(07-02-2013, 06:17 AM)skyler Wrote: I don't see you having this problem, but when I used an autoset the pressure would go higher to deal with apneas and the higher pressure would cause more apneas and the pressure would go higher- a vicious cycle. Be careful raising/changing pressures to fast. I'd give it a month between changes.
The new AutoSets detect CA and do not raise pressure in response to apneas occurring with a clear airway. Higher pressures can cause CA, but the AutoSet will not raise pressure in response - eliminating that vicious cycle. Of course, AHI could get worse with higher pressure because CAs are factored in; but, any increase in pressure is due to obstruction.
I have yet to hear of high pressures causing increased OA.
Some acclimate slowly, some quickly. Some are patient and can tolerate poor sleep, others can't. If I had been stuck with a pressure too low for a month, I would have given up on PAP. Some would give up if pressure is optimum for eliminating obstructions, but is too uncomfortable to sleep or CAs eliminate the benefit. It is a personal decision that people should make an informed decision about based on their own unique situation. The bottom line, though, is that someone with simple OA is more likely to realize greater health benefits long-term if they acclimate to the pressure needed to optimize reduction of OAs; rather than settling for a lower pressure that confounds the treatment of obstruction. How long it takes to acclimate and how it is achieved is a personal issue; but, pressure induced CAs are most likely to subside with time - OAs from untreated obstruction are not.
I personally slept my first night with PAP with an Auto CPAP set to 4 - 20 and only woke up once, early on, with the pressure at 19 and the mask floating on my face like a small hover-craft. I cinched the mask down, went back to sleep and woke up in the morning feeling better than I had felt in 20 years. I dealt with and eliminated pressure induced CAs, aerophagia, ear popping and having a hard time exhaling against the pressure by just sticking with it, not by lowering the pressure. It was easier to do because of the way I felt in the morning. If I had lowered the pressure to reduce the side-effects, then I probably would have reduced the benefit. With reduced benefit, I probably would have given up on PAP.
Just my 2 cents.