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Tighten up APAP ranges?
#1
Tighten up APAP ranges?
So, I have been on APAP (8-20 cm/H20) for >3 years without many problems, except recently I had a couple recent pressure runaways. (That seems to have been caused by inaudible vibrations in the mask "valve" that caused vibrations interpreted as snoring VS2.  New hose and quick disconnect - problem solved.)

There has been a lot of talk about not running APAP machines "open", such as mine at 8-20, but rather tightening down the pressure range once enough data is collected.

My pressures over the past year are below:

   

Some days, 8 cm/H2O is enough, so I am leaving that one alone, but I am going to try lowering the max. pressure to 14 cm/H2O to prevent accidental runaway conditions, since my highest 90% was 12 cm/H2O.

Thoughts? Comments?


Anyone else tighten up their APAP settings or do they run "open"?
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#2
RE: Tighten up APAP ranges?
Lowering the maximum pressure to prevent pressure run-away is fine. I set my wife's machine that way because she sometimes gets a run-away condition that results in her tearing her mask off. (Her run-away is caused by an occasional sleeping position that no amount of pressure can resolve, and the increased pressure just adds to the problem.)
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#3
RE: Tighten up APAP ranges?
Minimizing pressure fluctuations starts with an effective minimum pressure that stops most events. The objective is to be within 3 cm or less of your 95% pressure requirements. I usually don’t worry about the maximum pressure, it’s rare that I reach it. In my case I stay between 14/10 and 17/13 pretty much all the time. I don’t have runaway pressure which is more common with flow limitations or snoring if those can’t be controlled in a comfortable pressure range.
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#4
RE: Tighten up APAP ranges?
Your runaway situation was unusual, but I can see why you wouldn't want a repeat. Given your long-term pressure data, I don't see why you shouldn't set your max to 14, as you propose. Keep an eye on your AHI and on how often you see your pressure go up to the max and stay there.
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#5
RE: Tighten up APAP ranges?
Narrowing my min-max range seems to be optimum for me, currently 10 - 12.5. My AHI averages 2.0 or so, with the odd 'bad' night of 4-5, usually when I have partaken of some fruit juice (properly fermented of course).

I used to experience runaways, particularly when I tried a Devilbiss APAP that was slow to respond. My Autoset seems to react soon enough to avoid most high-pressure interventions.
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