Thoughts after less than a week, and questions

[SkySleep]

UPDATE from the OP: I did run OSCAR this morning and took a look at last night's data. Indeed, it was very interesting and, from my reading of the Wiki, all of the numbers were in range. Obviously, I need to look at more than just one night.

(I won't be posting any OSCAR reports here, but I appreciate the offers from several members to take a look at them.)

[joeblough]

Would you care to elaborate further on your assumption?  The absolute pressure range is 4 to 20 cm.  It can be only programmed to any value within that range.   The only time that it will increase in pressure, assuming it is not in the static CPAP mode, it when it detects flow limitation (i.e.: breathing restriction).
- Red

what i mean is that the OP indicated that the airsense 11 did not need any configuration for the pressure range and that "it figures it out on the fly." but my airsense 10 of course has a range of pressures, perhaps as you state, bounded by 4 and 20, but is otherwise user configurable. a big part of therapy optimization here is choosing those two values and i'd never let my airsense 10 "just figure it out on the fly" and just leave it set to 4-20.

that is what i was asking - is the airsense 11 somehow different in that it really can "figure it out on the fly" or is it substantially the same as an airsense 10?

[SkySleep]

OP here. What I meant is that the 11 figures out the pressure dynamically within that range. Maybe you can also set the pressure you want on this machine, but I have no interest in doing that. I prefer letting the machine choose the pressure (within the range).

I've only had my machine for a short time, as I indicated in my post, but the maximum range it's hit is well under 20 for the nights where I looked at the data.

I have no idea if anyone else needs something greater than 20 or if the machine can be set to a higher maximum.

[joeblough]

OK - in this respect i don't think the 11 is any different from any other APAP then. i'm not advocating more than 20cm but i am implying that you will probably benefit from titrating the pressure to some smaller range of values. it does really depend on your individual case though, and it is possible you could need as much as 20cm of pressure.

[SarcasticDave94]

The typical method doctors use is whatever the machine has preset that's good enough. And in most cases it's not good enough. This would be why there's settings to adjust per the individual users needs. Without adjusting the out of box setup, this is called default, and again for almost every user it's not good enough. But if you like default, ok have at it.

I will say this, you attempt to make me put a CPAP mask on at default 4 and it won't happen. I would certainly edit it to start at 7.

[SkySleep]

OK - in this respect i don't think the 11 is any different from any other APAP then. i'm not advocating more than 20cm but i am implying that you will probably benefit from titrating the pressure to some smaller range of values. it does really depend on your individual case though, and it is possible you could need as much as 20cm of pressure.

joeblough, can you explain the benefit of setting the pressure to a smaller range? If OSCAR reports that my pressure through the night ranged from 4 to 7, what is gained by setting the high end of the range to a number less than 20? Is the idea to set it to less than what it gave me, to 6, say?

And/or, are you suggesting that the low end be increased?

I'm very unclear about the need, expressed in several posts here directed at me, to narrow my range from 4 - 20 to something else.

[joeblough]

i guess i'm only saying that yes, these machine are 'autoset' but that never meant to just use them with default pressures out of the box and let the computer decide what to do. titrating CPAP pressures is a big part of sleep medicine.

i guess there are a lot of reasons that you might want to narrow your range. there's no pressure that one of these machines can generate that will cause your head or lungs to explode, so it's not as though it is a matter of safety. but the point of this therapy is to form a 'splint' which keeps your airway open while you breathe. the orthodoxy is that it should be set in a range that's appropriate for your physiology and the severity of your OSA, while still allowing you to sleep properly. if too much pressure causes arousals then it's not a very good therapy - the cure is the same as the disease.

keep in mind that these machines are not magic - if you cough, take deep breaths, or slow your breathing down while waiting to fall asleep, the machine can misinterpret these things as OA or H events and it will increase the pressure unnecessarily. if you have your high end way above what you actually need, it's possible that it will run way up to those pressures for no reason. i see this with my machine all the time and i end up having to turn it off and back on again to reset the pressure. the machines relax very slowly from pressure increases so once it's up there, it's going to stay up there for quite a while.

[Rickyricardo]

I don't know if this is just my supplier but when I started with CPAP I was allowed to try multiple masks until there was a mask that fit and worked.

A mask can "cost" $90 or $150 to the end user but take a look at one, made in quantities of thousands, they cost $5 (if that) to make and my supplier, at least, is given an allowance for returns.

If a mask is the wrong size or type you need a supplier which will fit you correctly.

It's an interesting question if a brand new APAP not opened by the vendor has a preset range making it an out of the box automated device. I suppose if it can go from 4 to 20 if could be set at the factory at 4-20 so at least it can find its own way if not set up.

[SkySleep]

Thanks, joeblough for the clearest explanation I've found here. I'll think of the high end as a limiter to prevent runaway pressure, and the higher low end as being closer to the preventative (splint, as you say it) number.