Posted by Bird Watcher on July 26, 2009 at 17:44:46:In Reply to: Re: Basic CPAP Questions posted by millich on July 26, 2009 at 08:18:26:
Correct, I'm not a Dr., so take what I say using your own awareness. I'm only an experienced user and a forum watcher. I'm commenting that a home study for a week or so with an auto adjust PAP set for a range of 4 to 20 cm probably won't be much fun because the machine is going to swing too much and not really zero in on what pressure is best because the AHI data recorded often doesn't tell if the events are obstructive or central in nature and it's difficult to analyize what position you where in when the bad breathing occured. It could by accident find a pressure for you, but that's what they're supposed to do in the lab for you - find your titration pressure. Auto adjust machines are best for people who are going to be on CPAP long term, have a ball park pressure and do well with that pressure, but are going to need changes due to seasonal weight gain or loss - or - activity and lifestyle changes day to day or over the years. In other words, people who already do well but are looking for better results long term.
As you said in your first post, at a pressure of 13 cm, you have an AHI of 11.7 - this is still not such a good result, albeit you are down from 33. You should have an AHI below 5 if everything is working.
If they make you go through with the home study with the auto, ask for an auto that has exhale relief feature that can be turned on while in auto mode over the period of the study. See if that helps. Some of the new Respironics and ResMed autos have this. Also, should be zeroing in more on the pressure range - probably 8 to 13 and not 4 to 20. No one person breathes in the range or has pressure needs of 4 going back and forth to 20.
I can't predict if you'll do better on Bi-level, or, CPAP at a pressure that hasn't been discovered yet for you. Auto adjust CPAP is only for people who first do well on a set CPAP pressure but need adjustments over time.
Your positional AHI results mean it may be more difficult to find one good pressure or one good range of pressures for the whole night since most people turn over from time to time. Sometimes positional problems may be indicators that you have too much food in your stomach at bedtime. Do some trials on your own not eating within 4 hrs of bedtime and see if your sleep is helped.
To answer your second question, yes, in a perfect world pressures are found in the lab with expensive instruments that have 'calibration due' stickers on them, and not consumer home equipment that rarely or never gets checked by anyone qualified.
Keep in mind that the PAP mask can be a significant factor in therapy and results. Full Faced masks should be avoided if possible.
It may be that a below 5 AHI result is ellusive for you. But if you feel that you do better on PAP than without, stay on theh PAP. Best Wishes, Birdwatcher.
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- Re: Basic CPAP Questions Bird Watcher 16:57 7/27/09 (0)