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Optimizing CPAP - high pressures - adlondon - 09-13-2024

Hi Apnea guys!

I'm a guy who finally started using cpap after receiving a cease snoring or desist sleeping in the same bed as my wife Too-funny 

I think I had thought I would see an overnight difference - but I've been plagued with issues with aerophagia, spoke to Vivisol (my supplier) and they switched me to a nasal mask + chinstrap + mouth tape which has worked well.

Oddly enough I feel more tired over the last week of using cpap but have been told this is normal.

I'm hoping to get help with an issue thats been happening on and off over the last couple of weeks.

In the morning around 0600 my pressures seem to spike and I wake, get aerophagia, take the mask off for a bit then put it back on, the pressures seem to be very high

Any ideas what may be causing this? I've attatched some graphs for OSCAR.


Thank you for your input! Would love to hear if anybody has also had similar issues/thoughts about perhaps trying full face mask again and minimizing aerophagia?


RE: Optimizing CPAP - high pressures - georgesadam - 09-13-2024

I'm using the same machine as you, the Prisma Smart Max, and I'm facing the same issues (high flow limitations, RERAs, hypopneas, etc.). Your minimum pressure of 4 is quite low, and your maximum pressure of 20 is very high. What worked best for me to start was setting the minimum to 6 and the maximum to 12 and let the machine settle for few nights so that later you can adjust if needed.

Also, switch your APAP mode to Dynamic—it reacts better. Can you send your OSCAR data again so we can take a look?

I don't want to scare you, but I've been struggling with this machine for over a month now with the exact same issues, and I've tried every pressure range. Right now, I'm on a minimum of 10 and a maximum of 13. I'm also looking into getting a BiPAP machine, which might be better for our situation.


RE: Optimizing CPAP - high pressures - adlondon - 09-13-2024

I'll switch the settings tonight and hope for some respite from feeling like I'm in a windtunnel at 6 in the morning and upload some more graphs tommorow

Apprehensive about what you said about struggling with the machine - from the reading and youtubing I've done about the various machines - the Loweinstein seems to be very well regarded.

I'm hoping its just me being at the beginning of therapy and adjusting - how long have you been using CPAP for in total?

If anybody else has any other insights about this machine (and hopefully good news) please do let us newbies know!


RE: Optimizing CPAP - high pressures - georgesadam - 09-13-2024

Yup, that’s exactly what I’ve read too (amazing blower, better algorithm, German-made, etc.).
However, the data shows a different story—some things just don’t work as expected. For our problem (high flow limitations), the solution was to raise the pressure until the flow limitations disappeared and in my case, it did not, unfortunately.