[Pressure] Concerned about Prescribed Pressure of 23. Just diagnosed!

[TXSawingLogs]

45 Male here just diagnosed with Severe OSA. After my at home sleep test resulted in 76 AHI and O2 saturation dropping to 61%, the sleep lab had me come in to the sleep lab and do a titration. I am concerned about what I feel is a scary high pressure they recommend of 23! I know I’m new to this and just beginning to learn, but i already feel like an outlier. I have asthma and COPD so likely this is why I needed a BiPAP.

Is this concern justified!?

Below is the sleep labs titration comments

COMMENTS:
This is a 45 year-old Male who is referred for a CPAP/BiPAP titration with a diagnosis of obstructive sleep apnea. This titration is being carried out to determine an appropriate pressure. During this study this patient was begun on CPAP at 5 cm of water pressure and titrated. The patient was subsequently changed to BiPAP due to intolerance to higher CPAP pressures and was titrated. At 23/18 cmwp the patient was observed for 53 minutes with an apnea/hypopnea index of 5.6 and a minimum oxyhemoglobin saturation of 89% on room air. No significant abnormal leg movements were noted,

[SarcasticDave94]

Welcome to Apnea Board,

A friendly suggestion is to get the detailed sleep study and Titration if you currently only have a summary of these.

COPD and asthma may not play well with a CPAP or standard bilevel, they might or not do well in treating your Apnea. Meaning it may very well be hit or miss.

Regarding COPD and/or asthma, have you had any Pulmonary Function Tests? Results if you have?

My background is that I have high Central Apnea that's not treatment emergent. And I've also a mix of GOLD level 3 COPD with asthma both within the diagnosis. Normally for my CA the ResMed ASV like I had was the recommended device. BUT COPD that worsened somewhat with symptoms refused to allow ASV to work as it used to. For me the best machine is a ResMed AirCurve 10 ST-A, a tweener bilevel to ventilator.

My ASV max was 25 which it did hit sometimes. This is 25 cmH20 as well as your suggested 23 is cmH20. That's not a lot of PSI though.

23 cmH20 = 0.327136896688555 PSI

25 cmH20 = 0.355583583357125 PSI

Most CPAP and bilevel minimum cmH20 is
4 = 0.05689337333714

Not making fun of the concern. It just might not be as bad as it appears at first.

So, while the pressure of 23 seems scary, it may not be that bad. There's an IF though. How will it be delivered, AKA which machine mode and with or without a backup breath rate. I'm taking a guess... Standard ResMed VAuto.

Right now it's guesswork unfortunately. There's data we are needing to hear, again the detailed test results with any info from the PFT.