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[Pressure] Pressures over 20?
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justMongo Offline

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Posts: 3,855
Joined: Sep 2013

Machine: ResMed VPAP Auto (S9)
Mask Type: Full face mask
Mask Make & Model: ResMed Mirage Quattro
Humidifier: ResMed H5i
CPAP Pressure: 18 IPAPmax - 11 EPAPmin, PS=5
CPAP Software: Other Software

Other Comments: μολὼν λαβέ

Sex: Male
Location: Калифорния

Post: #11
RE: Pressures over 20?
The 10 series in the next generation of ResMed Machines. The "Autoset" is an S9 -- one generation behind.

6' and 205# is above the desired weight -- but still very reasonable. Your BMI is 27.8
Your ideal weight is about 185#

I think you need to view your data in context to flow limitation and snore. These are precursors of an obstructive event.
Likely you'll see flow limitation and/or snore before the pressure increase.

Some people have devised ways to stay off their back. From sewing tennis balls into the back of their shirt to...

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.
03-06-2015 04:37 PM
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PaytonA Offline
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Posts: 3,016
Joined: Dec 2013

Machine: ResMed S9 VPAP Auto
Mask Type: Full face mask
Mask Make & Model: Resmed Mirage Quattro
Humidifier: H5i(distilled-top up)
CPAP Pressure: VAuto MinE14.0 MaxI 20.6 PS4.0
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Orange County,California

Post: #12
RE: Pressures over 20?
I am fairly certain that the Aircurve Auto uses the same auto algorithm that the Airsense Autoset does. It would give you the same benefits as the Autoset plus the ability to operate in the S (straight bilevel) mode. In addition it will operate in manually adjusted CPAP mode or bilevel Auto mode. I think that you may be able to solve this with the machine that you have.

Best Regards,

PaytonA
03-06-2015 05:07 PM
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TiredToo Offline

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Posts: 83
Joined: Mar 2015

Machine: ResMed AirSense 10 AutoSet
Mask Type: Full face mask
Mask Make & Model: Airfit F10 (also have a Simplus, Eson and P10)
Humidifier: Built-in
CPAP Pressure: 14-20
CPAP Software: SleepyHead Other Software

Other Comments: Started CPAP Feb 9th, 2015. Suffered for way too many years prior.

Sex: Male
Location: NW Indiana, USA

Post: #13
RE: Pressures over 20?
(03-06-2015 05:07 PM)PaytonA Wrote:  I think that you may be able to solve this with the machine that you have.

I think so too... I am definitely going to try. I'm still doing much better than I did without it! Big Grin
03-06-2015 05:57 PM
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gondolabob Offline

Members

Posts: 15
Joined: Dec 2014

Machine: Respirionics System One Auto CPAP With Humidifier
Mask Type: Full face mask
Mask Make & Model: Resmed Quatro
Humidifier: Respitionics System One
CPAP Pressure: 8 to 20 Auto
CPAP Software: Other Software

Other Comments: Started Therapy November 2007

Sex: Male
Location:

Post: #14
RE: Pressures over 20?
Tired TOO,

You say that "I still can't seem to get an AHI below 2.x, and it is usually closer to 5 or 6 it seems"

According to Wiki:
Normal is less than 5,
Mild 5-15
Moderate 15-30
Severe Greater than 30

It would appear that you aren't too far off from where you want to be.

Is your starting pressure 16 t0 18 or is that the high setting?
03-06-2015 08:49 PM
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TiredToo Offline

Preferred Members

Posts: 83
Joined: Mar 2015

Machine: ResMed AirSense 10 AutoSet
Mask Type: Full face mask
Mask Make & Model: Airfit F10 (also have a Simplus, Eson and P10)
Humidifier: Built-in
CPAP Pressure: 14-20
CPAP Software: SleepyHead Other Software

Other Comments: Started CPAP Feb 9th, 2015. Suffered for way too many years prior.

Sex: Male
Location: NW Indiana, USA

Post: #15
RE: Pressures over 20?
I had been starting at 10 then auto-ramping to 16 with a max of 20. I just changed it to 20 fixed with APR 3 and will see how it goes tonight. I'm still going to auto-ramp from 10 though. Initially 20 does feel a bit strong but by morning it is usually around 19-20 when I wake up and I can hardly feel it much any more. I guess I get used to it overnight.

I know technically <5 is considered normal/treated and I'm averaging around there but I'd love to get it as close to 0 as possible. I've gone so long without quality sleep and now that I have gotten a taste of starting to feel normal again I want more! Smile It's been going on for many years. Before I put 2 + 2 together and realized it was most likely apnea (and therefore treatable), I honestly thought I may have had early-onset Alzheimer's at 42 years old. My memory and concentration was terrible, and I have some problems with depression. I have a long way to go before the damage is hopefully repaired but I can feel a difference already.

My test resulted as "severe" (34ish AHI... can't remember exactly right now) so I'm definitely off to a good start. Aside from some occasional leaking problems I am taking to this CPAP pretty well, thankfully.
03-06-2015 10:18 PM
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retired_guy Offline

Preferred Members-2

Posts: 2,744
Joined: Jan 2014

Machine: ResMed S9 Autoset
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: ResMed
CPAP Pressure: 10.6/14, EPR 3
CPAP Software: ResScan SleepyHead

Other Comments: Is it bedtime yet?

Sex: Male
Location: Beautiful, albeit very wet Oregon Coast

Post: #16
RE: Pressures over 20?
You're really doing well. Your attitude is great, and your results are not too bad.

You are using pretty high pressures though, so keep good track of leakage. Also be aware that when you ramp from 10 to 20 it can take awhile to get there. In the meantime you are not being treated for any apnea's along the way, so sometimes you might get woken up before you really get asleep.

Personally, I'd really rather see you using a pillows mask and see if more of a gentle breeze rather than a hurricane might not meet your needs.

But in the meantime, good job.
03-06-2015 10:33 PM
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APAPqueen Offline

Members

Posts: 4
Joined: Mar 2015

Machine: Resmed Airsense S10
Mask Type: Nasal mask
Mask Make & Model: Resmed Mirage FX
Humidifier: unsure
CPAP Pressure: 4cmH2O-20cmH20
CPAP Software: ResScan

Other Comments:

Sex: Female
Location:

Post: #17
RE: Pressures over 20?
I agree with Sleeprider... turn off the EPR. Is your machine giving you an AHI, Total AI and Central AI data. Are you having centrals? If you go on BiPAP you'll probably have to go in for a BiPAP titration study. Then you will have an inspiratory and expiratory pressure. That machine is expensive!! Depending on what kind of events you are having, depends on what to do.
03-06-2015 11:07 PM
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TiredToo Offline

Preferred Members

Posts: 83
Joined: Mar 2015

Machine: ResMed AirSense 10 AutoSet
Mask Type: Full face mask
Mask Make & Model: Airfit F10 (also have a Simplus, Eson and P10)
Humidifier: Built-in
CPAP Pressure: 14-20
CPAP Software: SleepyHead Other Software

Other Comments: Started CPAP Feb 9th, 2015. Suffered for way too many years prior.

Sex: Male
Location: NW Indiana, USA

Post: #18
RE: Pressures over 20?
I've got pillows on the way and I also have some different size masks to try in nasal and FF on the way too. I'm determined to find what works best for me.

Last night's numbers weren't so good in my opinion. At least not what I had hoped for. I changed the ramp start to 15 and it had reached 20 before I fell asleep so it was a 20 all night, save for the EPR of 3. I think I will turn EPR off tonight. What also may have affected it was that I came off of a 12 hour night shift yesterday morning and stayed up all day so I wouldn't have as many problems sleeping last night. So it's possible that being extra tired may have made things worse.

When I looked closer at the mask pressures, many (but not all) of the OA events seemed to have occurred while the mask pressure was down for the EPR.

   
03-07-2015 08:24 AM
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DeepBreathing Offline
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Posts: 2,296
Joined: Sep 2013

Machine: Resmed S9 VPAP Adapt
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: Resmed H5i
CPAP Pressure: EPAP: 9 - 15 PS: 3 - 10
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Perth, Western Australia

Post: #19
RE: Pressures over 20?
It's generally regarded as good practice to only change one parameter at a time and wait a week or so between changes. If you change too frequently you'll never get a handle on what each change is achieving or what the trend is.

DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


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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.
03-07-2015 08:40 AM
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justMongo Offline

Monitors

Posts: 3,855
Joined: Sep 2013

Machine: ResMed VPAP Auto (S9)
Mask Type: Full face mask
Mask Make & Model: ResMed Mirage Quattro
Humidifier: ResMed H5i
CPAP Pressure: 18 IPAPmax - 11 EPAPmin, PS=5
CPAP Software: Other Software

Other Comments: μολὼν λαβέ

Sex: Male
Location: Калифорния

Post: #20
RE: Pressures over 20?
You're showing flow limitation and snore even at 20 cm-H2O.
That's why on auto, you were bumping up to max pressure.

You are past the ramp up time when that cluster of OAs occurs at around 22:30.

Take a look at event duration using the events tab. If short, that's good. Min time to score an apnea is 10 seconds.

There appears to be large leak around 1:30 AM and in the 4:30-5:00 AM time.
Need to control those leaks.

In the interest of not running too high pressure; do not try for perfection.
An AHI of 6 will serve you well. Trying to get AGI=1 may not be a reasonable expectation.
You should feel pretty good with your present setup.

Retired_Guy is a big fan of the P10 pillows mask. We're going to have his nostrils drilled and tapped for 1/4 NPT and install hose barbs with locktite.

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.
03-07-2015 09:04 AM
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