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Re: Removal of posts about settings - thoughts

Posted by Kevin (in Walla Walla) on January 11, 2002 at 09:52:22:

In Reply to: Removal of posts about settings - thoughts posted by westernjoe on January 11, 2002 at 08:07:56:

One could look at this like diabetics adjusting their insulin based on frequent blood sugar monitoring. However this is a drastically different situation. There is no simple test you can do at home to check on if you should adjust your xPAP pressure.

If your pressure is set at a subclinical or subtheraputic level you can actually do more harm than good. A subtheraputic level can and will convert a short apnea into a prolonged hypopnea or period of hypoventilation. This can and does result in significant drops in oxygen saturation as well as cardiac instability. Likewise, if your pressure is set at a supertheraputic level it can result in central apneas. These central events are the result of various factors including lung stretch reflex, barrow adjustment, and ventilation/perfusion mismatch. Too high a pressure can also result in a forced opening of the upper esophageal sphincter by overcoming the pressure gradiant. This can and does result in esophageal reflux and possible aspiration.

Auto Titrating machines are not for everybody. Various machines use different technology and algorhythms to adjust pressures. Since everyones upperairway anatomy is different and their flow volume loops look different it is very easy to confuse the machines. An ongoing study is showing that up to 40% of people are getting the wrong pressures delivered by auto titrating systems.

If you are still showing signs of EDS while on xPAP it may or may not be related to the pressure. Sleep is not a static state and there are many different things that can affect the quality and quantity of sleep.

There are no simple answers.

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