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Query on higher pressure
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Visitor Offline

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Joined: Feb 2014

Machine: Resmed Airsense 10 Autoset
Mask Type: Nasal pillows
Mask Make & Model: Resmed P10 nasal pillows
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CPAP Pressure: 9
CPAP Software: SleepyHead

Other Comments: Started APAP on May 26, 2014. Benefits kicked in on May 31 thanks to forum help (leakage resolved)

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Post: #1
Query on higher pressure
I'm currently set at 7.5 to 12.

My 95% is listed as: 9.4 (mean value over all days as specified by software).

I'd like to experiment with higher min pressure. E.g. 8 or 9.

I noticed some of you are on even higher pressures. What benefits do you see from that? My AHI is fine at the moment and I plan to increase slowly (by halves) as I tend to feel better with higher pressure.

I am facing two issues with trying that out:

First: The software does not indicate central apneas. I get all the other info though that you might expect, including the various graphs. Is there a way to find out if I experience central apneas by looking at the graphs? Don't worry if you don't know the Breas software. If you could explain it from the graphs you use (i.e. shape and type of graph) I can work it out in my case. I just don't know what to look for.

Second: I experience mouth breathing despite using masking tape (that comes off easily when I gasp for air). I'm determined to make it work and got rid of a moustache to deal with more leaks, so hope this will fix the problem. I imagine that higher pressure might increase the mouth leakage problem? I.e. I may need to switch to a full facial mask? I use a chin strap and masking tape. The problem came about at 7.5 min pressure.

Before APAP: [Image: DARTH-VADER_zpsa57946df.png]

After APAP: See avatar: R2D2 for the win!

"Be kind, for everyone you meet is fighting a great battle"
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I don't snore! I just make creepy noises so the aliens know I'm not someone to be messed with.
07-15-2014 03:40 PM
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diamaunt Offline

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Posts: 436
Joined: May 2012

Machine: S9 VPAP Auto 36006
Mask Type: Full face mask
Mask Make & Model: mirage quattro/pilairo q
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CPAP Pressure: 9-20ish
CPAP Software: SleepyHead

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Sex: Male
Location: texas

Post: #2
RE: Query on higher pressure
(07-15-2014 03:40 PM)Visitor Wrote:  I'm currently set at 7.5 to 12.

My 95% is listed as: 9.4 (mean value over all days as specified by software).

I'd like to experiment with higher min pressure. E.g. 8 or 9.

I noticed some of you are on even higher pressures. What benefits do you see from that? My AHI is fine at the moment and I plan to increase slowly (by halves) as I tend to feel better with higher pressure.

the benefits of higher pressures are reduced apneas for those that *need* higher pressures.

no one number works for everybody, or there wouldn't be so many different machines, with such a wide variety of setting options.
my pressure's currently varying between 9 and 20, depending.

your 95% means it's at, or below that 95% of the time.

and, 8 isn't much change from 7.5.
07-15-2014 04:06 PM
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robysue Offline
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Posts: 1,233
Joined: Oct 2013

Machine: PR Dreamstation BiPAP Auto
Mask Type: Nasal pillows
Mask Make & Model: Swift FX
Humidifier: PR Dreamstation humidfier
CPAP Pressure: min EPAP = 4; max IPAP = 9;
CPAP Software: SleepyHead EncoreBasic EncorePro

Other Comments: Papping since September 2010

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Location: Buffalo, NY

Post: #3
RE: Query on higher pressure
(07-15-2014 03:40 PM)Visitor Wrote:  I'm currently set at 7.5 to 12.

My 95% is listed as: 9.4 (mean value over all days as specified by software).

I'd like to experiment with higher min pressure. E.g. 8 or 9.

I noticed some of you are on even higher pressures. What benefits do you see from that? My AHI is fine at the moment and I plan to increase slowly (by halves) as I tend to feel better with higher pressure.

I am facing two issues with trying that out:

First: The software does not indicate central apneas. I get all the other info though that you might expect, including the various graphs. Is there a way to find out if I experience central apneas by looking at the graphs? Don't worry if you don't know the Breas software. If you could explain it from the graphs you use (i.e. shape and type of graph) I can work it out in my case. I just don't know what to look for.
The thing is: A central apnea and an obstructive apnea look very much a like when you look at the graphs. The machines that detect CAs and OAs use proprietary algorithms for determining the patency of the airway: If the algorithm's test indicates there is a high probability that the airway is clear (NOT blocked or NOT obstructed), the machine scores a CA. If the algorithm's test indicates that there is a high probability that the airway IS obstructed (blocked), the machine scores an OA.

Long chains of pressure induced centrals, however, do tend to have a certain pattern to them: There is typically a waxing/waning pattern of breathing between the apneas, and the pattern tends to repeat pretty regularly every 60-120 seconds.

Quote:Second: I experience mouth breathing despite using masking tape (that comes off easily when I gasp for air). I'm determined to make it work and got rid of a moustache to deal with more leaks, so hope this will fix the problem. I imagine that higher pressure might increase the mouth leakage problem? I.e. I may need to switch to a full facial mask? I use a chin strap and masking tape. The problem came about at 7.5 min pressure.
Yes, a higher median pressure is likely to increase problems with mouth leaking.

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See my Guide to SleepyHead
07-15-2014 04:18 PM
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retired_guy Offline

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Posts: 2,744
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Machine: ResMed S9 Autoset
Mask Type: Nasal pillows
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CPAP Software: ResScan SleepyHead

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Post: #4
RE: Query on higher pressure
What is your AHI doing these days Visitor?

Since your 95% is at 9.4, increasing the minimum to 8 or 8.5 would probably not be much of a difference, but when you say you feel better at higher pressure, what do you base that on?

As to increasing your leak rates; maybe, but I don't think the pressures being considered are a real problem for you as far as the P10 is concerned. I run as high as 14 and as long as I use my chinstrap I don't have any particular problem. Certainly much less of a problem than I had with a full face mask. Apparently you're not using a chinstrap but you might think about doing that. I personally don't think you should tape your mouth shut unless you're being repainted, but that's just me.
07-15-2014 06:17 PM
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woozie38 Offline

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Machine: Fisher & Paykel Icon + Auto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
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CPAP Pressure: 8 to 14
CPAP Software: SleepyHead Other Software

Other Comments: 17 years of CPAP + supp. oxygen @ 3 L/min

Sex: Male
Location: Toowoomba, Queensland Australia

Post: #5
RE: Query on higher pressure
(07-15-2014 03:40 PM)Visitor Wrote:  I experience mouth breathing despite using masking tape (that comes off easily when I gasp for air). I'm determined to make it work and got rid of a moustache to deal with more leaks, so hope this will fix the problem. I imagine that higher pressure might increase the mouth leakage problem? I.e. I may need to switch to a full facial mask? I use a chin strap and masking tape. The problem came about at 7.5 min pressure.

It seems a sleeper using nasal pillows will suffer from therapy air exhausting via their mouth.
As do you, I taped my mouth with 50mm Micropore surgical tape and did so for 6 years. However APAP pressure rises will dislodge the tape allowing air to escape. It goes without saying, increased pressure will do the same. The air flow will dry the tape & it will re-attach, giving the impression it's been in place all night. My solution was to apply the tape like this:- Click here
It's understood that too high a pressure can trigger central apneas so best to stay with your Rx pressure or consult your sleep doc before changing your max pressure setting.

[Image: signature.png]Keep on breathin'
07-15-2014 06:35 PM
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Sleepster Offline
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Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

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Location: Houston, Texas

Post: #6
RE: Query on higher pressure
(07-15-2014 03:40 PM)Visitor Wrote:  My AHI is fine at the moment and I plan to increase slowly (by halves) as I tend to feel better with higher pressure.

In what way do you feel better?

Quote:I use a chin strap and masking tape.

I'm not a fan of tape. Is the chin strap tight enough?

How do you know you're mouth-leaking? Do you see significant periods of large leak on the graph? Do you wake up with air hissing out of your mouth?

Sleepster
Apnea Board Moderator
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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.
07-15-2014 07:22 PM
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zonk Offline

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Post: #7
RE: Query on higher pressure
(07-15-2014 03:40 PM)Visitor Wrote:  I'd like to experiment with higher min pressure. E.g. 8 or 9.
Do you have permission from your doctor ... unsupervised, you can hurt yourself Rolleyes
(This post was last modified: 07-15-2014 08:39 PM by zonk.)
07-15-2014 08:38 PM
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mdh235 Offline

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Location: West Coast U.S.

Post: #8
RE: Query on higher pressure
(07-15-2014 03:40 PM)Visitor Wrote:  I'm currently set at 7.5 to 12.

My 95% is listed as: 9.4 (mean value over all days as specified by software).

I'd like to experiment with higher min pressure. E.g. 8 or 9.

I noticed some of you are on even higher pressures. What benefits do you see from that? My AHI is fine at the moment and I plan to increase slowly (by halves) as I tend to feel better with higher pressure.

My apnea is totally controlled with a maximum pressure of around 12.6 (typical nights AHI .2 to .6). However, my machine seems to think the maximum pressure should be higher because my 95% number always equals my maximum pressure number, so I've been experimenting by raising the upper limit until my 95% value is always below it. For me, that's a setting of 14.

However, at the higher pressure my AHI goes up to over 1 and I have more leaks. Now I know that AHI is not bad, but it's odd that my machine thinks my pressure needs to be higher even though that results in more apneas.

I'm going to stick with it for a few days, but unless something changes I see no reason to keep my pressure so high.
(This post was last modified: 07-17-2014 07:00 PM by mdh235.)
07-17-2014 06:57 PM
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diamaunt Offline

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Posts: 436
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Machine: S9 VPAP Auto 36006
Mask Type: Full face mask
Mask Make & Model: mirage quattro/pilairo q
Humidifier: none
CPAP Pressure: 9-20ish
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: texas

Post: #9
RE: Query on higher pressure
look for snores and flow limitations, the autoset will bump pressure on those, because that indicates there may be apneas on the way.
07-17-2014 07:34 PM
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Sleepster Offline
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Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

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Post: #10
RE: Query on higher pressure
(07-17-2014 06:57 PM)mdh235 Wrote:  My apnea is totally controlled with a maximum pressure of around 12.6 (typical nights AHI .2 to .6). However, my machine seems to think the maximum pressure should be higher because my 95% number always equals my maximum pressure number,

I don't understand. To me all this means is that you're spending 5% of the time at your maximum pressure, and that's successfully treating your apneas and hypopneas.

Is there an issue with your sleep quality? Like are you waking frequently or feeling tired during the day?

Quote:so I've been experimenting by raising the upper limit until my 95% value is always below it. For me, that's a setting of 14.

However, at the higher pressure my AHI goes up to over 1 and I have more leaks. Now I know that AHI is not bad, but it's odd that my machine thinks my pressure needs to be higher even though that results in more apneas.

The difference 0.6 and 1.0 is not significant, especially with just a few days of data. Is it your CA index that's gone up?

And when you say the leaks are worse what do you mean? Do you have large leaks that have gotten worse, or have you gone from acceptable leaks to large leaks?

And do these leaks wake you up?

Sleepster
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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.
07-17-2014 09:40 PM
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