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Upper pressure setting on a CPAP Autoset machine
#1
Hi all! Just wondering about the upper pressure setting on my CPAP Autoset machine, why is it necessary to adjust it? I can see the importance of the lower pressure setting since it provides an individual base pressure according to the wearer`s needs. But I imagine that the autoset function adjusts the upper pressure according to the specific AHI situation, so I wonder a bit why it has to be adjusted.

Have a nice WE!Big Grin
Dom
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#2
(05-16-2015, 05:52 AM)XDom321 Wrote: Hi all! Just wondering about the upper pressure setting on my CPAP Autoset machine, why is it necessary to adjust it? I can see the importance of the lower pressure setting since it provides an individual base pressure according to the wearer`s needs. But I imagine that the autoset function adjusts the upper pressure according to the specific AHI situation, so I wonder a bit why it has to be adjusted.

Have a nice WE!Big Grin
Dom


You can leave upper pressure at 20 if you wish, the AutoSet will only go as high as needed to clear an apnea. I personally like a tighter range.

I see you have a setting of 4-14.
Do you check your pressure graph in Sleepyhead to see how high your pressure
goes? If it tops out at 14 and stays there, then you may need to raise it.

I know you didn't ask about the starting pressure, but a lot of us here feel smothered starting at a pressure of 4; as if you are not getting enough air.
Ideally, your starting pressure should be set slightly below your 90% number.

What are your AHI readings and how do your feel? Your pressure should be adjusted according to what you see on SleepyHead reports.
Smile




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#3
Okay this is not based on any medical journal, just something from my own observation ... take it with a pinch of salt

Both pressure setting (minimum and maximum are important to me
The minimum pressure has to be right and feel comfortable, not too low so it feel like suffocating or too high feel uncomfortable ... comfort is the key in setting the minimum pressure, trail and error process

The AutoSet, not only respond to apnea events but also to snoring and flow limitation (both not included in AHI) so its not a good idea for some people like myself to set the maximum pressure too high because the AutoSet can reach the maximum pressure in no time by increasing pressure in response to flow limitation, even obstructive apnea and hypopnea are been treated at lower pressure, unnecessary high pressure can cause central apnea, leaks, sleep disturbance, and discomfort in some cases

Basically, its a compromise or trade-off of some sort and much flow limitation are acceptable ... again trail and error process

Time for another cup of tea ... have a good day folks





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#4
The theory is it could always stay at 20. But in practice I have experienced occasions where the machine decided to crank the pressure way up when it was not necessary. I have holes in my socks to prove it.

I too like a nice, tight range. Enough to let the machine think it's in charge, but still with a short leash.
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#5
Some APAPs, including the S9 Autoset, have been notorious for "runaway", where the pressure rises to 18-20 for no actual good reason, which will probably wake you up (so much for better sleep). Mine did that twice after I had been on it for a few weeks, so I topped it from 5-20 to 5-14, since I saw no other reasons within SH to need that high of a pressure. Now it can't run away on me.

There is also a point for some patients where a higher pressure will actually increase CA events, so as long as your APAP doesn't regularly hit whatever ceiling you have set, not allowing the top pressure to be at the max of 20 will probably lower your AHI. But monitor this all carefully. If this were to happen, you may be able to correlate your CA clusters with periods of high pressure, which is somewhat of a smoking gun as to why this might be happening.
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#6
Another thing about the AutoSet increase pressure in response to flow limitation, the machine have no way of knowing beforehand whether the minor obstruction that she responding to, will ever develop to fully fledged apnea or not, so she try preempt and be on the safe side and that in turn would increase the pressure haywire in some instances

According to the titration handbook, one should adhere to four main rules before making any changes
wait ... watch ... observe ... think

Coffee
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#7
(05-16-2015, 07:42 PM)zonk Wrote: According to the titration handbook, one should adhere to four main rules before making any changes
wait ... watch ... observe ... think

Coffee

There's actually a fifth rule: "fiddle," or "futz."

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#8
We do not want the conversation goes off-topic so SuperSleeper close down the thread and that does not helps anybody

The subject matter of the thread is so important to be closed down

Grumpy oldman
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#9
Hi all, thanks for your numerous replies!

(05-16-2015, 08:08 AM)OpalRose Wrote: I see you have a setting of 4-14.
Do you check your pressure graph in Sleepyhead to see how high your pressure
goes? If it tops out at 14 and stays there, then you may need to raise it.

I know you didn't ask about the starting pressure, but a lot of us here feel smothered starting at a pressure of 4; as if you are not getting enough air.
Ideally, your starting pressure should be set slightly below your 90% number.

What are your AHI readings and how do your feel? Your pressure should be adjusted according to what you see on SleepyHead reports.
Smile

I was raising the pressure steadily to 6 – 16 during the past few weeks, the upper pressure remains the same at approx. 11 (thus my question about tinkering with the upper pressure setting) and yes, you`re right, I also felt a bit smothered with the lower pressure setting at 4, it feels much more comfortable at 6 now and I might raise it to 7 in a few days to see whether it gets even more comfortable.

(05-16-2015, 05:46 PM)zonk Wrote: Basically, its a compromise or trade-off of some sort and much flow limitation are acceptable ... again trail and error process

Time for another cup of tea ... have a good day folks

Guess you`re right there, it is a trail an error process that takes a bit of time.

(05-16-2015, 06:04 PM)retired_guy Wrote: The theory is it could always stay at 20. But in practice I have experienced occasions where the machine decided to crank the pressure way up when it was not necessary. I have holes in my socks to prove it.

I too like a nice, tight range. Enough to let the machine think it's in charge, but still with a short leash.

Haven`t had a runaway incident yet, but then I only have been on the hose for a few weeks.
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#10
Can higher pressures cause air to be pumped into the stomach?
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