12-23-2013, 04:52 PM
I need help with the settings on my APAP, a REMstar APAP 550P. I had a recent sleep study because my previous mask was tearing up my nose bridge and leaking air into my left eye. Before the study I found a newer mask, probably my 6th since 2000, that seemed better, a ResMed Full Face Quattro FX, and it did well in the sleep study.
When I got a notice that my results were being sent to the equipment provider I went there and found out both the minimum and maximum settings were at 14. When I said something to the sleep specialist there he said he was also surprised because this basically turned it into a CPAP.
I stopped in to ask the sleep study director and he said the test showed I did fine with both set at 14. I got my new mask and settings on 11/19/13 and in the first 6 days my AHI (over last 7 days)rose from 5.5 to 6.9.
On 11/24/13 I revisited the sleep specialist and told him what was going on and that I knew how to change the settings. He thought it was worth a try. I probably overshot by raising the max to 16 but the AHI started dropping into the 2 - 3 range and large leaks dropped to 0% to 2%.
My concern is that my "90%" pressure has risen to almost 16. I have now lowered it to 15. I am worried that I do not understand the true meaning of the maximum setting. I thought it was the maximum amount of pressure the APAP would exert in an effort to prevent blockage of airflow. Therefore, it was an advantage to have it higher. Originally, I was at 17 in 2000.
I should state I know I am probably not supposed to be doing my own testing but in the last 2 years I have gone through 3 changes of doctors because the previous one left and each has their own ideas. I have been doing this for 13 years and feel I have learned some things and that I am not making radical changes.
I am sorry for giving you my life story but I felt it was important to know the "backstory".
The purpose of the Auto is to adjust as needed throughout the night. A setting of 14-16 is a very, very tight range so the 95% is going to be hard for the machine to determine since there's not much room.
My suggestion is to drop the lower number to13 or even 12. And raise the upper number to 17. Then collect data over the next ten to 14 days. You need trends, not one or two nights' worth. By then, you would have a more accurate 95% rate and can determine if that range is good for you.
Apnea Board Moderator
Breathe deeply and count to zen.
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.
Hi DISleepApnea, welcome aboard
You need to check whats AHI events made up of (numbers of obstructive and clear airways events)
imo, the minimum pressure is most important, the criteria for me to feel comfortable and keep airway open and the maximum a bit more pressure when needed like if rolled on my back or/and Rem sleep where pressure increase most needed
90% pressure means pressure was at or below for 90% of the time and at or higher for 10% of the time
SleepyHead pressure graph shows what pressure was at throughout the night
I have not seen good explanation for large leak other than the machine can no longer possible determine events accurately. Your machine report total leak (vents leak plus mask/mouth leak), vents leak of Quattro FX at pressure 14 about 44 L/m so assume leak above 70 L/m or whereabouts is considered large leak territory