[Pressure] Why to limit Pressure?

[avis]

I'm using CPAP for more than 20 years. All of them use to set low and high pressure.
Lately I purchased the Resmed AirMini for travel and decided to use it every night as my main device.
Also, I didn't limit the pressures, just let it 4 to 20. The reason is to let the machine decide about the needed pressure, why limit it?
Need your help and advice for below questions:
1. Is my decision to use the AirMini all nights is wrong? Do you know if the lifetime of the travel CPAP is shorter than the other CPAP?
2. Is setting 4 to 20 pressure is a wrong decision or can cause a problem. Why to limit the max pressure?   

[Gideon]

I'm using CPAP for more than 20 years. All of them use to set low and high pressure.
Lately I purchased the Resmed AirMini for travel and decided to use it every night as my main device.
Also, I didn't limit the pressures, just let it 4 to 20. The reason is to let the machine decide about the needed pressure, why limit it?
Need your help and advice for below questions:
1. Is my decision to use the AirMini all nights is wrong? Do you know if the lifetime of the travel CPAP is shorter than the other CPAP?
2. Is setting 4 to 20 pressure is a wrong decision or can cause a problem. Why to limit the max pressure?   

The ResMed AirMini does not have a way for us to see the detailed daily data and for that reason alone it is not a machine I would recommend for daily use.  IMHO the best situation would be to have a ResMed AirSense 10 Autoset as your daily machine and set the Airmini to the same settings for travel.
With the AirMini as your only machine, you are reduced to either going solely by how you feel for adjustments or getting another titration sleep study.

The range of 4-20 indicates to me that your therapy was never optimized.  4 for most adults is too low for comfort in breathing and 20 for some is too high as some events, such as Flow Limitations will run pressure inappropriately up to the maximum.  I run my machine with max set at the machines' maximum but I NEVER go anywhere near that and I tolerate the max pressure produced by any CPAP very well.  How to determine?  You look at the detailed daily charts produced by OSCAR which your AirMini is not capable of.  The other issue I see is the settings to not account for any EPR if you are using that feature.

[OpalRose]

Hello avis,
It’s probably not a good idea to use your AirMini machine for everyday use, especially should you need it for travel.  I don’t know the life expectancy of travel machines.  

A major reason to limit the max pressure would be if you suffer with central sleep apnea.  You don’t want the max pressure to be high as that will aggravate central apnea.  Other events like Flow Limitations and Snores will sometimes cause the pressure to go to the max setting.

If you were able to look at data (which you can’t with the AirMini), you would know if you needed to limit max pressure by the type of apnea events.

Also, a minimum pressure of 4cm can cause you to feel air starved, not to mention the machine has to work harder to get to the needed pressure.

What were you using prior to the AirMini?  Was it a data capable machine?  You could download OSCAR, and use your SD card to look at the data from your prior machine.  Post that data here, and someone can better advise.

With all that said, as long as you are sleeping well and not tired during the day, you must be doing something right.

[Sleepster]

Also, I didn't limit the pressures, just let it 4 to 20. The reason is to let the machine decide about the needed pressure, why limit it?

Sometimes the machine will allow the pressure to go too high, although this is not too common. I have my max set at 13.6 and it NEVER reaches it. But for some people it might go higher than what's needed which can cause problems like waking you up or leaking or central apnea.

But more importantly, when you set the min to 4 it will take some flow limitations, hypopneas, or even apneas to get the pressure to rise high enough for the therapy to be effective. You can avoid all that by starting at a higher minimum pressure.

[mesenteria]

I haven't bothered to educate myself about the Mini (I should go take a look), so take my comment for what it's worth.  


I don't know that it's capable of auto-titration like the bigger siblings such as the AS10 Autoset.  Is the Air Mini not just a smaller CPAP to get a person through a holiday?  And, is it not a small temporary machine meant to be a stop-gap and not something you'd want to wear out over several months of use where a more capable machine is the better idea?

If it is a CPAP machine set to a max of 20 cm, then it might climb up to a level that actually hinders you, including forcing leaking due to an otherwise sufficient facial seal being 'sprung' with stronger forced air behind it.  I would think that one's average max over the past month would be what you'd set on a traveling CPAP.

I agree with the observations about a lower limit of 4 being decidedly stingy.  Few find it comfortable when trying to sleep, or to fall asleep.  In my own case, 5 was prescribed, but within six months I upped it to 5.6 on my own accord and I feel more secure with that.

Finally, a question to avis: You haven't shared with us your reasoning for electing to use the Mini permanently.  Would you be willing to do that?

[Edit-added: Okay, so it offers three forms of therapy, including auto. But, the question still remains: why place a machine in auto-titration if you already know your upper and lower limits via experience and would have set them on a full Autoset or similar device?]

[DaveL]

Wonderful advice here.
I *wish* I had a machine that would autotitrate. I think that's the ideal.
once we know that we have OSA it should be easy to get a machine that maintains our treatment.

[ardenum]

Wonderful advice here.
I *wish* I had a machine that would autotitrate. I think that's the ideal.
once we know that we have OSA it should be easy to get a machine that maintains our treatment.

dave you got an s9, im sure its time for your insurance to kick in and upgrade you to an s10

[DaveL]

edit: (my story doesn't matter. However the member here has asked a really important question. I do appreciate your observation. I'll start a new thread.)

"Why do we limit pressure"?

My treatment would be so much better if I had a machine that autotitrated, and had settings that worked for me. I don't see why we have to limit pressure.

Wonderful advice here.
I *wish* I had a machine that would autotitrate. I think that's the ideal.
once we know that we have OSA it should be easy to get a machine that maintains our treatment.

dave you got an s9, im sure its time for your insurance to kick in and upgrade you to an s10

Thanks.
Sleep doc will write me a prescription.  cpap. 
He's new to me...I bought my S9 used and it was almost brand new.
The reason my treatment is effective is because of the wonderful people here.

[Sleepster]

once we know that we have OSA it should be easy to get a machine that maintains our treatment.

It's not. There are often complications such as CPAP-induced central apnea or aerophagia. We had a member here who had both, and they persisted instead of subsiding like they do in most cases.

You gotta check your own data to see that your therapy is working for you. That's the reason projects like OSCAR exist.

[avis]

Thank you, you raised some points that I have to take into account. 
I guess no-one has long time experience with travel machines.
I still have my RESMED S10 if perfect condition as spare machine. Maybe I have to use it as main machine and the AirMini as my travel machine.