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Pressure Setting
#1
Pressure Setting
Just picked up my apap machine today.  I am not optimistic re it's use.  I am told the setting is 4-15, which is the default range for the machine.  My ahi is 17.   When the therapist turned it on by the time the machine geared up to the "cruising speed" of 4 it felt like a hurricaine was blowing in my nose.  I understand the concept of use regarding a cpap or apap machine, but why does the thing have to be blowing air up my nose when I am trying to fall asleep.  Why can it not be set at 1 and then maybe, just maybe, in addition to my nightly battle with not being able to fall asleep under two hours insomnia, and severe restless legs requiring a two hour up and down "walk it off" nightly marathon, at least another "roadblock" to slumber will not be added.  And I have unsuccessfully been thru the full gambit of meds for restless legs, short of narcotics, so I do not need to hear any helpful hints of "why don't you try to treat the restless leg syndrome".   At a setting higher than 4 instead of being woke up twice a month or so from an apnea state I can forsee being woken up being blown to kingdom come, and that is assuming I even fall asleep in the first place!
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#2
RE: Pressure Setting
Welcome the forum. Please update you profile to show exactly which machine you have. If it's the ReMed AirSense 10 Autoset you have what many regard as the best. It's the machine I use and I find if very comfortable and effective. A minimum setting fo 4 is actually very low. My range is 9-14. Most people feel starved for air at 4 which is the minimum setting for the machine. It shouldn't feel like a hurricane. I'm not questioning your discomfort but wonder if the settings are incorrect. What pressure shows on the screen when you turn it on?

It would be helpful to see some data. I suggest you download SleepyHead software which supplies a wealth of helpful data. 
https://OSCAR Page ----> CLICK HERE ./
See the user guide for instructions. http://www.apneaboard.com/wiki/index.php...SleepyHead

Then collect some data and post it here. The best way is too use the image hosting service Imgur.  For complete instructions read  Posting SleepyHead Charts in 5 Easy Steps

You will need an SD card if your machine didn't come with one. Any standard SD card will do. 8 GB will be enough for years of data.

If you have questions feel free to post them.
Download OSCAR

Organize Charts
Attaching Charts

Mask Primer
Soft Cervical Collar

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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#3
RE: Pressure Setting
Hi catspurrrr,
The default setting for your Apap is 4-20.  A minimum pressure of 4 is as low as it goes.

I know you won't want to hear this, but a minimum pressure of 4cm makes most folk feel air starved.  

Ok, no "helpful" hints on restless leg syndrome, but you did bring it up.  Smile

The one thing I can advise that has helped myself and others when starting out.....
Try moving your machine to the living room, (empty water first) set it up with your mask and air pressure on, and watch TV or read for awhile.  If you do this a couple times a day, it eventually makes it easier to adapt to the pressure and the feel of the mask.

If you don't have a Clinicians manual, order here:
http://www.apneaboard.com/adjust-cpap-pr...tup-manual
OpalRose
Apnea Board Administrator
www.ApneaBoard.com

OSCAR Chart Organization


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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#4
RE: Pressure Setting
Once you have the Clinician's manual, you can set it up to start automatically when you take a breath with the mask already on. This avoids that big breeze you complained (rightfully) about.

My mask has a short, light hose which goes between the mask and the long hose from the machine. I leave that on the mask and slide the headgear over my head with one hand while holding the mask in place with the other. Because the short hose is not connected, I can still breathe comfortably while I adjust the mask fit. Once I'm satisfied, I connect the short hose to the long hose and take a big breath (or sometimes blow hard - either seems to work). The machine starts up and I can feel (and see on the dial) the pressure build up to my starting pressure. No big breeze, unless my mask is leaking somewhere - there's no place for the air to go except into your lungs. If you can blow up a rubber balloon, your lungs can easily handle the pressure from your machine.

It does take some time to get used to, but you don't have to have the breeze, and the pressure will not blow you up; I promise.
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#5
RE: Pressure Setting
Thank you for your response.  Since I posted my question I went out to my garage to get the contraption out of my car to set it up and read a little more about it on line and also the lit which came with it.  My choice for the "accessory" was the pillow as it appeared to be the least invasive.  My tendency, while at the demo, and when I hooked it up just now is to not have it snug against my nostrils, like a nasal canula, thus my question of why the pressure has to be at 4.  Oxygen can be delivered via mask or nasal canula, why can't these machines have a delivery system with a nasal canula?  Surely the sensors that pick up the breathing, or lack of, can operate without a tight fit?

I have it out in my family room and set up.  If it is set up correctly, I do have to admit that the pressure does not feel as strong as it did during the demonstration.  I have made several attempts at just putting it up to my nostrils, without strapping it on, and it is sending me in to hyperventilation and panic mode.  Why am I such a basket case with this?  When I asked the therapist today if other people had trouble, she said no.  I knew I was going to have trouble since the therapist during the sleep study brought one to me and woke me up to put one on with tubes running both sides of my face and above my forehead.  I doubt I lasted a minute with that one on also, and I have worried about being able to tolerate one for the past 4 weeks between the sleep study and now.  I don't relish the thought of undergoing a drug induced sleep endoscopy to isolate the cause of my apnea but I am starting to think this may be what I have to do.

I will go to my profile page to complete the info you asked for.  The brand of the unit is ResMed, AirSense10.
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#6
RE: Pressure Setting
Try sitting wathing tv or reading a book with it on. Also if you turn the lower pressure up to about 6 you should not feel like you are starving for air. You need to have patience with the process. It dose take a little getting used to. I been on apap for3 months now and i reach up constantly to find out if its still on. My pressure is 12 to 18. I use the ramr feature set too 8 for 5 min. and i do t feel the pressure change to 12 at all.
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#7
RE: Pressure Setting
Catspurrrrr, your therapist lied to you when she said nobody else had trouble getting used to CPAP. Almost everybody takes at least a little while to figure things out, and get comfortable.

The opening page of our Wiki (the link is in the black banner at the top of each page) has a short video explaining what happens during an obstructive apnea, and why the air pressure prevents them. I recommend watching it highly.

There are many varieties of mask, finding the right one to fit your face can take some experimentation. Here is a link to our Mask Primer: http://www.apneaboard.com/wiki/index.php...ask_Primer

Be patient and allow yourself time to learn about this new thing in your life.
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#8
RE: Pressure Setting
You are not alone, almost everyone has some trouble adapting to CPAP therapy.  
On the front of your machine you should have the word "AutoSet" which makes your machine a ResMed AirSense10 AutoSet, One of the best anywhere.

Many of us have had trouble adjusting, we have been thru it before, so state what issues you are having and we can, and will help you thru them.

That said, download and install SleepyHead (free) organize your charts, not all are as important as others, then post your charts.  We can see a lot that happens in the data and allows us to give you much better advice.


Fred
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#9
RE: Pressure Setting
I feel your pain. At the DME, I tried the mask on under pressure (4 cm) and I thought my lungs were going to blow up. They sent me home with a setting of 4 to 16 cmH2O and a small pillow. The small pillow only lasted one night and switched to the medium and things improved greatly. Then I found this forum. 

Now my starting pressure is 6 cm and anything lower makes me struggle to get air in.  Also I tried the Large pillow and again this made a huge difference. Now the large leaks a little more and the fit is better on the medium BUT I am more comfortable with the large and can breath much better.

My advice: Try everything but only one thing at a time. Pressure is probably too low and the pillow is too small. This is my story and I am sticking to it. 

Believe me, when I say "you will get used to it".
CPAP is a journey like “The Wizard of Oz”. It’s a long slow journey. You will face many problems and pick up many friends along the way. Just because you reach the poppies, it doesn’t mean you are in Kansas. 
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#10
RE: Pressure Setting
Thank you all for your recommendations.  I am going to print all and re-read them.  I have logged on zero minutes on the register (I thought maybe I was able to stand it at least a minute in a more relaxed, my home environment, but it shows zero).  I tend to be a "catastrophizer" which I tell myself to keep in the back of my mind when trying to adapt to new things.  Right now I am just so tired, from worry, and from two days in a row having to drive to Ralegh from Chapel Hll, first to a surg. consult, and then to pick up "this thing", trying to follow mapquest directions while driving on interstate (mapquest, which on the first day was misleading, making my arrival at destination 45 minutes late-the ENTsurgeon was so nice and still saw me), I am going to start my nightly 2 hour ordeal trying to fall asleep (w/o any cpap tonight, thank you), and start anew tomorrow.  One other comment/question I did have after reading all the responses is still, regarding the panicky feeling I am getting with the air blowing in and blowing out against it.  For the past 17 or 18 years I have been a swimmer, swimming laps for 35 minutes 3 times a week in an olympic size pool down the road, resting ~ 1 minute after 10 minutes, then resting another 1 minute after 10, then finish.  I am very aware of breathing in and out while swimming, and despite a grade 2 heart valve insufficiency have no problem forcing air on the breath out. There is no question the machine forcing air in is creating panic more than blowing out, but even blowing out seems to be difficult. This is just not making sense to me.

I have never used one of these forums before anywhere, but this site popped up when I typed in my initial question regarding pressure settings.  Do I need to sign out of it, or the "thread" (like is that a discussion?), or what?  I got an email when I came on after dinner saying I had to respond to the last response or it would end.
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