7 Day APAP Trial - What pressure to use?

[green wings]

Thanks, OpalRose, for asking yesterday if my machine had the option of APAP trial. I didn't think it did, but I went to double-check a little while ago and it does.

So now I need some advice about what min and max pressures to start my APAP trial with.

I started on CPAP therapy at 7.0 cm H2O in December but didn't really start using the machine regularly until after I found this board in late January.

I got frustrated a couple of weeks ago and increased my pressure to 8.0 and then to 9.0 (probably faster than is recommended). My impression is that things improved a bit in the first half of my sleep but are still taking off in the later part of the night.

I don't have a good idea how my body is going to respond when the pressure starts ramping up while I'm sleeping. I suppose I'm looking for suggestions for safe and comfortable settings for the first night's trial of APAP (and after that, too).

Thanks!

I've attached a couple of screenshots of my AHI for one night at 7.0 and one night at 9.0 if anyone wants to see them.

P.S. When I saw my sleep doctor in late February, he compared the just-over-5 AHI from the Encore Basic general report to my 50-something untreated RDI from my sleep study and pronounced it "very good", so I'm hesitant to call their office to discuss this.

They generally didn't return my calls when I was calling back in the winter with questions about the problems I was having with learning to use the CPAP mask and machine, so pfft on them.

There were even a couple of times I left messages to say that I needed to pay them money and they didn't call back, so maybe they are just really busy.

[PoolQ]

Hang in there, people in the know will respond. I could tell you what I would do, but there are better sources on this board. The graphs you posted should be enough to help you out.

[OpalRose]

Since your lastest graph shows improvement with a pressure of nine, I would set the APAP trial
to start at 8 with a maximum of 15. This is just a guess. How long will you set the trial for?

Someone else may have a better range to suggest, but you have to start somewhere.

Watch it for at least a couple weeks, and see how you feel. Since you are used to using a straight pressure, you'll know if the pressure ranges bother you. But the purpose of the ATrial is to find the optimum pressure, so give it a chance.

[green wings]

Aw, tell me what you think.

Hang in there, people in the know will respond. I could tell you what I would do, but there are better sources on this board. The graphs you posted should be enough to help you out.

[green wings]

Thanks, OpalRose. Your suggestion of 8-15 sounds good. I might use 7 for min, since that's what pressure I was at when I saw my sleep doc in Feb.

I wasn't sure what you meant by "how long will you set the trial for?" I had seen "7 days" in the settings and didn't realize that could be adjusted. I just checked again, and it says "min days" and is adjustable from 7-30. I thought I got only 7 days of APAP trial and then it went back to CPAP.

Do you mean how long will I use the machine in APAP mode before talking to my sleep doctor about getting an APAP machine? (That's not a conversation I'm looking forward to having. Can you be my sleep doctor?)

I suppose I should contact the doctor's office after a couple of weeks and maybe fax them a couple of graphs to see what they say about the APAP usage?

Should I tell the drs office that I'm going to do a trial of APAP?

What do people's doctors usually say when they put themselves on APAP?

If I had had an appropriate titration, this might not have come up at all. For some reason, the sleep technician during my titration set me at 5.0 then bumped me up to 6.0 for the rest of the trial, except for the last hour when they increased my pressure to 7.0 and declared me titrated.

Since they woke me up around 4:30 am to end the test, I suppose I never got into the stuff I'm typically seeing now from 4-7 am.

Thanks again.

Since your lastest graph shows improvement with a pressure of nine, I would set the APAP trial
to start at 8 with a maximum of 15. This is just a guess. How long will you set the trial for?

Someone else may have a better range to suggest, but you have to start somewhere.

Watch it for at least a couple weeks, and see how you feel. Since you are used to using a straight pressure, you'll know if the pressure ranges bother you. But the purpose of the ATrial is to find the optimum pressure, so give it a chance.

[OpalRose]

So it sounds like it will let you choose 7 days or a longer trial if you want. I would at least choose a couple weeks and check results on sleepyhead. Or set it for 30 days, that would probably give a more accurate number.

I don't see why your doctor would mind you trying out the Trial mode. It would be interesting to see what the machine would set your pressure to, and if it makes a difference in your AHI.