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[Pressure] how to exceed max ai of 19
#1
how to exceed max ai of 19
What a relief to discover the Apnea Board
I have a ResMed AirCurve 10.  The highest pressure I can program is 19.  This is acceptable for me, but I prefer earlier devices I've used which had a higher pressure. 
Is there a way to override the 19 limit?
BTW, my test for the right pressure involves opening my mouth slightly.  If thr air pressure makes my cheeks baloon out, the pressure is right for me. The 19 setting doesn't make my cheeks baloon.
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#2
RE: how to exceed max ai of 19
Resmed Aircurve 10 is a series of bilevel machines. Which do you have (look under the name on the right side) S, ST, VAuto?
The VAuto will run up 24 cm-water.

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#3
RE: how to exceed max ai of 19
That's an odd way to see if the pressure is right. The best way to determine that is to look at the data. No reason to have it higher if your apnea is being treated at a lower pressure.
PaulaO

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#4
RE: how to exceed max ai of 19
Hi lisaby,
WELCOME! to the forum.!
Hang in there for more responses to your post, good luck to you with CPAP therapy.
trish6hundred
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#5
RE: how to exceed max ai of 19
G'day Lisaby. Welcome to Apnea Board.

All Aircurve machines can give you a maximum pressure greater than 19. How to achieve that depends on the particular model of machine. On the front of the machine will be printed the machine type - S, ST or ST-A, VAuto, ASV or CS Pacewave. Please let us know which it is.

The next thing is to find out what your prescription settings are, and then whether the machine is treating your appropriately. As Paula said, allowing the machine to inflate your cheeks is a strange way to determine its efficacy. You can look at the numbers on the machine screen to see what your apnea and hypopnea indices are. Preferably, use SleepyHead to give you a detailed view of what is happening and whether your settings are working.
DeepBreathing
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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.
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#6
RE: how to exceed max ai of 19
Thanks for your rapid reply.  Please see my answer to Deep Breathing below.

My device is an Air Curve 10 CS Pacewave
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#7
RE: how to exceed max ai of 19
Thanks to all of you for your rapid replies.

I've used ResMed devices for several years.  They quickly reduced my apneas from 33 to 1.  They were a pleasure to use.  I slept better with them.

A couple of years ago, consistent with my doctor's prescription, the supplier changed to bi-level devices.  Ever since, I've had trouble breathing with the devices.

The device doesn't fill my lungs (I use a face mask) and I start to suffocate.  After several minutes, I have to remove the mask in order to breathe normally.

In the past, when I underwent chest X-rays, the technicians always told me that I had big and deep lungs.  That may be related to my problem.

If I suffocate with a device, I can't use it.  I noticed long ago that devices that caused my cheeks to balloon always provided me enough air.  When the supplier proposes a new device, it's a rapid way to check if it provides enough air.

One of you said that it was possible to increase the AI beyond 19 cm H2O on all ResMed devices.  I'd certainly like to learn how.  The AI max counter on my device stops at 19.

Another one of you mentioned an Air Curve device that goes up to 25.  It may be a solution if my supplier carries it.

I sense that my doctor and the supplier are losing patience with me.  Nevertheless, I have 10 months left on my subscription for rereimbursement by my health insurrance.  I don't want to let it go to waste.

That's why I turned to you.
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#8
RE: how to exceed max ai of 19
The pressure settings are dependent on the particular model you have.

Generally there will at least be an EPAP setting (the pressure at which you breathe in) and a pressure support, which is additional pressure added as you breathe in. The actual inhalation pressure is called IPAP. EPAP + PS = IPAP

You need to let us have the machine type and your prescription settings in order for us to advise how to increase your maximum if that's what you need.

By the way, you refer to your pressure as "AI". in English AI refers to apnea index, not a pressure setting.
DeepBreathing
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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.
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#9
RE: how to exceed max ai of 19
Again, thanks you for your rapid and informative replies.  I'll donate shortly.

I experimented with the device today.  I have no choice.  We're in our vacation home.  My doctor is 750 mi. away and not very interested in my case.  The supplier's nearest office is two hours away.  He doesn't seem to be interested either.

The two of them treat the parameters of my device as a trade secret.  I suppose that you threaten their monopoly.

Now that I've been able to contact you, I have the hope that I can find settings with which I can sleep.

My device has three modes: CPAP, ASV and ASV Auto.

I tried all three this afternoon.  

With CPAP, I was able to get a good input pressure, which permitted me to inhale normally, with settings around 15.  It is the only parameter available for CPAP.  The problem was that I couldn't exhale properly.  At 10, I couldn't inhale properly.

With ASV, with a maximum EPAP of 15 and a minimum of 6, again I could inhale properly, but not exhale.  ASV Auto was about the same.

My goal is to be able to sleep comfortably with my device tonight, after five months without a device - and several years before that when my device performed perfectly.

I recognise that you can't prescribe settings.  Would you, however, be able to explain to me how to find a mode and a setting which would permit me to exhale easily?

My doctor prescribed a ASV device.  I have no problem returning to CPAP mode if that is the only solution to my breathing problems.
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#10
RE: how to exceed max ai of 19
Please post your daily charts,  The data that these provide will help immensely to understand what is going on.  Organization is important and if additional charts are needed or desired we will be sure to ask.

Thanks

Fred
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
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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.
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