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Quick Question about Max pressure and sleep disturbance potential
#1
Hi All,
As I am reviewing my "stuff" in anticipation of first post pap visit with Doctor on Wednesday, I notice that at least for last night, I came close to my max of 14.0 at about 13.84. So it seems obvious to me I should raise my top pressure number to at least 15.0.

I then note that in the last 3 months, my max pressure for whole periods 9 could have been a blip, no time to go page by page at mo) was 15.54.

So Maybe I should raise it to 16.

I am very sensitive to increases in the lower number, and have had to inch a week-10 days at a time up by .2 at a time to get to where I am now at 7.8.

How likely is it, that I will mind or even notice the top being increased to 15-or 16? Which would you go for?

The Hen,
More excited than anxious, about the BIG appt.
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#2
I'm still pretty new at this, but here's my thought on it...

If you're frequently hitting the top limit, coming down a little and bouncing right up against it again, you should probably raise it because it's acting as a ceiling for where the pressure wants to go.

If you only come near the limit one time during the night (and especially if you don't even touch it), you could probably lower the top limit and still get basically the same result, without having your pressure change so much from low to high. In general I would think a narrower range is better than a wider range (as long as it covers your needs).

p.s. I did raise my upper limit one night in a similar case to what you described, and found it wasn't using that area. So I have gone exploring in that direction just to see if it was needed... Smile
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#3
I would not recommend you increase upper pressure until after you talk to your doctor. With EPR at 3, your EPAP pressure remains at 12 when you're hitting those peaks. As I discussed in the other thread, I think that you will be trading OA for CA. This is one of the limitations of CPAP that might move you to bilevel.
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#4
My view on this is:
The Auto machines use snores and FLs as precursor events and use it to raise pressure. Consequently, if you are not seeing any Real events while your pressure is bumping at top limit, there is no point in raising the roof.

The frequent pressure changes in itself may cause microarousals in some people and bump them out of a deeper sleep stage to a shallower stage and cause them to feel Unrefreshed in the morning. I am one of them. I now sleep at a straight pressure of 7.5.

Started APAP 4-20, Closed range to 7.5-14, then straight 8.0 w/ Aflex 3
RDI always below 1. But sleep much much better at straight pressure.
Started on F10, Tried Quattro Air successfully. Finally settled on P10.
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#5
Given the SH charts you posted in another thread, I would suggest not increasing pressure.
Pressure treats OAs -- and you seem to have those in control. You may exacerbate your CAs.
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#6
Thanks All. Good point Mongo! Agreed.
The Hen
Pecking on iphone ruffling feathers .
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#7
Nah. Occasional blips probably don't mean much. I wouldn't unless you were actually hitting it consistently (several times a night, most nights) and it was causing disturbance in sleep.

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#8
I have to go with the hold off bumping up the pressure school of thought. You don't want to get those CA's all riled up.
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