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[Pressure] Changed pressure setting
#1
With all of the information on this site I was able to gain access to my machine (ResMed S9 VPAP Auto) and change my settings.

At first I was under the impression that when in the "VAuto" mode the machine would adjust the pressure settings as needed. Reason for changing the settings was I was waking up very bloated and not very refreshed. Today, I woke up a little better than the previous weeks. Here are my "95% Percentile" results after changing my Max. pressure settings from IPAP 22/EPAP 14 to IPAP 12/EPAP 6.

IPAP 17.0 down to 10.4
EPAP 14.0 down to 7.5
Leak 33.6 down to 13.2 (Using nasal pillow):
Tidal Volume 720 down to 600
Minute Ventilation 8.4 down to 7.8
Respiratory Rate 15 up to 18
AHI & AI Events/hr .1 up to .5
I:E Ratio 2:1 down to 1.61:1

Any input on these numbers would be greatly appreciated.

Thanks
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#2
Your AHI is fantastic. You should feel much better than you did without your machine, but sometimes, it takes sleep deprived patients a while for patient to feel as good as their AHI looks. Be sure you are getting enough hours of sleep per night. Regardless of your AHI, you will feel tired if you aren't getting enough hours of sleep.
My AHI is also quite low, but I frequently am tired because of awakening during the night to use the bathroom, and then sometimes not being able to fall back asleep. I need 6.5 to 7 hours of sleep, even with a good AHI, in order to feel refreshed. You might need more or less.

Your awakening and feeling bloated, may mean that you are breathing through your mouth and possibly swallowing air.
Today, your leak numbers are better, indicating perhaps you did less of that mouth breathing and air swallowing last night. You might benefit from a chin strap if you see that bloated feeling is still happening quite frequently.
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#3
Thanks for the input. I usually get 7.5 hours of sleep per night. My thought on the bloating was from the pressure being too high? Looking back at all of the Leak numbers for the past three weeks, they were all pretty high. Actually, on average there weren't many variances throughout that timeframe in any category until I changed the settings last night. My two concerns were Tidal Volume and I:E Ratio. Based on these numbers should I continue with my changed pressure settings or increase slightly? Seems like my AHI & AI numbers are good regardless....
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#4
Hi Mattkevi, First of all Welcome! to the forum.! I'm sure you'll get more suggestions so just keep checking back, I'm sorry I'm not able to help you with your question. Best of luck to you with your CPAP therapy.
trish6hundred
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#5
(07-18-2012, 02:50 PM)Mattkevi Wrote: Based on these numbers should I continue with my changed pressure settings or increase slightly? Seems like my AHI & AI numbers are good regardless....

Welcome

I just wanted to warn you about changing your pressure so rapidly. It can take weeks of therapy at a specific pressure to know whether or not it is going to work for you. If you already made a change I would leave it for a few weeks and see what happens. Your body needs to get used to the new pressure and you need to collect the data over a period of time to get a good idea on where to go with the settings. Good luck!
As always, YMMV! You do not have to agree or disagree, I am not a professional so my mental meanderings are simply recollections of things from my own life.

PRS1 - Auto - A-Flex x2 - 12.50 - 20 - Humid x2 - Swift FX
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#6
Thank you, I appreciate the concern...
Another good night though with the new pressure settings. AHI 0 and NO bloating!

Two areas that have changed with the new decreased pressure settings are Respiratory Rate - breaths/min. up to 19 from 15 & I:E Ratio down to 1:60:1 from 2:1. Other than that, Tidal Volume & Minute Ventilation seem to be unchanged. All numbers based off 95th %.

One question I have to throw out there would be:

Are there Pro's or Con's to reducing the pressure settings if you are experiencing AHI of 3 or below?

My thought was to have the least amount of pressure and still maintain AHI at 3 or below, someone please tell me if this is off base!

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#7
(07-18-2012, 02:13 PM)Mattkevi Wrote: Any input on these numbers would be greatly appreciated.

You've got no significant increase in your AHI, but you do have a significant reduction in your leaks.

More importantly, the bloating is probably due to swallowing air. Reducing the pressure can help a lot in relieving this, so I would say you're in great shape. Lucky, too, as that's a pretty big adjustment you made to your pressure.
Sleepster
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#8
(07-19-2012, 08:00 PM)Sleepster Wrote: More importantly, the bloating is probably due to swallowing air.
Also due mouth breathing ............a chinstrap may help keeping mouth closed when using nasal mask

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#9
Mouth breathing was absolutely affecting my Leak numbers and what I have found to be true is the higher pressure settings were the culprit. At times, I could actually feel my mouth filling up with air to the point I needed to open my mouth. I have no explanations just an observation... Now, three nights completed with the new "lower" settings, I feel much better in the morning and Leak numbers are at an all time low, posting a 3 last night. For me this has been a beneficial change while keeping my AHI below 1 and my wife enjoying a soundless night due to my excessively loud snoring that has diminished completely! All is good...
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#10
(07-20-2012, 10:31 AM)Mattkevi Wrote: Mouth breathing was absolutely affecting my Leak numbers and what I have found to be true is the higher pressure settings were the culprit. At times, I could actually feel my mouth filling up with air to the point I needed to open my mouth. I have no explanations just an observation... Now, three nights completed with the new "lower" settings, I feel much better in the morning and Leak numbers are at an all time low, posting a 3 last night. For me this has been a beneficial change while keeping my AHI below 1 and my wife enjoying a soundless night due to my excessively loud snoring that has diminished completely! All is good...

If you find that you do need higher pressure for your therapy to work properly, try raising it back up, but very slowly. Only raise it up by like .5 and then give your body like a month to get used to that change. You did kind of go from 0 to 120 MPH in under 1 second! I have read a lot of people with higher pressures complain about the same things you had issues with and it makes me wonder if it would not be beneficial for the sleep docs to settle on a lesser number and slowly raise it. Everyone wants us to be compliant, but it seems there is no middle ground. I'm sure there would be more success if patients were more slowly introduced, but what do I know?! Dont-know
As always, YMMV! You do not have to agree or disagree, I am not a professional so my mental meanderings are simply recollections of things from my own life.

PRS1 - Auto - A-Flex x2 - 12.50 - 20 - Humid x2 - Swift FX
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