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Time to increase pressure?
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sunglide Offline

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Posts: 1
Joined: Sep 2016

Machine: Resmed AirSense 10
Mask Type: Nasal mask
Mask Make & Model: unsure
Humidifier: Resmed
CPAP Pressure: 7-13
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: USA

Post: #1
Time to increase pressure?
I've been using my CPAP machine for about a year now, and it reduced my AHI from 10.6 on my sleep study to around 5 on most nights. I feel way better than I did before having it, but still a long ways from great.

My pressure is currently set to 7-13, should I experiment with increasing it? What are reasonable thresholds to try?

I'm also worried that most of my events appear to be central if I'm reading the data correctly, does that mean that I might need to switch to a Bibap machine?

I would ask my sleep doc, but I have to book appointments months in advance, so.... Sad

Thanks!

   
   
09-10-2016 07:40 PM
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justMongo Offline

Monitors

Posts: 3,853
Joined: Sep 2013

Machine: ResMed VPAP Auto (S9)
Mask Type: Full face mask
Mask Make & Model: ResMed Mirage Quattro
Humidifier: ResMed H5i
CPAP Pressure: 18 IPAPmax - 11 EPAPmin, PS=5
CPAP Software: Other Software

Other Comments: μολὼν λαβέ

Sex: Male
Location: Калифорния

Post: #2
RE: Time to increase pressure?
If you up your pressure, you risk increasing centrals. Looks like you have EPR set to 3. Using less EPR may decrease CO2 washout, lowering centrals. If your doc is concerned about CA... Bilevel (called VPAP by Resmed) isn't the best way to treat it.

The ASV is the gold standard of mixed and central apnea treatment. Although, insurance may make you FAIL on a Timed mode bilevel first.

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09-10-2016 09:49 PM
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OpalRose Offline

Monitors

Posts: 3,180
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: #3
RE: Time to increase pressure?
Agree with justMongo.....lower your EPR setting. I would turn it down to 2 and watch and see if the Centrals are reduced, if so, then lower EPR further down to 1.

Your minimum pressure is fairly low to treat Obstructives, but I would not advise raising it uttill you see if lowering the EPR helps.

You also have a bit of a leak issue to deal with. It could be your mask, or could be mouth breathing.

Try mask liners and/or adjusting the straps. If you are mouth breathing, try a chin strap.

OpalRose
09-11-2016 07:21 AM
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Sleeprider Online
Wiki Editor
Advisory Members

Posts: 3,367
Joined: Dec 2014

Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Where they make Respironics

Post: #4
RE: Time to increase pressure?
Here is a third to reducing EPR and leaving pressure the same. Unlike OpalRose, i would suggest turning EPR off or setting it to 1. Note at your minimum pressure, EPR causes your EPAP to be 4.0. I think this combination of low pressure and high EPR directly causes both your obstructive and clear events.

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09-11-2016 09:18 AM
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trish6hundred Offline

Advisory Members

Posts: 6,449
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #5
RE: Time to increase pressure?
Hi sunglide,
WELCOME! to the forum.!
It's good to hear that you are noticing some improvement with your CPAP therapy.
I wish you good luck as you continue on your CPAP journey and also with getting your machine better adjusted to meet your needs.

trish6hundred
09-11-2016 09:27 AM
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Maskup Sleepwell Offline

Preferred Members

Posts: 55
Joined: Aug 2016

Machine: Respironics Dreamstation Auto BiPAP
Mask Type: Full face mask
Mask Make & Model: Resmed AirFit F10 FFM
Humidifier: Dreamstation Heated Humidifier
CPAP Pressure: EP 16-20 IP 17.5-20 PS 1.5-4.0
CPAP Software: SleepyHead EncorePro

Other Comments: Untreated AHI 48.0 - Treated AHI 1.1 (30 day average)

Sex: Male
Location: Santa Clarita, California

Post: #6
RE: Time to increase pressure?
I'd be inclined to bump the pressure up a couple of points and see what happens. Your min is way below your 95%.
09-12-2016 05:45 PM
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