changing from CPAP to APAP- which pressure to use?

[Walla Walla]

I think I'd bump the minimum up to 11.5cm to get rid of those snores (VS) your having. That's what is pushing up your pressures now.

If the snores don't go away at 11.5cm than try 12cm. The max pressure looks OK at 15cm. It didn't rise above 14cm.

[trish6hundred]

Hi cbrts765,
WELCOME! to the forum.!
Good luck as you continue CPAP therapy and also with getting your settings fine-tuned.

[cbrts765]

I got my record AHI - 0 - last night. But frankly i do not feel different and not sure now if change from CPAP mode with 11 to APAP  with 11.5/15  is better for me. It worries me that i sleep now with 90% pressure of 14.8 versus constant 11 for the past 4 years, and average AHI for past week in APAP mode 2.36 does not differ too much from average in the past 4 years (2.86).

Any thoughts if ongoing increased pressure could cause some negative impact?

I attach below statistics and last day screenshots from sleepyhead.

regards, Alex

[Walla Walla]

Your under 5 API so whatever you do at this point is to feel better rested. If you feel worse at these pressures than you did before than go back to the fix pressure. But I would give it some time to work before going back. It takes some time to feel the effects of treatment.
Your the best judge of how you feel though.

[Sleep2Snore]

Hello, do you want to say that for APAP mode best is to setup max to 20 and min to 0, i.e. fully rely that it will self adjust as needed?

No you might have reasons why you do not want it to go to too high a pressure. but for most people you can let the machine decide where it wants to be.  I was at 18 on a CPCP machine.  The hospital turned round and asked me what settings I wanted on the new APAP machine.  Why do you think I would know, they are supposed to be the experts, not me.
So they decided to set it to 10 as a low pressure and 20 as the high setting.  They said it would only go as high as it needed to go, which is right, provided there is not a leak.  Even though the newer machines usually don't shoot up in pressure like the older ones.  My mask came off the other night, the adjusting strap which is held with Velcro decided it didn't want to hold anymore.  The machine rose in flow/pressure, then decided to drop down again.  It was the noise of the air escaping that woke me up, so I just held the nasal pillows I was using in place and the machine dropped down what flow/pressure it had risen up to.  I just held the mask in place and used the pillow to keep it there for a while.  When my partners alarm went off I had a look to see what had happened, the Velcro had let go, so I looped it through and attached the Velcro strap again.  So you can leave the machine open at full pressure and it will let you know what pressure it goes up to.  Then you can limit it if you want to just above what it goes up to.
However, as I said there is on the odd occasion that you might not want to machine to go to high.
For most people it would not matter.
]The biggest problem people have is if you set the low pressure to low and the machine has to rise a lot in pressure to clear an event that you have, the rise in pressure will waken a lot of people, it is best if the low pressure is just high enough to head off most events, or at least keep a lot of then from becoming bigger events, then allowing the machine to rise and deal with other events as they happen.  It is not quite that straight forward, but for Obstructive Sleep Apnea it is.
However, some people have other events such as centrals apneas so sometimes the pressure has to be adjusted to try to cut down on these, if that makes any sense.

[Walla Walla]

I wanted to add that the reason your machine wants to keep increasing pressure is it's reacting to the snores (VS) it's recording.

Now on the Dreamstation the machine stops recording snores at pressures above 16cm. I'm not sure if this is true for your machine.

If your machine does the same thing and you where to set your max pressure at 18cm, I would think your pressure wouldn't climb above 17cm. I'm just throwing this out there for info.

I wonder if it's really snores the machine is picking up?

[Sleep2Snore]

You appear to have some big leaks, so I would try to get these leaks down a bit if you can.
If you had a better nights sleep at 11 it may be that you had less leaks at that pressure, so getting leaks under control will make a difference.  If you think 11 is the ideal pressure, try setting it at 10 low and 15 high,  It appears the only time it gets that high is when you have a leak.  See what happens after a couple of nights at those pressures.
If at the end of the day CPAP instead of APAP is better for you than you can switch to CPAP mode and adjust the pressure to get the best results.  You have Sleepyhead so you can monitor it or post your data for feedback.
The night I get 0.00 is not my best nights sleep, I find if I have 0.01 or something I feel a lot better, maybe due to something else going on.

I had a strange problem last nigh, the machine went straight to 13 of pressure and I just turned it on and it read the data card, then it shot straight up to 13?  It worked fine after that as for as I know, I fell asleep anyway, so it was fine.
I have smart start enabled as I can't be annoyed reaching out into the cold night to press start.  Besides, I always get a sigh from the other half if I disturb her by reaching across to turn it on.
It is switched on before I go into bed, so all I have to do is take a couple of breathes and away it goes slowly building up pressure to 10 then it will do what it has to.  Last night it didn't, it went straight to 13!