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Having difficulty adjusting to CPAP
#1
Hi everyone, been lurking on the site for about a month. I just received my first CPAP, the Respironics Dreamstation auto CPAP with humidifier and heated tube and am using the Respironics Amara View mask. The machine is set to auto CPAP with A-flex with a minimum pressure of 5 and maximum of 15 and the heater and humidity are set mid range 3 out of 1 - 5 scale. My problem I notice quite often is that I feel as though I am not getting enough air while sleeping. I keep waking up feeling as though I am being smothered. The average pressure was 8. When I am awake I feel fine with the mask on, maybe a little restricted when it is at 5. Is this a normal occurrence that I will get used to or do I need to change the settings.

My sleep study had an AHI of 20.4 and the first trial with the CPAP the AHI was 11 with no leaks detected.

Thanks in advance,

Scott
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#2
Sometimes technicians setup a machine without real knowledge of how responsive they are to your needs. Your minimum pressure is too low. Based on a titrated pressure of 11.0, you should be starting no lower than 8.0. With a minimum pressure of 5.0, your machine never quite catches up to the obstructive precursors, and as it drops down in pressure you are left feeling air-starved, while the obstruction again goes unaddressed. This is characteristic of the Dreamstation Auto which is slower to increase pressure, and faster to decrease pressure than a Resmed Autoset. The slower pace is less disruptive once optimized, but minimum pressure needs to be high enough to resolve OSA events.

Put simply, change the minimum pressure to 8.0. No other changes needed for now. Be prepared for a minimum pressure of 9.0 if you feel comfortable at 8.0 and still have residual OA.
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#3
thanks for the prompt reply Sleep Rider. That makes a lot of sense, just being new, I would hate to do something to make it worse. It will be nice when I have some data trends to work with and get this machine dialed in to me.
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#4
Welcome to the forum, cbdoc.

Best of luck with your treatment.
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#5
Thanks Pupcamper
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#6
Quote: I would hate to do something to make it worse. It will be nice when I have some data trends to work with and get this machine dialed in to me.

cbdoc, if it was even close, I'd say stick with your current settings and things normally get better. Your description is all we need:

Quote:I feel as though I am not getting enough air while sleeping.

This is common with people on minimum or very low pressure. Increasing minimum pressure always works to fix it. Normally, I would agree to take some time and see where the data takes us, but not with your minimum pressure of 5. Take it up to 6 or 7, but do increase the minimum pressure.
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#7
Hi cbdoc,
WELCOME! to the forum.!
I wish you good luck with your CPAP therapy, hang in there for more responses to your post.
trish6hundred
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#8
I started at 5-15 and quickly found 5 was too low. I moved my pressure up in steps. I feel that I could moved the pressure higher faster. It is a learning thing for each of us.

Sleep-well

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#9
I'm going to concur, 5 is too low for you. 8 may even be too low. I'm at 10-15, and I tried the ramp option starting at 8 my first day with the machine, I didn't get enough air, so I never used it again.
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#10
Well 4 days into the life of a hose breather and I think there may be something to this. I increased my minimum pressure to 8.5 and it has helped a little bit, I will need to increase it some more I suspect. I have only had a couple of times where I felt like I wasn't getting enough air since the increase and that was always at the lower end of the pressure range. I have noticed that the machine is spending more time at the max of 15, and my AHI has decreased to just under 8, but more importantly my wife says she hasn't heard me snore in a couple days (except for the couple hour period where I took the mask off while asleep). I assume that is also a common thing for new PAP users.
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