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Time to increase pressure?
#1
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!

   
   
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#2
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.
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.
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#3
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
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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.




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#4
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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#5
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
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#6
I'd be inclined to bump the pressure up a couple of points and see what happens. Your min is way below your 95%.
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