[Pressure] Best settings for my machine?

[SuperSleeper]

Once you all receive and play with your new toys for a while, sure would appreciate a review in the Product Reviews Forum.

[Sleepster]

Wonder why the subtle changes in pressure as you breathe would cause central events?

Is it the changes itself that is confusing the brain?

The only thing I've been able to learn is the following bit of information. It seems that if the pressure is too high, the brain assumes you're getting enough oxygen and fails to tell you to breath.

I realize that this doesn't answer your questions. These are questions I've asked, too, and so far have gotten no answers.

Or do the changes work better and the too high pressure is what confuses the brain?

You may be on to something here. My CPAP therapy had my AHI under control at a pressure of 13 cm. They switched me to a BiPAP (because of aeropagia) at 13 cm IPAP and 8 cm EPAP. This caused my AHI to go way up, and it was due entirely to clear-airway apneas.

They lowered it to 11 cm IPAP and 8 cm EPAP, which helped a lot. One out of every ten nights or so my AHI would go above 5.

So, they lowered it to 10 cm IPAP and 7 cm EPAP. Now my AHI averages under 2, and never goes above 5.

[PaulaO2]

When I was first diagnosed, the best pressure for the OSA was 12 but the CSA spiked really really really high. As in in the AHI was in the 30s where it had been only 4.

So I started out at 7. Four weeks later, they raised it to 8. Three years later and I had that wonderful blood pressure fun, they raised it to 12. I've been doing good with it but am again starting to feel like crap. (and, not surprising, it's been about 4 yrs since the last change)

[Sleepster]

I've been doing good with it but am again starting to feel like crap. (and, not surprising, it's been about 4 yrs since the last change)

Do you see a sleep doc on a regular basis so you can have the effectiveness of your treatment evaluated? I'm new to CPAP therapy (5 months, now) but my doc told me my insurance required me to visit him once per year.

[Chuck]

Well, I thought I was done with this thread, but lots of good replies.
I'll get one of these oximeters here soon.
I'm going to do something that I notice isn't recommended on here, and I'm going to drop my pressure to maybe 10 tonight with C-Flex at 2. If I'm having a crappy night, I'll know it because I'll wake up suffocating (I often wake up during my CA's with a sore chest gasping for breath).
I'm not having any sinus problems or other known health issues.
In fact, I've improved my diet (I'm a celiac and eat gluten free, have for 15 years), and I swim a mile at a time. Health should be pretty good overall.
My insurance is pretty poor, and will only allow a visit a year to the sleep doc - my year begins in July.
I'll stick around and even comment occasionally. The best to you all. --Chuck

[Sleepster]

My insurance is pretty poor, and will only allow a visit a year to the sleep doc - my year begins in July.

You don't need a visit to have your doc adjust your pressure. I send my data to my DME, he prepares a report and sends it to my doc, then gets back to me with a change in the prescription pressure.

[PaulaO2]

I've been doing good with it but am again starting to feel like crap. (and, not surprising, it's been about 4 yrs since the last change)

Do you see a sleep doc on a regular basis so you can have the effectiveness of your treatment evaluated? I'm new to CPAP therapy (5 months, now) but my doc told me my insurance required me to visit him once per year.

When I was first diagnosed, a return visit was not mentioned. I saw him a total of three times. Once to get the sleep study. Then to get the results, then roughly 4 weeks later to get it raised. Then I guess it was 3 or 4 yrs when the BP stuff started happening. I saw him once then. He said I should see him every other year or so, as long as all is well.

I have Medicare and Medicaid. Neither care about compliance. I've never had to show any compliance data to anyone ever. The S7 did not have anything but hours. No one every looked. For all anyone knows, I take the machine and gear and re-sell it.

[Sleepster]

I have Medicare and Medicaid. Neither care about compliance. I've never had to show any compliance data to anyone ever. The S7 did not have anything but hours. No one every looked. For all anyone knows, I take the machine and gear and re-sell it.

I was talking not about compliance data, but things like AHI and leaks. Things that indicate the effectiveness of your therapy.

[PaulaO2]

I've never had a data capable machine. My sleep doc does not like APAPs so I doubt he is interested in any data at all.

Yes, I will most likely switch sleep doctors.

[Sleepster]

My sleep doc does not like APAPs so I doubt he is interested in any data at all.

He may like data-capable CPAP's and BiPAP's, but not like APAP's. I think many doctors don't realize that APAP's are far less expensive than BiPAP's, and only slightly more expensive than CPAP's. That wasn't always the case. Also, doctors don't like the restrictions imposed on them by insurance companies, and so they tend to over-react when they encounter them.

More importantly, there is no research to indicate that APAP's are really a good idea. They change the pressure throughout the night. This may be a good thing for some patients, but we know it doesn't work for others.

Regardless, APAP's may be used to determine if the CPAP pressure needs adjustment. They can then be set in CPAP mode. I think that we, as patients, must monitor our therapy, communicate with our doctors and DME suppliers, and get our pressure adjusted when necessary. Unless there's some medical condition other than OSA to be considered, I think the self-monitoring is more important than the choice of APAP over CPAP. And of course, you can't self-monitor unless you have a data-capable machine.