[CPAP] Why pressure is rising without events

[SleepySleeper]

I've got my AHI from double digits down to typically 1.5-2.5, but my machine is ramping up pressure which seems unnecessary. Can someone think of a reason why this is happening or is there a setting I could ask my doctor to adjust so it doesn't happen? I wake up very early in the morning to the feeling of being bloated/full of gas, to which I can imagine excess pressure is contributing.

[Crimson Nape]

Hi SleepySleeper! -
A Resmed uses flow limitations to trigger a pressure increase. Your charts depict this scenario.
- Red

[OpalRose]

It sounds like you're suffering from Aerophagia (the swallowing of air).

Pressure can increase for reasons besides apneas. The most common is from Flow Limitations. Also leaks, even low level leaking for whatever reason is often linked with the flow limitation rising and in turn that causes the pressure to rise.

You could try using a static pressure (Cpap mode) for a while to eliminate pressure increases. Try setting your pressure to 8cm and use EPR 2. Watch for a week and keep track of the Aerophagia.

[G. Szabo]

 Can someone think of a reason why this is happening...

You can compare the inhalation peaks at 23.01.20 and 23.02.20. The latter is after the pressure increase. The latter pesks do not show inhalation flow limitation, while the former peak is ragged. Hence, the flow is limited.

[PeaceLoveAndPizza]

Note that even if the machine is not showing flow limitations, you may still be having them, just not large enough for the machine to count it. By looking at the waveforms in a 2-3 minute zoom, you may see flattened peaks, which is indicative of flow limitations. See the attached for examples.

[SleepySleeper]

Thanks everyone for the answers! For insurance reasons I can't change the settings myself (I think), but I'll ask my doctor to see what could be done. The flow limitation does seem clear - flatter tops before, sharper peaks after increasing the pressure. Seems like working as intended.

Anything that can be done for Aerophagia, or is it what it is?

[G. Szabo]

Anything that can be done for Aerophagia, or is it what it is?

Lower pressure lowers Aerophagia, but it is evident you need the pressure support.
Higher EPR lowers Aerophagia, but you are already at the maximum setting. Try an AirCureve 10, where you can have an even higher pressure difference between ins. and exp. (Kind of higher than  EPR 3)  You might be able to rent it for a test.

[Sleeprider]

Insurance is only concerned that you use your machine and benefit from its use as documented through your treating physician. Insurance does not monitor nor care about what settings you use. If you read the preamble to the Setup Manuals page, it is discussed there that we consider patient empowerment and access to settings to be a basic patient right. https://www.apneaboard.com/adjust-cpap-p...tup-manual

[OpalRose]

Anything that can be done for Aerophagia, or is it what it is?

See my response above (post #3)