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Is it safe to increase the minimum pressure of my cpap?
#1
Is it safe to increase the minimum pressure of my cpap?
Hello!! I have been using my cpap for almost 1 year, and although I am not always constant (there are days that I use it a few hours during the night, other nights I just don't use it) my apneas have decreased a lot during this period. I started with a minimum pressure of 4 and a maximum of 10, which were the recommendations of my neurologist, and after a few weeks of use I increased the minimum pressure to 5 because I felt that I was short of breath when I put on the mask every night. Besides that, i increased the maximum pressure to 15, because I have an auto cpap and I thought that the machine should give me the pressure that my body needed, and not the one the doctor told me. My apneas stayed between 5 and 15 approximately with those pressure ranges, and the pressure 90% was about 13. Within months of realizing that my AHI did not diminish, I began to read in this forum, and I realized that many users who had been spending a lot of time using cpap machines commented that they had 0 apneas per night, which I thought was incredible, because I did not even get 5, and the maximum pressure i was needing didn't rise, so I did nott know how my AHI could get lower. Then I saw that a user recommended increasing the minimum pressure, and that's what I did. I increased it from 5 to 8, and my apneas dropped to between 2 and 8, and a week ago I increased it to 9, and for the first time I reached 1 AHI for one night, and my apneas during this week have stayed between 1,5 and 5 approximately.

Finally, my question is, is it safe to increase the minimum pressure? since I think that if the increase from 9 to 10, or from 9 to 9.5 i could reach 0 apneas per hour, which is the final goal that we all have insn't it? Or the goal is to stay just under 5? I have increased the minimum pressure with a little fear, thinking that it can be harmful for me to continue increasing it, so if someone can explain me a bit better if there is any risk in continuing to increase the minimum pressure, it would be very helpful for me.

Thank you very much for your time!! Have a very nice week!
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#2
RE: Is it safe to increase the minimum pressure of my cpap?
Sounds like you haven't downloaded Sleepyhead. I am sure you will get lots of helpful information from other members if you were to use Sleepyhead and then upload screenshots of your results for interpretation. Go to the Sleepyhead link at the top of every page.
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#3
RE: Is it safe to increase the minimum pressure of my cpap?
Anything under 5 is considered treated by Doctors. Many here like to get it lower due to the fact they feel better at lower AHI's. Zero AHI is not a normal occurrence. It's unrealistic to expect zero apneas every night. Anything under 2 AHI is considered really good. Once you get under 5 AHI on a steady basis start going on how you feel. Ditto the above advice about sleepyhead.
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#4
RE: Is it safe to increase the minimum pressure of my cpap?
(04-16-2018, 10:40 AM)Kalule1 Wrote: Finally, my question is, is it safe to increase the minimum pressure? since I think that if the increase from 9 to 10, or from 9 to 9.5 i could reach 0 apneas per hour, which is the final goal that we all have insn't it? Or the goal is to stay just under 5? I have increased the minimum pressure with a little fear, thinking that it can be harmful for me to continue increasing it, so if someone can explain me a bit better if there is any risk in continuing to increase the minimum pressure, it would be very helpful for me.

As cate said, it would be much more helpful if you downloaded SleepyHead so you could see what is actually happening, and you could post the results here for better comments. See the links at the bottom of this post for help in doing this.

Since you have adjusted the maximum pressure to 15 cm, which is fairly normal, the pressures are being determine by what the machine thinks you need, not by the minimum pressure you have set. The few numbers you gave suggests it is actually running quite a bit over the minimum. That is normal too. You can optimize your results by limiting how low the pressure goes in auto by setting the minimum higher. It can reduce events as you have found out. The machine will slowly ramp down to minimum in the absence of events, and sometimes can go too low. Setting a higher minimum can avoid that. 

But, the best way to set the minimum is to use SleepyHead, so I would encourage you to do that, and post the Daily screenshot here. Pay close attention to all the tips below to optimize the screen layout so you get the important stuff on the screen. Also maximize your SleepyHead window before doing the screen capture.
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#5
RE: Is it safe to increase the minimum pressure of my cpap?
Thanks a lot for all your advice! I'll download sleepy head now, and start posting me results for better advice of you. But i  still don't know what i really want to know, is it safe to turn up the minimum pressure? Or could it be harmfull for me?

Thanks for all your responses!
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#6
RE: Is it safe to increase the minimum pressure of my cpap?
FWIW I believe it is "safe" for the patient to do adjustments on their CPAP if you do so based on knowledge of WHY you are adjusting. As for your question, it is safe to adjust it yourself.

The thought I govern my settings adjustment by is "just because you can do it, does not mean you should". Now, I am not saying you should not adjust, just know WHY you do it. Which brings us back to what others stated, use SleepyHead to view and post charts. This can give you WHY to adjust. Hope that makes sense. All this is an IMO message from DNN (Dave's non--anti-caffeine network). Coffee
Dave

I'm not a doctor in real or fictional life. My posts include opinions based upon user experience regarding CPAP therapy and should not be considered medically professional direction or advice. Even a 1,000 mile trip requires a good first step. My recommended first steps include getting good walking shoes, 1 great cup of coffee, and a good GPS.

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#7
RE: Is it safe to increase the minimum pressure of my cpap?
Do you have any other medical conditions besides sleep apnea?

My sleep tech increased my min pressure from 10 to 12 which triggered my vertigo (BPPV). After a couple nights I couldn't take it anymore and changed my min back to 10. My AHI were less than 3 at the time. I am slowly increasing my min by 0.2cm h2o every week or two to see if I will feel more rested.

Dave
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#8
RE: Is it safe to increase the minimum pressure of my cpap?
(04-16-2018, 11:43 AM)Kalule1 Wrote: Thanks a lot for all your advice! I'll download sleepy head now, and start posting me results for better advice of you. But i  still don't know what i really want to know, is it safe to turn up the minimum pressure? Or could it be harmfull for me?

Thanks for all your responses!

Hi Kalule1,
No, it’s not harmful, but you shouldn’t be adjusting pressures without a clear reason for doing so.

It’s not just the total AHI number that is considered, but the breakdown of that number. Is your AHI mostly Obstructives, Hypopneas or Clear Airways?

If you were see mostly Clear Airways, then you would not want to increase pressure.

Once you are able to post some data here, we can take a look and give better advice.
OpalRose
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#9
RE: Is it safe to increase the minimum pressure of my cpap?
(04-16-2018, 11:43 AM)Kalule1 Wrote: Thanks a lot for all your advice! I'll download sleepy head now, and start posting me results for better advice of you. But i  still don't know what i really want to know, is it safe to turn up the minimum pressure? Or could it be harmfull for me?

Thanks for all your responses!

Based on your opening message your machine is at or below 13 for 90% of the time so the minimum pressure could be raised to 11 without adversely affecting your treatment. But graphs from sleepyhead would help us confirm
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#10
RE: Is it safe to increase the minimum pressure of my cpap?
The Philips Respironics Dreamstation Auto functions best when the pressure is optimized to within two to three centimeters of the 90% pressure needed to fully treat apnea. This is a normal and SAFE method for self-titrating an auto CPAP. It is safe because those pressures are easily tolerated by most individuals. If you had a problem with the pressure like ear pain, aerophagia or increased central apnea, then those are signs that pressure has been raised too high. You have experienced improved efficacy and are apparently comfortable with the increased minimum pressure, so what you have done is appropriate and assuredly safe.
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