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Increased Min. Pressure & CAs really high?
#1
Question 
Increased Min. Pressure & CAs really high?
Many thanks to all for their replies and suggestions.  Last night tried increasing min. pressure 1 cm. and the AHI more than doubled plus the CAs up 4X.  Increased pressure made the leaks hard to control also.  Going to try different nasal pillows in the hybrid mask to better control the leaks and going back to the min. pressure of 9.0 to see if I at least get back to AHI under 5.  Any/all suggestions will be greatly appreciated.  Hope to not have to go back to doctors who just concentrate on AHI and leak data....

(Prior Post)  Still not sure which setting on the Airsense 10 Auto to use for my ResMed Hybrid mask - seems to be better set on Nasal than Full Face?

Note - my mask is a hybrid - full face style but only small mouth cover with pillows - half or less the volume as a complete full face mask - PAP only has selection of full, nasal, or pillows and this is not any of those choices so still sorting out the best PAP setting for me.

Tried to attach a chart but out of quota(?) - suggestions to get around this issue?

Posting as a new issue to see if I can get the results posted.

[Image: sAokHawm.png]
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#2
RE: Increased Min. Pressure & CAs really high?
I don't know how to read Respironics graphs, but I do want to say that raising the lower number a whole cm at a time may be too much. Once you are close, it's better to go in much smaller increments. Leaks of course, are totally mucking it all up. Smile I know nothing about hybrid masks, so no help here. Good luck!! Smile
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#3
RE: Increased Min. Pressure & CAs really high?
(04-30-2017, 05:36 PM)TexasTiger Wrote: Many thanks to all for their replies and suggestions.  Last night tried increasing min. pressure 1 cm. and the AHI more than doubled plus the CAs up 4X.  Increased pressure made the leaks hard to control also.  Going to try different nasal pillows in the hybrid mask to better control the leaks and going back to the min. pressure of 9.0 to see if I at least get back to AHI under 5.  Any/all suggestions will be greatly appreciated.  Hope to not have to go back to doctors who just concentrate on AHI and leak data....

(Prior Post)  Still not sure which setting on the Airsense 10 Auto to use for my ResMed Hybrid mask - seems to be better set on Nasal than Full Face?

Note - my mask is a hybrid - full face style but only small mouth cover with pillows - half or less the volume as a complete full face mask - PAP only has selection of full, nasal, or pillows and this is not any of those choices so still sorting out the best PAP setting for me.

Tried to attach a chart but out of quota(?) - suggestions to get around this issue?

Posting as a new issue to see if I can get the results posted.

[Image: sAokHawm.png]



why did you increase it at all

why not lower it back if that gave better results ?

mask setting sets a crude pressure calibration start point for the machine
the numbers fine tune it

the actual proper pressure depends on the volume of the mask as well as other factors
so that in the end you get the pressure you need and the co2 is cleared from the mask too
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#4
RE: Increased Min. Pressure & CAs really high?
TexasTiger,
Until you can get control of your leaks, it's possible that the AHI may not be accurate.

Consider using a "soft" cervical collar to help keep your mouth/jaw from dropping, plus it will keep your neck aligned.

Also, you might want to try turning the EPR off.  In some folk, it causes more clear airways.
OpalRose
Apnea Board Administrator
www.apneaboard.com

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#5
RE: Increased Min. Pressure & CAs really high?
I appreciate all the replies but it seems that I'm still going in reverse with this Hybrid Mask.  Even "MyAir" is telling me that I'm having too many events.  I know something's wrong as it seems like a very long time since I've had a decent night's sleep.  I'm going to go back to the DreamWear mask where at least I felt better and the stats were better as well - just too many leak problems.  Suggestions for improving results with the Hybrid will still be much appreciated but not tried for at least a few days till I'm up to it.   Thanks again to all for the input.
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#6
RE: Increased Min. Pressure & CAs really high?
as opal said about turning off EPR, I would too. I found my CA settled down after a while, some people are like this. it can take a while for the brain to get use to CPAP. Some people have a real problem and need another machine. I would also look at raising my lower pressure to treat the OA. I'd move to 11 for a week
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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#7
RE: Increased Min. Pressure & CAs really high?
Tried raising the lower and all got worse plus lousy night's sleep.  It was like added pressure as well with lots of leak problems.  Going back to dreamwear nasal mask for a while to get sleep again.  Much better even if there are leak problems to be fixed.  For what it is worth here is the sad results from last night's sleep attempt...

[Image: IcLP4Obm.png]
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#8
RE: Increased Min. Pressure & CAs really high?
I wouldn't be discouraged if I were you, I think all in all your chart isn't too bad. Most of the night your leak rate was under 25. It is frustrating in the beginning. If you are having issues with the pressure, you could use the ramp function and start at a pressure you're ok with, till you're asleep. I'm running 15-20cm and when I wake up during the night now, I can't tell if my machine is on, I have to lift the mask so it makes some noise. It took a couple of months, I had a hard time in the beginning and was sleeping for 90 minutes at a time.
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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#9
RE: Increased Min. Pressure & CAs really high?
Not new to CPAP - been using for over 14 years - just discouraged from lack of help from the "so called" professionals not really looking for answers to our problems as the problems have been there almost all of those 14 years - I was just not aware of them till I got a machine (Airsense 10) that allowed me to actually see the results and try to improve on my own sleep.  I now have a real reason for all those years of poor sleep.  At my 78 years plus age my impatience level is higher than it should be cause I feel that I have been robbed of what should now be good health but possibly now have my heart problems due to "the professionals" not really looking at sleep apnea as a real problem.  I really appreciate all of the help this forum is giving those with this problem to better understand what is going on with the sleep therapy and assist in what should be a simple thing - GETTING A GOOD NIGHT'S SLEEP!

Many thanks to all on this forum - I have not given up and know a solution to these problems is possibly only 1 post away - keep up the good work!
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#10
RE: Increased Min. Pressure & CAs really high?
you may need another sleep test if it's been that long, there may be other stuff. I put my dad on my s9. My dad's chart looked worse than yours and it turned out he didn't even have sleep apnea. He had PLMD and the machine was picking up his response to it,

this is all PLMD
[Image: 7oMbofK.png]
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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