3 questions about Pressure for Pap Geeks

[TheManseHen]

Greetings Cpappys, (and CMammys...)

Things are rolling along here on my 39th night completed. I have a few new (to me) questions.

1. If one were to have their bottom most pressure number say, at 7.0 and along comes an event that could have been dealt with at a 5.8 say, will the event still be dealt with, just by a bigger burst of air/pressure, or will it sneak through and be untreated because the pressure range was too high to include it? I'm guessing everything is treated, but would be glad to know the hows and whys.

b. If it does deal with it by use of a higher pressure than minimally necessary, is there any negative in that from a health/treatment point of view? I'm guessing not because folk were set at fixed numbers for years.

2. Is there a sort of "expanding to fill the space" reality in the upper limit number? ie, if you have an outer limit, you will GO to the outer limit just because it's there? Or will you only go to the outer limit if you would have regardless of the machine? So if you were coping at 13 and getting okay numbers, and you move to 14 and now you hit 14...does it just mean you haven't gotten to your sweet spot yet, or does the machine just use the room because it overshoots a little or something?
Hope this makes sense.

3. Is there a "typical" range that most end up happy with, not numerically but size wise, ie a 5 point spread from 10-15, or 6-11 or such, or an 8 point range of 10-18 or 5-13 and so on? or is that so broadly individual that a common range size isn't even possible to say/guess.

I'm not asking this so I can play with my numbers, I've learned my move to fast lesson and am happily inching very slowly based on comfort plus sleep. I'm asking because I'm wondering what things look like when all the dust settles. (yes I know that a good AHI is hopefully what that will look like but pressure settings wise is what I'm pondering)

Thank You folks,
Susan AKA The Hen, in surprisingly sunny San Francisco.

[justMongo]

Greetings Cpappys, (and CMammys...)

Things are rolling along here on my 39th night completed. I have a few new (to me) questions.

1. If one were to have their bottom most pressure number say, at 7.0 and along comes an event that could have been dealt with at a 5.8 say, will the event still be dealt with, just by a bigger burst of air/pressure, or will it sneak through and be untreated because the pressure range was too high to include it? I'm guessing everything is treated, but would be glad to know the hows and whys.

It would not occur, there would be no obstructive event.
You are by definition above the pressure at which airway collapse would occur at pressure = 5.8

b. If it does deal with it by use of a higher pressure than minimally necessary, is there any negative in that from a health/treatment point of view? I'm guessing not because folk were set at fixed numbers for years. No.

2. Is there a sort of "expanding to fill the space" reality in the upper limit number? ie, if you have an outer limit, you will GO to the outer limit just because it's there? Or will you only go to the outer limit if you would have regardless of the machine? So if you were coping at 13 and getting okay numbers, and you move to 14 and now you hit 14...does it just mean you haven't gotten to your sweet spot yet, or does the machine just use the room because it overshoots a little or something?
Hope this makes sense.
It's good to give the machine a little working room at the top end. We vary from night to night; and that allows it to adjust. Just because you set a higher limit, does not mean it will use it. (Unlike people on an LA Freeway.) Now, for comfort, you may set an upper pressure that doesn't resolve all apneas. I don't like it when my machine goes up to 19, so I have limited it slightly lower. Results still good.

3. Is there a "typical" range that most end up happy with, not numerically but size wise, ie a 5 point spread from 10-15, or 6-11 or such, or an 8 point range of 10-18 or 5-13 and so on? or is that so broadly individual that a common range size isn't even possible to say/guess. IMHO, nothing is typical. But, too wide a spread means it will have to increment up more to abate apneas. Too high, and it defeats the purpose of an auto.

I'm not asking this so I can play with my numbers, I've learned my move too fast lesson and am happily inching very slowly based on comfort plus sleep. I'm asking because I'm wondering what things look like when all the dust settles. (yes I know that a good AHI is hopefully what that will look like but pressure settings wise is what I'm pondering) When the dust settles, you'll readout your data card less often; and probably not change a setting in many months -- just check the sleep quality screen in the morning.

Thank You folks,
Susan AKA The Hen, in surprisingly sunny San Francisco.
Say Hi to my sister in SF!
[/quote]

[PaulaO2]

1 - You got a bunch of cats. And a bunch of boxes. Some of the cats way 5.8 lbs. Some weigh 7. Some weigh 11. The blue boxes will hold a cat up to and including 7 lbs. Then there are red boxes that will hold cats up to and including 11 lbs. If you put out all blue boxes, the 7 lb cats and the 5.8 lb cats will be happy. The bigger cats won't be. You'll need the other boxes. You put out all sorts of colors for all sorts of sized cats until you get to the red boxes. These will fit pert near every cat in the room. Except the 5.8lb cats will itty bitty in the red boxes so when there's no 11lb cats around, you might as well take the red boxes away, right?

That's essentially what an APAP does. In a nutshell.

1.b. Nope.

2. That's why we look at our data. And just because you once or twice actually hit a pressure of 17 doesn't mean you NEED a max of 17. That's what the 95% is for. We look at the data, watching the numbers, and we try to figure out where we would be the best. And our best isn't automatically the lowest AHI possible. How we fell, how well we slept - all that figures into it too.

3. Far too individualized. Some of us do better with a wider range to accommodate positional changes, others need a narrower range because that's what works best. The machines can go from 4 to 20. And go to any online supplier and look at all the different masks they sell.

And say Hi to Mongo's sister. And my friend Karin. Much thanks!

[OMyMyOHellYes]

1 - You got a bunch of cats. And a bunch of boxes. Some of the cats way 5.8 lbs. Some weigh 7. Some weigh 11. The blue boxes will hold a cat up to and including 7 lbs. Then there are red boxes that will hold cats up to and including 11 lbs. If you put out all blue boxes, the 7 lb cats and the 5.8 lb cats will be happy. The bigger cats won't be. You'll need the other boxes. You put out all sorts of colors for all sorts of sized cats until you get to the red boxes. These will fit pert near every cat in the room. Except the 5.8lb cats will itty bitty in the red boxes so when there's no 11lb cats around, you might as well take the red boxes away, right?

That's essentially what an APAP does. In a nutshell.

Cats are living in my APAP? Oh, My! My!

[TheManseHen]

Ohmymy,

It is apparently Cat's or Aliens....I don't know if the Aliens have cats, or if the two fight it out, but that's the picture I've gotten on the board. Must be true.

The Hen

[quiescence at last]

We only have one 11 lb cat, and it sleeps curled up on/near Mrs. QAL's face. I don't need no stinking red boxes!

QAL

[TheManseHen]

LOL QAL,
I can't have cats anymore due to allergies to them, had one when raising family. But now, I have my first ever dog as an adult (had one as a kid) and HE thinks he is supposed to sleep similarly to your cat. Unlike your cat however, He goes into a crate at night.

The Hen

[BigEars]

I hope thinking about all this doesn't keep you awake.

The truth is you'll never know what's going on when you're asleep. If you have an APAP machine stop worrying about everything except mask leaks, they're the only thing you can affect.

If your AHI is below 5 and you have no leaks, be happy enjoy your improved sleep quality.

If you're taking medicines it's not normal to be constantly checking your blood levels and elimination dynamics. Why should APAP be different?

Just my 2p worth after 9 years of treatment.

[justMongo]

2. That's why we look at our data. And just because you once or twice actually hit a pressure of 17 doesn't mean you NEED a max of 17. That's what the 95% is for...

I wanted to add an * to Paula's point. Suppose we set a machine to 17 max; and it spends considerable time at 17. (More than just grazing 17 for a couple of instances.) Then, using the 95% may result in too low a pressure. That's why we see many people who start out with an auto set to 4 to 20. It's a terribly wide window; and usually can be narrowed. But, except in unusual cases will the 20 upper limit be hit. That 95% is useful for setting the upper limit.

What I'm suggesting is: The 95% number is useful for setting the max after we see the machine running with enough top end pressure "headroom" such that it either doesn't hit max or barely grazes the max. Once set to a number determined by the 95%, then we should see some nights were the machine spends some time at max pressure. All things being equal that would be 5% of the time. (However, each night is different.)

[justMongo]

2. That's why we look at our data. And just because you once or twice actually hit a pressure of 17 doesn't mean you NEED a max of 17. That's what the 95% is for...

I wanted to add an * to Paula's point. Suppose we set a machine to 17 max; and it spends considerable time at 17. (More than just grazing 17 for a couple of instances.) Then, using the 95% may result in too low a pressure. That's why we see many people who start out with an auto set to 4 to 20. It's a terribly wide window; and usually can be narrowed. But, except in unusual cases will the 20 upper limit be hit. That 95% is useful for setting the upper limit.

What I'm suggesting is: The 95% number is useful for setting the max after we see the machine running with enough top end pressure "headroom" such that it either doesn't hit max or barely grazes the max. Once set to a number determined by the 95%, then we should see some nights were the machine spends some time at max pressure. All things being equal that would be 5% of the time. (However, each night is different.)

Yeah, I know I danced around that -- but, I hope I was understandable...