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Rule of thumb for top pressure setting?
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TheManseHen Offline

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Posts: 243
Joined: Jan 2015

Machine: RedMed A10 Airsense 10 Autoset
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: One that came with machine
CPAP Pressure: 7.6-14.0 EPR 3
CPAP Software: ResScan SleepyHead

Other Comments: Started C-pap Boxing Day 2014. Tortured sleep more or less since 2000. Trigeminal Neuralgia.

Sex: Female
Location: San Francisco

Post: #11
RE: Rule of thumb for top pressure setting?
SleepRidr, I have my flickr set to public. My most recent night is the first one on the page, others are there too. Not necessarily in order.

https://www.flickr.com/photos/131278161@N05/

If you want a close up or enlarged horizontally pic of part, let me know what and I'll upload one.

Thanks,

The Hen.
(This post was last modified: 02-20-2015 10:16 PM by TheManseHen.)
02-20-2015 10:15 PM
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TyroneShoes Offline

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Posts: 505
Joined: Oct 2014

Machine: Resmed S9 Autoset
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10
Humidifier: Resmed H5i
CPAP Pressure: 10-14
CPAP Software: SleepyHead

Other Comments:

Sex: Undisclosed
Location:

Post: #12
RE: Rule of thumb for top pressure setting?
I used a little different approach to limiting top pressure. I was 5-20 for the first 50 days. On a couple of those nights the APAP did a "runaway", which I will define as going to a very high pressure without any events to support this. I verified on the forums that this could sometimes happen with the S9 Autoset.

On those two days it woke me up and I needed to shut it off and start it again for it to behave normally. So I looked at everything and found that otherwise it never really got above 13 (in the other 48 days), and that it needed to get to about 16 or 17 before it woke me up.

So I set the top pressure to 14, and it has never gone above 13 since (next 122 days). If it ever hits the ceiling again (with events to support that) I would raise it up, but have not had to. Got a 0.0 last night, BTW.

Bottom line, an APAP is supposed to raise pressure to help you get quality sleep without events. But on rare occasions it may raise without having a good reason, or at least that has been my experience. The science is sophisticated, but not perfect. If it raises the pressure (without a reason) enough to wake you or if that starts increasing centrals, it probably can't hurt to reign it back in a bit, as long as you are vigilant about hitting the pressure ceiling.

What others have posted here about the lower range setting seems very true, as does the theory about OA causing peeing while CA might not. Setting the low end high enough to prevent OA (and high enough for it to not take too long to raise in the face of events) while not causing CA is where the sweet spot is, but raising the lower end can also contribute to leaks, because higher pressure can break the seal easier.
02-21-2015 11:02 AM
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OpalRose Offline

Monitors

Posts: 3,181
Joined: Nov 2014

Machine: PR System One REMstar Auto 560 with A Flex
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10 For Her
Humidifier: REMStar heated humidifier with heated hose
CPAP Pressure: Auto Cpap 10-13 AFLEX 1
CPAP Software: SleepyHead EncoreBasic

Other Comments: Started CPAP Therapy October 23, 2014

Sex: Female
Location: Northeast Ohio, USA

Post: #13
RE: Rule of thumb for top pressure setting?
(02-21-2015 11:02 AM)TyroneShoes Wrote:  I used a little different approach to limiting top pressure. I was 5-20 for the first 50 days. On a couple of those nights the APAP did a "runaway", which I will define as going to a very high pressure without any events to support this. I verified on the forums that this could sometimes happen with the S9 Autoset.

On those two days it woke me up and I needed to shut it off and start it again for it to behave normally. So I looked at everything and found that otherwise it never really got above 13 (in the other 48 days), and that it needed to get to about 16 or 17 before it woke me up.

So I set the top pressure to 14, and it has never gone above 13 since (next 122 days). If it ever hits the ceiling again (with events to support that) I would raise it up, but have not had to. Got a 0.0 last night, BTW.

Bottom line, an APAP is supposed to raise pressure to help you get quality sleep without events. But on rare occasions it may raise without having a good reason, or at least that has been my experience. The science is sophisticated, but not perfect. If it raises the pressure (without a reason) enough to wake you or if that starts increasing centrals, it probably can't hurt to reign it back in a bit, as long as you are vigilant about hitting the pressure ceiling.

What others have posted here about the lower range setting seems very true, as does the theory about OA causing peeing while CA might not. Setting the low end high enough to prevent OA (and high enough for it to not take too long to raise in the face of events) while not causing CA is where the sweet spot is, but raising the lower end can also contribute to leaks, because higher pressure can break the seal easier.


TyroneShoes,
I used the same approach as you with setting the upper limit. I also noticed with my data that the pressure rarely went past 13,except for a few times when machine deceided to raise it higher to 15 with nothing to support it...that I could see anyway.
This always disrupted my sleep when pressure went up that high. If it hadn't disruped my sleep, I would have left it set at a higher number. So I keep my high limit at 14, but watch it closely.
Now as to the lower limit, still haven't found that "sweet spot". Unsure
I also have used Optistart, and it doesn't change my pressure from the 8 that I have it set.
OpalRose

OpalRose
(This post was last modified: 02-21-2015 11:37 AM by OpalRose.)
02-21-2015 11:34 AM
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Jemstone Offline

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Posts: 8
Joined: Dec 2014

Machine: Resmed s9 VPAP Auto (36006)
Mask Type: Full face mask
Mask Make & Model: Resmed AirFit F10
Humidifier: Resmed humidifier and climate line hose
CPAP Pressure: Auto 4, 13
CPAP Software: SleepyHead

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Sex: Female
Location: SLC Utah

Post: #14
RE: Rule of thumb for top pressure setting?
"because the older machines would sometimes "run-away" and increase pressure beyond any reasonable need"

How to fix a runaway machine??? Should I purchase a different machine? Yikes

I'm doing a happy dance! I feel vindicated. I didn't know I had a known issue! I need to know more about this "run-away" problem. I have a Resmed S9 and an airfit F10. About 3 hours into sleep, the dang machine's pressure goes really high and blows my mask off. I shut it down then turn it back on, it's ok for a bit then runaway again. Every night. I thought maybe the mask was slipping off and it was trying to compensate so I purchased an Airfit P10. I woke up with my lungs hurting and I was kind of sick for a few days.

I purched my machine from a local classified. I've had prescriptions to get a sleep study but they are too expensive, so I've been doing it on my own. The low is set at 4 and the high is 13.

Even though I'm having this frustrating issue, I have less headaches and I wake up when I wake up! I need far less sleep. I can't wait to see what happens when I fix the run-away issue.
Thanks, y'all! Jemstone
(This post was last modified: 02-23-2015 02:26 AM by Jemstone.)
02-23-2015 02:22 AM
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truckerdad57 Offline

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Posts: 36
Joined: May 2012

Machine: tester - lots
Mask Type: Nasal pillows
Mask Make & Model: tester lots
Humidifier: ResMed S-9 climateline
CPAP Pressure: APAP 15-17
CPAP Software: SleepyHead

Other Comments: Truck driver active on issues with apnea and DOT medical exams.

Sex: Male
Location: Batavia, Il

Post: #15
RE: Rule of thumb for top pressure setting?
Jemstone.....

If no one else had told you buying a used CPAP like you did and self-titrating is not a medically great idea.

You can get home sleep studies for $ 300-400.

Being sick for a few days due to too high a pressure can cause major complications. Aerophagia is where air leaks past your epiglottis and inflates your stomach while using CPAP can cause a host of other complications. As discussed elsewhere in this thread too high a pressure can cause central apneas.

The other issue with buying a used CPAP was .... was it properly disinfected prior to you using it? TB would be a worst case scenario.

I know a full in lab psg is too expensive for anyone without insurance. But a home sleep study can be a way to start. Get a proper diagnosis and then you can work on getting proper medical advise and help on the settings based on your total medical history and issues. Not just what you post and get from an online forum.

Hope this helps.

(Just a truck driver with sleep apnea )
02-23-2015 02:50 AM
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OpalRose Offline

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Posts: 3,181
Joined: Nov 2014

Machine: PR System One REMstar Auto 560 with A Flex
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10 For Her
Humidifier: REMStar heated humidifier with heated hose
CPAP Pressure: Auto Cpap 10-13 AFLEX 1
CPAP Software: SleepyHead EncoreBasic

Other Comments: Started CPAP Therapy October 23, 2014

Sex: Female
Location: Northeast Ohio, USA

Post: #16
RE: Rule of thumb for top pressure setting?
(02-23-2015 02:22 AM)Jemstone Wrote:  "because the older machines would sometimes "run-away" and increase pressure beyond any reasonable need"

How to fix a runaway machine??? Should I purchase a different machine? Yikes

I'm doing a happy dance! I feel vindicated. I didn't know I had a known issue! I need to know more about this "run-away" problem. I have a Resmed S9 and an airfit F10. About 3 hours into sleep, the dang machine's pressure goes really high and blows my mask off. I shut it down then turn it back on, it's ok for a bit then runaway again. Every night. I thought maybe the mask was slipping off and it was trying to compensate so I purchased an Airfit P10. I woke up with my lungs hurting and I was kind of sick for a few days.

I purched my machine from a local classified. I've had prescriptions to get a sleep study but they are too expensive, so I've been doing it on my own. The low is set at 4 and the high is 13.

Even though I'm having this frustrating issue, I have less headaches and I wake up when I wake up! I need far less sleep. I can't wait to see what happens when I fix the run-away issue.
Thanks, y'all! Jemstone

Jemstone,
Welcome to the forum.

Now I agree with previous post about purchasing a used machine from someone you don't know. I hope you bought new hoses and mask. Those should not be reused for obvious reasons. I understand when money can be an issue, but you need to be careful. Can you afford a home study?

But with all that said, and since you already have machine, (and I love your enthusiasm), you can request the clinical manual if you don't already have it,
but it may be hard for anyone here to help you without a sleep study done and knowing what your titrated pressure is.
OpalRose

OpalRose
02-23-2015 09:11 AM
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OpalRose Offline

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Posts: 3,181
Joined: Nov 2014

Machine: PR System One REMstar Auto 560 with A Flex
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10 For Her
Humidifier: REMStar heated humidifier with heated hose
CPAP Pressure: Auto Cpap 10-13 AFLEX 1
CPAP Software: SleepyHead EncoreBasic

Other Comments: Started CPAP Therapy October 23, 2014

Sex: Female
Location: Northeast Ohio, USA

Post: #17
RE: Rule of thumb for top pressure setting?
Jemstone,
I also think you should start your own thread on this subject since you are new. Your post may get lost or not noticed in this thread.
OpalRose

OpalRose
02-23-2015 09:17 AM
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Jemstone Offline

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Posts: 8
Joined: Dec 2014

Machine: Resmed s9 VPAP Auto (36006)
Mask Type: Full face mask
Mask Make & Model: Resmed AirFit F10
Humidifier: Resmed humidifier and climate line hose
CPAP Pressure: Auto 4, 13
CPAP Software: SleepyHead

Other Comments:

Sex: Female
Location: SLC Utah

Post: #18
RE: Rule of thumb for top pressure setting?
(02-23-2015 09:17 AM)OpalRose Wrote:  Jemstone,
I also think you should start your own thread on this subject since you are new. Your post may get lost or not noticed in this thread.
OpalRose

Good idea. Thanks

Jemstone
02-23-2015 11:15 AM
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Jemstone Offline

Members

Posts: 8
Joined: Dec 2014

Machine: Resmed s9 VPAP Auto (36006)
Mask Type: Full face mask
Mask Make & Model: Resmed AirFit F10
Humidifier: Resmed humidifier and climate line hose
CPAP Pressure: Auto 4, 13
CPAP Software: SleepyHead

Other Comments:

Sex: Female
Location: SLC Utah

Post: #19
RE: Rule of thumb for top pressure setting?
I will absolutely do a home test! Thanks! Any suggestions?

Jemstone


(02-23-2015 02:50 AM)truckerdad57 Wrote:  Jemstone.....

If no one else had told you buying a used CPAP like you did and self-titrating is not a medically great idea.

You can get home sleep studies for $ 300-400.

Being sick for a few days due to too high a pressure can cause major complications. Aerophagia is where air leaks past your epiglottis and inflates your stomach while using CPAP can cause a host of other complications. As discussed elsewhere in this thread too high a pressure can cause central apneas.

The other issue with buying a used CPAP was .... was it properly disinfected prior to you using it? TB would be a worst case scenario.

I know a full in lab psg is too expensive for anyone without insurance. But a home sleep study can be a way to start. Get a proper diagnosis and then you can work on getting proper medical advise and help on the settings based on your total medical history and issues. Not just what you post and get from an online forum.

Hope this helps.
02-23-2015 11:23 AM
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Jemstone Offline

Members

Posts: 8
Joined: Dec 2014

Machine: Resmed s9 VPAP Auto (36006)
Mask Type: Full face mask
Mask Make & Model: Resmed AirFit F10
Humidifier: Resmed humidifier and climate line hose
CPAP Pressure: Auto 4, 13
CPAP Software: SleepyHead

Other Comments:

Sex: Female
Location: SLC Utah

Post: #20
RE: Rule of thumb for top pressure setting?
Oh YES, I bought a new mask! But I did use a used (used once) climateline hose that I disinfected the heck out of. I won't buy a used one of those again.

I'm going to find a home test today.

I still want to figure out the run-away issue. Jemstone

(02-23-2015 09:11 AM)OpalRose Wrote:  
(02-23-2015 02:22 AM)Jemstone Wrote:  "because the older machines would sometimes "run-away" and increase pressure beyond any reasonable need"

How to fix a runaway machine??? Should I purchase a different machine? Yikes

I'm doing a happy dance! I feel vindicated. I didn't know I had a known issue! I need to know more about this "run-away" problem. I have a Resmed S9 and an airfit F10. About 3 hours into sleep, the dang machine's pressure goes really high and blows my mask off. I shut it down then turn it back on, it's ok for a bit then runaway again. Every night. I thought maybe the mask was slipping off and it was trying to compensate so I purchased an Airfit P10. I woke up with my lungs hurting and I was kind of sick for a few days.

I purched my machine from a local classified. I've had prescriptions to get a sleep study but they are too expensive, so I've been doing it on my own. The low is set at 4 and the high is 13.

Even though I'm having this frustrating issue, I have less headaches and I wake up when I wake up! I need far less sleep. I can't wait to see what happens when I fix the run-away issue.
Thanks, y'all! Jemstone

Jemstone,
Welcome to the forum.

Now I agree with previous post about purchasing a used machine from someone you don't know. I hope you bought new hoses and mask. Those should not be reused for obvious reasons. I understand when money can be an issue, but you need to be careful. Can you afford a home study?

But with all that said, and since you already have machine, (and I love your enthusiasm), you can request the clinical manual if you don't already have it,
but it may be hard for anyone here to help you without a sleep study done and knowing what your titrated pressure is.
OpalRose
02-23-2015 11:29 AM
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