11. My number the last couple of nights had been between 10 to 12, but I think that was due to mask leak. I pulled the straps a little tighter last night and the number dropped to 6.6 so I think I have been wearing it a little loose. Wish I could get it into the sub 1's like a lot of folks.
07-12-2015 11:15 PM
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tedburnsIII Offline

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Machine: 3B RESmart APAP
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CPAP Pressure: 10 cm CPAP
CPAP Software: Other Software

Other Comments: Dx moderately severe OSA. Overnight pulse oximeter-CMS50D Plus

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Location: San Diego

Post: #15
RE: Fixed vs auto pressure ?
(07-12-2015 10:16 PM)zonk Wrote:  
(07-12-2015 12:53 PM)tedburnsIII Wrote:  Titration study by definition comes up with one 'cover all' pressure to handle all sleep positions/scenarios adequately.
Not sure about this, my pressure vary during the night
Whether sleeping on my side or back, during REM sleep, and even when had a glass too many

But in any case scenario, I trust my AutoSet to come to the rescue ... YMMV

Titration optimal pressure handles all those positions with one fixed pressure. It may be a bit much if you side sleep, perhaps more than needed. The basis is to get the pressure while patient is in REM sleep and supine, the position most likely to result in higher incidence of events.

http://www.aastweb.org/Resources/Guidelines/Guidelinesummary.pdf

[Image: CPAP%20TITRATION%20EXPLAINED_zpswpt5uay1.png]
(This post was last modified: 07-13-2015 02:56 AM by tedburnsIII.)
07-13-2015 02:53 AM
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OpalRose Offline

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Post: #16
RE: Fixed vs auto pressure ?
My titrated pressure was 9, which my doctor wanted me to stay on.

Tried it for about a month, only to find a lot of arousals and less sleep.
Have been tweeking my settings for awhile now on auto setting, and have found what I think is the best for me. It is a very narrow range of 9 to 12.

My PR System One Auto reacts to RERAs and Flow Limitations. With that said, and after studing my graphs on Sleepyhead, I can clearly see the pressure would rise especially for Flow Limitations. Most of the time it would reach a pressure of 11 to help clear out the FL and prevent apneas.

Now when I was at a fixed pressure of 9, I experienced higher AHI readings. The reason being it couldn't react to the FL and RERAs. My AHI readings now are always under 1.0. This morning was .2
I feel rested with less awakenings.

The bottom line is that Titrated pressures are a guideline based on one night. I find every night to be different, and I feel good in knowing that my Auto CPAP will react properly and do its job, whether I'm on my side or back.

OpalRose
(This post was last modified: 07-13-2015 06:53 AM by OpalRose.)
07-13-2015 06:47 AM
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zonk Offline

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Post: #17
RE: Fixed vs auto pressure ?
(07-13-2015 02:53 AM)tedburnsIII Wrote:  Titration optimal pressure handles all those positions with one fixed pressure.
I've said my piece and will leave to that
Whatever float your boat

Coffee
07-13-2015 04:38 PM
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tedburnsIII Offline

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Machine: 3B RESmart APAP
Mask Type: Nasal mask
Mask Make & Model: Wisp nasal; ResMed FX nasal
Humidifier: came with unit-I vary it, currently set at '3', '5' is max
CPAP Pressure: 10 cm CPAP
CPAP Software: Other Software

Other Comments: Dx moderately severe OSA. Overnight pulse oximeter-CMS50D Plus

Sex: Male
Location: San Diego

Post: #18
RE: Fixed vs auto pressure ?
(07-13-2015 06:47 AM)OpalRose Wrote:  My titrated pressure was 9, which my doctor wanted me to stay on.

Tried it for about a month, only to find a lot of arousals and less sleep.
Have been tweeking my settings for awhile now on auto setting, and have found what I think is the best for me. It is a very narrow range of 9 to 12.

My PR System One Auto reacts to RERAs and Flow Limitations. With that said, and after studing my graphs on Sleepyhead, I can clearly see the pressure would rise especially for Flow Limitations. Most of the time it would reach a pressure of 11 to help clear out the FL and prevent apneas.

Now when I was at a fixed pressure of 9, I experienced higher AHI readings. The reason being it couldn't react to the FL and RERAs. My AHI readings now are always under 1.0. This morning was .2
I feel rested with less awakenings.

The bottom line is that Titrated pressures are a guideline based on one night. I find every night to be different, and I feel good in knowing that my Auto CPAP will react properly and do its job, whether I'm on my side or back.

That's cool info.

At 9-12cm, what is your average pressure running?

And, if you know, what causes a RERA to occur? I do know the titration Guidelines raise pressure if 5 RERA's appear at any given pressure. It's in the chart that I posted, above. It may be considered acceptable to have <5 RERA an hour, one might think, if everything else is in order.

In any event, Auto works better for you for reasons stated. It appears you have found the 'sweet spot' at 9-12cm. That is good.
(This post was last modified: 07-13-2015 05:19 PM by tedburnsIII.)
07-13-2015 04:45 PM
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BIGELI Offline

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Post: #19
RE: Fixed vs auto pressure ?
Having been under treatment for sleep apnea for over 8 years I feel the number one indicator of successful therapy is HOW LONG TO YOU SLEEP on the average night. My breathing stopped enough times throughout the night that I was given a pacemaker when in reality I needed treatment for apnea. Thats to the good advise I got from this 'board' I sleep with my machine on auto 9 to14. Getting 7 hours or so sleep each night. The lower the pressure you can find success with the less leaks you'll have and sinus trouble. At least that as been my experience.
07-13-2015 05:30 PM
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OpalRose Offline

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Post: #20
RE: Fixed vs auto pressure ?
(07-13-2015 04:45 PM)tedburnsIII Wrote:  
(07-13-2015 06:47 AM)OpalRose Wrote:  My titrated pressure was 9, which my doctor wanted me to stay on.

Tried it for about a month, only to find a lot of arousals and less sleep.
Have been tweeking my settings for awhile now on auto setting, and have found what I think is the best for me. It is a very narrow range of 9 to 12.

My PR System One Auto reacts to RERAs and Flow Limitations. With that said, and after studing my graphs on Sleepyhead, I can clearly see the pressure would rise especially for Flow Limitations. Most of the time it would reach a pressure of 11 to help clear out the FL and prevent apneas.

Now when I was at a fixed pressure of 9, I experienced higher AHI readings. The reason being it couldn't react to the FL and RERAs. My AHI readings now are always under 1.0. This morning was .2
I feel rested with less awakenings.

The bottom line is that Titrated pressures are a guideline based on one night. I find every night to be different, and I feel good in knowing that my Auto CPAP will react properly and do its job, whether I'm on my side or back.

That's cool info.

At 9-12cm, what is your average pressure running?

And, if you know, what causes a RERA to occur? I do know the titration Guidelines raise pressure if 5 RERA's appear at any given pressure. It's in the chart that I posted, above. It may be considered acceptable to have <5 RERA an hour, one might think, if everything else is in order.

In any event, Auto works better for you for reasons stated. It appears you have found the 'sweet spot' at 9-12cm. That is good.

Ted
I hope I've found that sweet spot. It seems to be working for me for now, but that's the beauty of an auto CPAP, it will adjust to my needs, no matter how I'm sleeping.

My 90% pressure will stay anywhere between 10.5 and 11. Mostly 10.5 though not that much higher than the titrated pressure, but at that titrated straight pressure
of 9, apneas would be missed.

I have no idea what causes RERAs. Some nights I see between 2 or 3 an hour, then other times hardly any.

Now with all that said, I have nothing against using a straight pressure if that's what works best for you. As Retired_Guy says, we are all different. Smile

OpalRose
07-13-2015 05:50 PM
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