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+--- Thread: [Pressure] What's the down-side of too high a pressure? (/Thread-Pressure-What-s-the-down-side-of-too-high-a-pressure)
What's the down-side of too high a pressure? - RonWessels - 06-14-2013
In my research on sleep apnea, I've come across all sorts of extra issues faced by people with higher CPAP pressure settings. Things like: discomfort because of the higher pressure, nasal pillows less likely to work, greater chance of mask leakage, etc.
My question is this: aside from "lowering the pressure means that you don't have to deal with the issues of higher pressure", are there any down-sides of having a CPAP pressure that is too high?
To put it another way, imagine that you are completely comfortable with the pressure you are currently using. You then have another sleep study and find out that a lower pressure will now be an effective treatment. What is the down-side of staying at your current (higher) pressure?
By the way, I am not in this situation. The question is pure curiosity.
RE: What's the down-side of too high a pressure? - Paptillian - 06-14-2013
Well there's the obvious one: it takes more power to blow harder
Not that electricity is the main concern here...
RE: What's the down-side of too high a pressure? - zonk - 06-14-2013
(06-14-2013, 06:35 PM)RonWessels Wrote: To put it another way, imagine that you are completely comfortable with the pressure you are currently using. You then have another sleep study and find out that a lower pressure will now be an effective treatment. What is the down-side of staying at your current (higher) pressure?Over treatment and possibility of inducing central sleep apnea
By the way, I am not in this situation. The question is pure curiosity.
For this reason, I use S9 so don,t have to be on fixed pressure all night also can differentiate between types of apnea and treat accordingly
The trick is to find start pressure that is comfortable and treat run the mill type apnea and have some leeway to go higher if needed
RE: What's the down-side of too high a pressure? - RonWessels - 06-14-2013
(06-14-2013, 07:00 PM)zonk Wrote: Over treatment and possibility of inducing central sleep apnea
Ok, but don't you have the same possibility of inducing central sleep apnea if you actually need the higher pressure to overcome obstructive sleep apnea? In other words, is CSA induced because of high pressures independent of need, or because of excess pressure over and above what is required to keep your airway open? If the latter, how does your brain know what pressure is required to keep your airway open?
RE: What's the down-side of too high a pressure? - zonk - 06-14-2013
I think you,re correct, the same apply on higher pressure too but if the machine don,t score central apnea, there is no way of knowing
Usually people switched to bilevel machines if higher pressure needed and ASV machines for the treatment of central apnea
RE: What's the down-side of too high a pressure? - jgjones1972 - 06-14-2013
Everyone is different and I think some people have an easier time with high pressures than others. I run fairly high pressure and I like the pressure. I no longer have any aerophagia and get a 10 or 12 second CA about once a week (which probably isn't even pressure related). The only way I could see higher than necessary pressure as harmful to an otherwise healthy PAPer is if they couldn't shake the hyperventilation or aerophagia.
RE: What's the down-side of too high a pressure? - archangle - 06-15-2013
(06-14-2013, 07:09 PM)RonWessels Wrote: Ok, but don't you have the same possibility of inducing central sleep apnea if you actually need the higher pressure to overcome obstructive sleep apnea? In other words, is CSA induced because of high pressures independent of need, or because of excess pressure over and above what is required to keep your airway open? If the latter, how does your brain know what pressure is required to keep your airway open?
Pressure induced CSA seems to be independent of OSA. Some people will not be able to use a high enough pressure to fix their OSA because it will cause CSA. Sometimes, you have to find the best compromise.
RE: What's the down-side of too high a pressure? - archangle - 06-15-2013
Some possible disadvantages of higher pressure.
- Patient discomfort
- Difficulty sleeping
- Aerophagia (gas)
- Increased leaks around mask
- Opening the mouth with nasal masks, causing leaks
- Central apneas and more subtle breathing problems
- Ear popping
- Muscle soreness (usually temporary)
- Difficulty exhaling
- Chipmunk cheeks
- More water usage
- More noise, more air blowing on your arms or your partner
RE: What's the down-side of too high a pressure? - skyler - 07-29-2013
Ron, what I found using and AUTO machine was the higher the pressure on ipap, the
more apneas I would have and the pressure would go higher to compensate and it turned into a vicious cycle.
It's good to run through different scenarios that can come up with therapy.
RE: What's the down-side of too high a pressure? - vsheline - 07-29-2013
(06-15-2013, 01:18 PM)archangle Wrote: Some possible disadvantages of higher pressure.
- Patient discomfort
- Difficulty sleeping
- Aerophagia (gas)
- Increased leaks around mask
- Opening the mouth with nasal masks, causing leaks
- Central apneas and more subtle breathing problems
- Ear popping
- Muscle soreness (usually temporary)
- Difficulty exhaling
- Chipmunk cheeks
- More water usage
- More noise, more air blowing on your arms or your partner
Also, a few people experience dizziness or vertigo from high pressure, and so must limit their machines to use pressure too low to fully avoid OSA.
Also, when one is recovering from surgery done on the airway areas, I think one may be told to stop CPAP for about a month, to allow the airway to heal.