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Auto-PAP Data. Now what?

Posted by Todd4218 on February 24, 2004 at 15:28:17:

I got my new Puritan Bennett 420E last week and have started using the Auto-PAP for the first time in 5 years. Sure enough, I'm seeing quite different pressure being applied throughout the night and different nights are very different.

Three sleep studies have suggested pressures for me of 7, 13, and finally 9. The majority of my "incidences" in the sleep studies were hypoapneas, with very few actual apneas.

I've been using a setting of 9 on my cpap for the past 5 years, having difficulty tolerating 13 and having my last sleep study say 9 was ok. But I am feeling tired a lot of the time.

For the APAP, I set the minimum to 7 and max to 11, and set it to adjust based on the defaults supplied (pretty much everything).

Looking at three night's data, I had almost no hypopneas (the vast majority of my events in the sleep labs were hypoapneas), but only a very few apneas (5 total throughout the night). However, there were a lot of acoustical vibrations so the unit jacked my pressure up to 11 most of the time for two nights and showed it going up and down between 9 and 11 but without apneas or hypoapneas.

One night the pressure stayed down around 8 and I had fewer acoustical vibrations.

Both of the days after the pressure was very high, I noticed I was very tired.

I'm wondering if the pressure should be set so high, when I had so few apneas (5 total on the two high pressure nights scattered out, none on the low pressure night), and no hypoapneas at all, but only had lots of acoustical vibrations.

Should there really be no snoring with CPAP at all? Should the pressure keep going up until snoring disappears?

I'm having some sinus congestion during the night in one nostril or the other (not both) and am using a nasal mask and am convinced this is causing the acoustical vibrations.

I'd like to know whether I should raise the max pressure or reduce it. I'm thinking the higher pressure might actually be interfering with my sleep instead of helping me sleep better. My sleeping partner has never said that I snore while wearing my CPAP, and yet this machine is reporting tons of acoustical vibrations (in the 500 range in one night).

I'm thinking of changing to have the machine only raise the pressure on hypoapneas and apneas but not acoustical vibrations, but I'm not sure this is possible. It seems like acoustical vibrations is always one of the triggers to increase the pressure.

But if there are acoustical vibrations but no hypoapneas and no apneas, why should I care?

Any suggestions you can make to help me understand this data would be appreciated.

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