Too much pressure has diminishing returns?

[G. Szabo]

Some of the 99.99999% just died early.

Agree. Or they sunk into Dementia / Alzheimer.

[G. Szabo]

The one thing I noticed it’s easy to get baited into using the med. pressure to set your starting pressure.   If you do that and then the very next night the med. pressure will be a little higher and then you take the bait and adjust again.   Pretty soon you’re adjusted to the increase but you don’t really need it.

I have the opposite experience. When I tune down the minimum pressure or pressure support, the overall average pressure throughout the night increases because the device responds to the flow limitation with a pressure increase and pressure spikes. 

Hence, if you really want to control your pressure and tune it down, you need to reduce your maximum pressure. Then, you enter a high flow limit regime during the night, and I do not want to have fun with that.

[StevesSp]

I observed a couple of years into my CPAP journey that, for some reason, there was a 'sweet spot' for me in terms of AHI. If I recall correctly, it was around 4-5. When I scored thus, for some inexplicable reason, I felt better than when I scored higher - or lower. I couldn't explain it and so continued to chase low AHI before more or less giving up on the tuning side of things. This thread has caused me to consider tweaking again, reducing max pressure till I land in that mysterious sweet spot again.

[40plus]

I found this myself. I titrated myself to clinical perfection.

At CPAP mode, 13.6 cm, nose pillows, no ramp, epr 3, humidity auto my numbers were absolute perfection.

Flow limits 0.0, even the 95%, Snore 0.0, AHI 0.0, Leaks 0.0 and the curve of my inspirations had a beautiful round peak. Amazing results.

But my sleep quality was horrendous. Even if i slept all night 7-8h i woke up feeling like i did in my younger years in the military when we was awake for 2-3 days while napping under a cold wet tree. I was ruinied.

Taking away epr helped a lot. But to keep flow limitaions kinda ok i kept it at 1. And now im on APAP 10-13. Medain is usually around 10 and max never hits 13 even on narcotic sleep pills and alcohol.

My ahi range from 0.0 to at worst 3. The data in Oscar is much much worse, but still within reason. My sleep quality is much better.