[Pressure] Blown Away

[GoodNightSleep]

Two days ago I got my first CPAP (ResMed 10) and it seems to deliver much higher pressure then the APAP (ResMed S9) that I was loaned after my initial sleep study a month ago. A pressure of 10 on my new CPAP sounds and feels more powerful than 12 on the loaner APAP.
I’m looking for some help in isolating the factors. I imagine that it’s possible that either the APAP or CPAP are not calibrated correctly. Alternately, my perception of pressure might be off.
The APAP pressure was set for a range of 7-14, which I narrowed to 10-14 because I couldn’t get enough flow even with the ramp feature turned off. The CPAP was set for 11.8 (95th percentile of APAP average) but that feels like driving down the highway with my head out the window. I didn’t have any trouble adjusting to the APAP but had to drop the pressure of my CPAP to 10.0 because I can’t contain any higher pressure within my nasal passage.
I’ve asked my CPAP vendor to test the calibration of the APAP but don’t expect much cooperation since they are a preferred provider and have provided minimal service because I insisted on a ResMed rather than their stock unit. My titration study is 3 months away and I don’t mind managing my care in the interim but want to make sure that I haven’t missed anything.
I’m using software to track data and while my events are just as low as while using the APAP, my leaks are more than double.

[k_ogre]

do you have the mask type set to pillows? that might make a difference

[GoodNightSleep]

Yes, the mask type is set to pillows.

[justMongo]

Two days ago I got my first CPAP (ResMed 10) and it seems to deliver much higher pressure then the APAP (ResMed S9) that I was loaned after my initial sleep study a month ago. A pressure of 10 on my new CPAP sounds and feels more powerful than 12 on the loaner APAP.
I’m looking for some help in isolating the factors. I imagine that it’s possible that either the APAP or CPAP are not calibrated correctly. Alternately, my perception of pressure might be off.
The APAP pressure was set for a range of 7-14, which I narrowed to 10-14 because I couldn’t get enough flow even with the ramp feature turned off. The CPAP was set for 11.8 (95th percentile of APAP average) but that feels like driving down the highway with my head out the window. I didn’t have any trouble adjusting to the APAP but had to drop the pressure of my CPAP to 10.0 because I can’t contain any higher pressure within my nasal passage.
I’ve asked my CPAP vendor to test the calibration of the APAP but don’t expect much cooperation since they are a preferred provider and have provided minimal service because I insisted on a ResMed rather than their stock unit. My titration study is 3 months away and I don’t mind managing my care in the interim but want to make sure that I haven’t missed anything.
I’m using software to track data and while my events are just as low as while using the APAP, my leaks are more than double.

The APAP gave you the advantage of not having to be at higher pressure all night. It could retreat when it detected no need to run higher pressure.

I suspect both machines are in calibration. The design is such that they are closed loop systems -- as long as the pressure sensor works and is connected to the output, the system keeps correct pressure. If it goes open loop, the blower will max out at about 30 cm-H₂O and set a fault code.

Why did you accept a CPAP when an APAP would seem to better serve you?

Why the delay in the titration study? If a doc set you up with an APAP and prescribed a CPAP, why is a titration study even needed? Seems like the APAP was the titration study.

[Sleeprider]

What model Airsense 10 Elite is a data capable CPAP. You can reduce pressure until you reach that happy medium where you are effectively treated and comfortable. In time, you may find increased CPAP pressure more tolerable. There are inexpensive manometers available for sale, or you could make the one SuperSleeper showed in this article on the forum: http://www.apneaboard.com/forums/Thread-...ew-dollars

It's unlikely the pressure is actually different, but as suggested above, the APAP hit that maximum pressure less than 5% of the time, mostly when you were deeply asleep, so your were not aware of it.

[trish6hundred]

Hi GoodNightSleep,
WELCOME! to the forum.!
The machine you have now runs at a constant pressure, instead of a range of pressures like the APAP did, and that' why you are having trouble getting used to this one.
Hang in there for more suggestions and answers to your question and much success to you with your CPAP therapy and fine tuning it.

[vsheline]

Hi GoodNightSleep,

What settings are you using for EPR?

Perhaps EPR was enabled on the AutoSet and is not enabled on the Elite?

I suggest enabling EPR full time.

[GoodNightSleep]

EPR:
The EPR is set to Full Time level 1 on my new CPAP and checking my data it was set to level 2 on the APAP so I’ll change it to level 2.
I truly appreciate the support of this group!

Coverage & Choice:
Unfortunately my coverage only extends to CPAP unless an APAP is medically necessary and I don’t even have the option of paying the difference. From a layman’s perspective, using a CPAP makes as much sense as riding a single speed bike.
I made a poor choice in sleep clinics. If I had done my research I could have had the sleep study, titration and script done in one evening. But I used a local hospital with great reputation and severe backlog.

[iSnore]

You might want to experiment with EPR on 3 to see if it allows you to raise your pressure above 10. Just a thought.

[retired_guy]

The proof is in the pudding. On your old machine you were at or BELOW 11.8 95% of the time. What might be more interesting is what was your median pressure, and how does that feel in comparison on your new machine.

But, may that as it be, none of that matters too much. What's important is what pressure do you need to control your events. To determine that you need to set the pressure on your new machine to a comfortable level, then watch the results using Sleepyhead, or other software. If you have too many breakthough apnea events, then up the pressure a little at a time until they go away.

Don't make too many changes at once, and do allow some time between changes to determine the effectiveness.