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some newbie concerns?
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Beth T. Offline

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Posts: 12
Joined: Mar 2012

Machine: ResMed S9 Autoset
Mask Type: Nasal mask
Mask Make & Model:
Humidifier: H5i
CPAP Pressure: 7-10
CPAP Software: ResScan SleepyHead

Other Comments: newbie!

Sex: Female
Location: Texas

Post: #11
RE: some newbie concerns?
duh - of course. Sorry for not thinking about that. Of course the AHI over a 3 month period would be an average. Sigh - obviously math was not my strong suit - majored in philosophy in college. I can BS really well, does that count?
Thanks for your replies. I dowloaded the software and will see if I can make sense of it. My leak rate is good or so it seems on my machine - averaging about 6. Why aren't APAPs set up to just be open ended at the top and actuallly at the bottom for that matter. If it takes you where you need to be then why have actual settings of pressure? The last few nights my 95th percentile -pressure has been 8.8 so I believe I will raise the upper pressure to somehwat over 9 and see what happens. My AHI was 5.0, 5.1, 3.2 (when I deliberately slept primarily on my right side) and 4.8 last night. My doctor and his office was excellent when I was getting the machine and sleep studies, after care not so much. Told me I was the first patient that ever asked about seeing their data and getting reports...Really? I find that hard to believe.
03-15-2012 08:51 AM
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zimlich Offline

Preferred Members-2

Posts: 392
Joined: Feb 2012

Machine: Respironics PR System One BiPap Auto SV Advanced
Mask Type: Nasal mask
Mask Make & Model: ResMed gel Nasal Mask
Humidifier: System One
CPAP Pressure: 8-20 ASV, 8 EPAP,PS 12
CPAP Software: Not using software

Other Comments: I use the Quattro FFM when necessary

Sex: Female
Location: Norfolk, VA

Post: #12
RE: some newbie concerns?
Sometimes you need to go down instead of up. After giving the new settings a fair chance- really a good fair chance is a month though it seems like forever, perhaps go down a cm, or .5 at a time.
Good luck. Also AHI less than one is unrealistic- stay under five, or under three or four for sure. Anything less is icing on the cake.

Just read the post after mine and I concur you can titrate fine with a CPAP. I think it's easier. The reason you don't want an open ending setting on an AUTO is that it takes the machine time to "hunt" for the optimum pressure. I would set the bottom number at my CPAP prescription and the top number a few cm about what your 95% pressure is.
(This post was last modified: 03-16-2012 06:46 AM by zimlich.)
03-15-2012 10:55 AM
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Sleepster Offline
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Posts: 4,993
Joined: Feb 2012

Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #13
RE: some newbie concerns?
(03-15-2012 08:51 AM)Beth T. Wrote:  Why aren't APAPs set up to just be open ended at the top and actually at the bottom for that matter. If it takes you where you need to be then why have actual settings of pressure?

Apparently, APAP's don't always find your correct pressure. They may overshoot or undershoot, so they need to be monitored and corraled.

Humans can essentially do the same, or perhaps even better, when adjusting a CPAP.

The thing a APAP will do that a CPAP won't is adjust the pressure throughout the night, while you're sleeping. Now, whether this is an advantage or not, and for which patients, is something that hasn't been made clear to me.

Sleepster
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03-15-2012 03:40 PM
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Steven Offline

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Posts: 92
Joined: Feb 2012

Machine: ResMed S9 AutoSet (Mfg 10-18-11 in Aus) (Software Version SX474-0903)
Mask Type: Nasal mask
Mask Make & Model:
Humidifier: ResMed H5i Humidifier (Mfg 11-16-11 in Aus) (Software ID SX496-0212)
CPAP Pressure: APAP 12 - 18 cmH2o
CPAP Software: ResScan

Other Comments: ResMed S9 AutoSet & H5i purch 12-22-11 but were both exchanged 1-31-12 for more recently mfg items

Sex: Male
Location: Southwest USA

Post: #14
RE: some newbie concerns?
(03-15-2012 08:51 AM)Beth T. Wrote:  Why aren't APAPs set up to just be open ended at the top and actuallly at the bottom for that matter. If it takes you where you need to be then why have actual settings of pressure?

There are two beliefs here.

Those who feel that it should be open ended (top & bottom - i.e. 4 - 20).

And those who feel there should be a much narrower range.
I fall in this 2nd category.

While I believe that having the top pressure at it's max of 20 may not be that bad, since you will probably never get there, my preference is for a narrower range of about 3 lower than & 4 higher than your titrated pressure.
So, if your pressure should be 15, I would set it at 12 - 19.
As time goes by & you review your data, you can change either one either up or down as the data suggests.

While having the upper limit at its max of 20 may be OK, having the lower limit at 4 could produce problems because it does take some time for the machine to realize that you may need a pressure of 15 & get up to that. It starts off & 4 & gradually goes up to 15.
So, while it is going from 4 to 15, you are not getting the optimum pressure that you really need.

Whereas if you start at 12, it allows for the pressure to go down when you don't really need 15. But it starts off at a high enough pressure to be helping you.

The reason I don't set my APAP at the max pressure of 20 is that in some very isolated instances the machine goes up to a higher pressure for some unknown reason that may not be a valid reason for a pressure increase.
I don't want it to have to take the time to trend back down to the pressure I really need (say 15) from that high of 20.

Now if my APAP was consistently at the high end of the range I have set (which it is not), I would move the high end even higher.

Using the ResMed Mirage SoftGel Nasal Mask with a chinstrap

I do not use either the Ramp nor the EPR Comfort features

Have been on CPAP since December 1998

This is my 3rd machine

I use the ResMed ResScan Software (Version 3.16)
03-15-2012 04:02 PM
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CHanlon Online

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Posts: 292
Joined: Mar 2012

Machine: ResMed S9 Autoset
Mask Type: Nasal mask
Mask Make & Model: ResMed Activa LT
Humidifier: ResMed Hi5
CPAP Pressure: 12 -20
CPAP Software: ResScan SleepyHead

Other Comments: Mirage Activa LT nasal mask

Sex: Male
Location: Ontario, Canada

Post: #15
RE: some newbie concerns?
(03-15-2012 03:40 PM)Sleepster Wrote:  [quote='Beth T.' pid='3005' dateline='1331819505']
The thing a APAP will do that a CPAP won't is adjust the pressure throughout the night, while you're sleeping. Now, whether this is an advantage or not, and for which patients, is something that hasn't been made clear to me.

Having experienced both - with an APAP range of 12 to 20 vs CPAP at 18, then 16 when I yelped...

It's an advantage.

The biggest thing I noticed was that, with the fixed pressure, I never slept as soundly or without being woken up by the pressure, or a leak, or whatever, as I changed position. With the APAP, when I start to rouse, the pressure backs off, and I settle again without really being disturbed. I never felt as rested or refreshed on fixed CPAP as I did on APAP before, and after, a couple months with fixed CPAP.
03-15-2012 10:54 PM
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CHanlon Online

Advisory Members

Posts: 292
Joined: Mar 2012

Machine: ResMed S9 Autoset
Mask Type: Nasal mask
Mask Make & Model: ResMed Activa LT
Humidifier: ResMed Hi5
CPAP Pressure: 12 -20
CPAP Software: ResScan SleepyHead

Other Comments: Mirage Activa LT nasal mask

Sex: Male
Location: Ontario, Canada

Post: #16
RE: some newbie concerns?
(03-15-2012 04:02 PM)Steven Wrote:  
(03-15-2012 08:51 AM)Beth T. Wrote:  Why aren't APAPs set up to just be open ended at the top and actuallly at the bottom for that matter. If it takes you where you need to be then why have actual settings of pressure?


While I believe that having the top pressure at it's max of 20 may not be that bad, since you will probably never get there, my preference is for a narrower range of about 3 lower than & 4 higher than your titrated pressure.
So, if your pressure should be 15, I would set it at 12 - 19.
As time goes by & you review your data, you can change either one either up or down as the data suggests.

While having the upper limit at its max of 20 may be OK, having the lower limit at 4 could produce problems because it does take some time for the machine to realize that you may need a pressure of 15 & get up to that.

I agree - and I've actually experimented with it. I have to have 20 upper, because often I'm 19+ (as a high, less often that's the 95% average, but that happens too...) but I found the 10 - 20 range that I was prescribed didn't work as well as the 12 to 20 I have it at now. 13 to 20 might be better...but I've noticed a trend downward in the last couple months, as I've lost weight, so I'm not going to tinker just yet.
03-15-2012 10:59 PM
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