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Pressure Numbers, what do they mean? (Newbie Alert)
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ShelaghDB Offline

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Posts: 267
Joined: Sep 2013

Machine: S9 Auto-Set +Resmed H5i
Mask Type: Full face mask
Mask Make & Model: Quattro Air FF Mask
Humidifier: resmed H5i
CPAP Pressure: 13
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Female
Location: Toronto, Ontario, Canada

Post: #1
Pressure Numbers, what do they mean? (Newbie Alert)
Cpap 13cm/h2o


So apparently my pressure is 13. Ive been looking at numbers besides members posts and see various different ones, of course.

I've seen some that might say, 10-18 so I am assuming that this is the range they have decided, for whatever reason to set their machines at. Assuming that they have the auto-set and can do so.

But for those of us with the Escape, we can't and must set it, I gather, at just the one number?

So in my case, I take it that it would be 13??!!

Now, what exactly does that number mean and is it worse to have 13 than a lower number?


And one last questing pertaining to it....I have found that the pressure sometimes feels overwhelming. I am guessing that some of you, that are able to set it at 10-18 or so are having the pressured lowered at some point. If so, what point and why?
Is it because it helps to make it feel less overwhelming, or is there another reason?


T.I.A.
(This post was last modified: 02-22-2014 03:37 PM by ShelaghDB.)
02-22-2014 03:36 PM
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herbm Offline

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Posts: 852
Joined: Jan 2014

Machine: ResMed AutoSet S9
Mask Type: Oral
Mask Make & Model: ResMed Airfit P10 Nasal Pillow
Humidifier: ResMed H5i
CPAP Pressure: 11-16
CPAP Software: ResScan SleepyHead

Other Comments: Backup Mask: Innomed Hybrid FFM -- Oral+Nasal Pillows

Sex: Male
Location: Austin, TX

Post: #2
RE: Pressure Numbers, what do they mean? (Newbie Alert)
(02-22-2014 03:36 PM)ShelaghDB Wrote:  Cpap 13cm/h2o


So apparently my pressure is 13. Ive been looking at numbers besides members posts and see various different ones, of course.

You have a ResMed S9 Escape listed as you machine.

This is a straight CPAP machine with which delivers pressure at a SINGLE setting (e.g., 13 in your case.)

Presumably this was "titrated" or measured as the most suitable pressure during your (titration) sleep study (or the 2nd half of a "split study".)

(02-22-2014 03:36 PM)ShelaghDB Wrote:  I've seen some that might say, 10-18 so I am assuming that this is the range they have decided, for whatever reason to set their machines at. Assuming that they have the auto-set and can do so.

Those of us with an APAP (or other automatic machine) have two numbers, Minimum (or nightly start pressure) and Max (the highest the machine can go.

APAP machines can be set to deliver a single straight CPAP pressure but the other way around won't work.

My machine for instance is a ResMed S9 AutoSet.

Notice how confusing it is that we BOTH has an "S9" -- this is the series number and the AutoSet or Elite is the actual model.

Both are the latest SERIES but the APAP Autoset is a more capable machine.

(02-22-2014 03:36 PM)ShelaghDB Wrote:  But for those of us with the Escape, we can't and must set it, I gather, at just the one number?

So in my case, I take it that it would be 13??!!

That is correct.

(02-22-2014 03:36 PM)ShelaghDB Wrote:  Now, what exactly does that number mean and is it worse to have 13 than a lower number?

No, not exactly, especially if you don't need a VERY high number, e.g,. >20. Which may requires ANOTHER more advanced machine.

Some people respond at a lower pressure even though their Apnea is worse, i.e., their AHI number is higher, than some one who needs a higher pressure.

13 is about the middle of those of us who don't need the very high pressures.

Almost everybody needs 7-8 or more or they don't need the machine (not everyone, but maybe the 95%.)

(02-22-2014 03:36 PM)ShelaghDB Wrote:  And one last questing pertaining to it....I have found that the pressure sometimes feels overwhelming. I am guessing that some of you, that are able to set it at 10-18 or so are having the pressured lowered at some point. If so, what point and why?
Is it because it helps to make it feel less overwhelming, or is there another reason?


T.I.A.

The point of the APAP (auto-adjusting CPAP) is to give effective therapy at the lowest practical setting but increase the pressure as needed.

Frankly, I can't even FEEL 13 (my machine is set to 11-14 right now).

I have to OPEN my mouth and let out a little air pressure to be sure the machine is pumping.

I know that some people find the air blowing overwhelming but just don't understand it (if I am being honest.)

You are not alone -- it's my failure to understand, not yours.

So intellectually it's clear that some people find that more air is worse, it just doesn't work that way AT ALL for me.

The only reason I don't turn my pressure up even more is it looked to me like that might be causing some CA events (clear airway) where we just stop breathing rather than having an obstruction.

For *ME*, more air pressure it better (up to a point I suppose.)

BTW, by default, we are supposed to be letting the doctor prescribe the changes and the DME supplier make them on the machine.

Many of use have just taken control of our machine and read our own data card to review our statistics and guide those changes.


EDIT: Others have pointed out that your machine is a "Brick" (sorry), meaning that it doesn't collect detail data needed and displayed by the following programs:

SleepyHead software is free and downloadedable from SourceForge.net.

Rescan is available if you ask on this forum (for a private link.)

Sweet Dreams,

HerbM
Sleep study AHI: 49 RDI: 60 -- APAP 10-11 w/AHI: 1.5 avg for 7-days (up due likely to hip replacement recovery)

"We can all breathe together or we will all suffocate alone."
(This post was last modified: 02-22-2014 04:50 PM by herbm.)
02-22-2014 04:15 PM
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PaulaO2 Offline
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Machine: S9 Autoset
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: H5i
CPAP Pressure: 14-20
CPAP Software: SleepyHead

Other Comments: Ehlers-Danlos Syndrome, Hypermobility Type; chronic sarcasm

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Location: western NC, USA

Post: #3
RE: Pressure Numbers, what do they mean? (Newbie Alert)
The Escape is what we refer to as a "straight" CPAP as in it delivers just one set pressure all night, just like the Elite, for example. A lot of people are just fine using straight CPAP and get excellent results that way. However, the Escape is also what we refer to as a "brick" meaning it is not collecting any data except for compliance data. This means just hours used.

The Autoset is an APAP or autoPAP. APAPs are set with a range of pressures, a minimum and maximum. During the night, the machine stays within that range and tries to maintain the minimum pressure needed to keep the airway open while also keeping the maximum pressure needed to prevent the next apnea event.

The pressure is a personal thing. It is what your body needs to keep the airway open. Some need very little, some need a lot more. It isn't about what feels comfortable, it's about staying alive and healthy. That's why it is called "treatment pressure". There are things you can do to help yourself adjust to it and make it comfortable with time.

PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


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.
02-22-2014 04:24 PM
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zonk Offline

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Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #4
RE: Pressure Numbers, what do they mean? (Newbie Alert)
Both S9 Escape and S9 Elite are fixed pressure machines, can only be set to deliver constant pressure all night
(except Ramp period) but S9 Elite is data capable machine and S9 Escape is not ... meaning the machine is brick, no useful data other than how many hours using the machine each night

Pressure range apply to APAP such as S9 Autoset or PRS1 Auto and other APAP machines, the range consist of two set pressures, minimum pressure and maximum pressure, the machine auto-adjust pressure during the night as needed between the minimum and maximum set pressures (cannot go lower or higher than set pressures). Everyone is different, mine set at 9-14, pressure start at 9 and machine auto-adjust pressure in response to flow limitation and obstructive/hypopnea events, the trick is the minimum pressure, comfortable enough so don,t feel like not getting enough air to breathe and not too low so the machine in a good position to respond for any events occurring

btw ... APAP machine can be set to function on both modes, CPAP and APAP, two machines in one
Not all APAP machines are equal, S9 Escape Auto is an APAP machine but nevertheless is a brick
02-22-2014 04:29 PM
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mjbearit Offline

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Posts: 605
Joined: May 2012

Machine: REMstar Auto AFlex DS550
Mask Type: Nasal pillows
Mask Make & Model: RESMed Swift FX
Humidifier: Heated humidifier - 2
CPAP Pressure: 12.5-20
CPAP Software: SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: So Cal

Post: #5
RE: Pressure Numbers, what do they mean? (Newbie Alert)
You have received excellent advice so the only thing I can really add is in regards to the comparison to other people's numbers. This is not a contest. Higher numbers do not necessarily mean "worse". It's like taking medication. My blood pressure meds are set very low, so if you take that out of context, you may think, "Why is he on BP meds?". But what you have no way of knowing is that when I stand up, my BP drops and after the last time I passed out and hurt myself, they lowered the dosage! For some people, higher pressures can cause CSA or Central Events. In this case the doctor and team will work to find the balance that will minimize both the OSA AND the CSA. Some people may have many events an hour, but it only takes 10 cmH2O to open their airway. Some may have half the number, but it takes 20 cmH2O to open their airway. Please don't try to compare your settings to others. It is always like comparing apples to shrimp!
Mike

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
02-23-2014 07:44 PM
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trish6hundred Offline

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Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

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Location: Missouri, USA

Post: #6
RE: Pressure Numbers, what do they mean? (Newbie Alert)
Hi ShelaghDB,
What mjbearit said.

trish6hundred
02-23-2014 08:05 PM
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Sleepster Offline
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CPAP Software: ResScan SleepyHead

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Post: #7
RE: Pressure Numbers, what do they mean? (Newbie Alert)
A pressure of 13 cm H2O is enough to push a column of water to a height of 13 cm.

It's equivalent to about 0.18 psi or 1.3 kPa.

That's the pressure it takes to keep your airway from collapsing.

Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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.
02-23-2014 08:57 PM
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retired_guy Offline

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Machine: ResMed S9 Autoset
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Post: #8
RE: Pressure Numbers, what do they mean? (Newbie Alert)
(02-23-2014 08:57 PM)Sleepster Wrote:  A pressure of 13 cm H2O is enough to push a column of water to a height of 13 cm.

It's equivalent to about 0.18 psi or 1.3 kPa.

That's the pressure it takes to keep your airway from collapsing.

So... That being the case, how come everytime I turn my machine on my socks blow off?
02-23-2014 09:34 PM
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herbm Offline

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Machine: ResMed AutoSet S9
Mask Type: Oral
Mask Make & Model: ResMed Airfit P10 Nasal Pillow
Humidifier: ResMed H5i
CPAP Pressure: 11-16
CPAP Software: ResScan SleepyHead

Other Comments: Backup Mask: Innomed Hybrid FFM -- Oral+Nasal Pillows

Sex: Male
Location: Austin, TX

Post: #9
RE: Pressure Numbers, what do they mean? (Newbie Alert)
(02-23-2014 08:57 PM)Sleepster Wrote:  A pressure of 13 cm H2O is enough to push a column of water to a height of 13 cm.

It's equivalent to about 0.18 psi or 1.3 kPa.

That's the pressure it takes to keep your airway from collapsing.

It's also about the pressure you would experience when your lungs are about 5 inches (average) under water (i.e., 12.5 cm)

It's more than you would think but not a tremendous pressure.

Sweet Dreams,

HerbM
Sleep study AHI: 49 RDI: 60 -- APAP 10-11 w/AHI: 1.5 avg for 7-days (up due likely to hip replacement recovery)

"We can all breathe together or we will all suffocate alone."
02-23-2014 09:35 PM
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mjbearit Offline

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Machine: REMstar Auto AFlex DS550
Mask Type: Nasal pillows
Mask Make & Model: RESMed Swift FX
Humidifier: Heated humidifier - 2
CPAP Pressure: 12.5-20
CPAP Software: SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: So Cal

Post: #10
RE: Pressure Numbers, what do they mean? (Newbie Alert)
(02-23-2014 09:34 PM)retired_guy Wrote:  So... That being the case, how come everytime I turn my machine on my socks blow off?

So, Retired_guy, I had the unfortunate experience of "breaking" my machine (not to worry, I fixed it the next day!) and it was horrendous! I relate to your socks being blown off! My machine did not auto adjust and was blowing a constant pressure that kept rising! This problem caused my mask (nasal pillows) to constantly dislodge creating a major leak problem! I just read the card today and that night it did not even give me AHI readings or any readings as the leaks were continual. So, what does this mean? Well for one it means that non-auto machines are never going to be on my purchase list! But more seriously, above a certain pressure certain masks are ineffective because the do nothing but leak. You machine is apparently not an auto machine so the choice of mask becomes important in minimizing leaks. Secondly, and I know this is not something you want to hear, you would probably be better off with a machine that will auto titrate and will give you options about comfort settings. The Escape, from what I understand, is NOT one of those machines. I feel for you after my one night of a "dumb brick" and it really brought me back to the days when we did not have all these great features on our machines. In truth, my insurance would not have paid for the machine I have now. I paid for that out of pocket just to try to become more compliant.
Mike

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
02-24-2014 07:48 PM
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