Airsense 10 minimum pressure being reset by other than me?

[cpap450]

I've been using CPAP for about 3-4 months now. Happy with the results. Normal events/hr is in the 1.0-1.5 range, although a couple times a week I'll be well under 1. Doctor says as long as under 5, don't worry. Haven't been close to 3 since my first week or two.

But I've noticed that the pressure felt "different" for a while, and today I went into the clinical menu and looked.

The minimum pressure, I'd bumped from 5.0 to 5.6 then 6.0 in late November. When I looked today, it was 5.0.

Can some "outside force" reset my pressure?

Obviously I am a "if it ain't broke, don't fix it" person. Other than the adjustment to minimum pressure, the only other changes I've made were decreasing the humidity setting, then eventually turning the humidification off 5-6 weeks ago.

BUT - my tweaks have been small and for a reason, and I am not happy if something other than me can remotely play with my settings.

What possibly happened?

We have had zero electric power failures, so that would not have been a cause.

[palerider]

I've been using CPAP for about 3-4 months now. Happy with the results. Normal events/hr is in the 1.0-1.5 range, although a couple times a week I'll be well under 1. Doctor says as long as under 5, don't worry. Haven't been close to 3 since my first week or two.

5 is actually crap, it's like being poked with a sharp stick every 12 minutes.

But I've noticed that the pressure felt "different" for a while, and today I went into the clinical menu and looked.

The minimum pressure, I'd bumped from 5.0 to 5.6 then 6.0 in late November. When I looked today, it was 5.0.

Can some "outside force" reset my pressure?

Yes.

Obviously I am a "if it ain't broke, don't fix it" person. Other than the adjustment to minimum pressure, the only other changes I've made were decreasing the humidity setting, then eventually turning the humidification off 5-6 weeks ago.

BUT - my tweaks have been small and for a reason, and I am not happy if something other than me can remotely play with my settings.

What possibly happened?

We have had zero electric power failures, so that would not have been a cause.

Nope, Your DME likely went in and changed it without your permission.

[Miss Emerita]

They can do that remotely. Change it back, would be my advice. If they mess with it again, have a conversation with them. Try to be collaborative with them; e.g., explain that you feel less air-starved starting with the higher minimum (or whatever other reason you have), so you sleep better, plus your results continue to be great.

Ideally, they'll say, "Oh, OK; that makes sense," and leave you alone. But they may tell you that you are not allowed to change the pressure settings, you're breaking the law, SWAT team is coming, Katie bar the door. None of that is correct. Ask them why they changed the settings back. If the answer is, "Doctor's orders," then get a doctor involved.

[cpap450]

They can do that remotely. Change it back, would be my advice. If they mess with it again, have a conversation with them. Try to be collaborative with them; e.g., explain that you feel less air-starved starting with the higher minimum (or whatever other reason you have), so you sleep better, plus your results continue to be great.

Ideally, they'll say, "Oh, OK; that makes sense," and leave you alone. But they may tell you that you are not allowed to change the pressure settings, you're breaking the law, SWAT team is coming, Katie bar the door. None of that is correct. Ask them why they changed the settings back. If the answer is, "Doctor's orders," then get a doctor involved.

Thanks. I had a followup visit with the sleep doctor about a month after I started, and they were fine with my adjusting it. In fact, I'd messaged the doctor concurrent with my making the adjustment, and he was fine with it at that time.

I just contacted the DME provider explaining the situation, and making it clear that the adjustments I make are for a reason, and that I want it left alone.

[palerider]

But they may tell you that you are not allowed to change the pressure settings, you're breaking the law, SWAT team is coming, Katie bar the door. None of that is correct. Ask them why they changed the settings back. If the answer is, "Doctor's orders," then get a doctor involved.

Actually, it's much simpler than that, tell them that you revoke their permissions to adjust your machine remotely.

[carey.bolam]

5 is actually crap, it's like being poked with a sharp stick every 12.5 minutes.

Why is 5 crap? It sounds like it's working for OP and is also appears to be working for me.

My assumption is that everyone is different and some might not need as much pressure as others but maybe I'm wrong.

[palerider]

5 is actually crap, it's like being poked with a sharp stick every 12.5 minutes.

Why is 5 crap? It sounds like it's working for OP and is also appears to be working for me.

My assumption is that everyone is different and some might not need as much pressure as others but maybe I'm wrong.

I just EXPLAINED Why it's crap., and it's NOT working for the OP, who said quite clearly:

Normal events/hr is in the 1.0-1.5 range, although a couple times a week I'll be well under 1

An AHI of 5, AS I SAID equates to a sleep interruption *AT LEAST* every 12 minutes, if not more often., that's not restful, that's not recuperative, that's BAD, no matter what the average doctor and insurance company may say.

[carey.bolam]

Sorry, thought you were referring to the minimum pressure of 5.

[palerider]

Sorry, thought you were referring to the minimum pressure of 5.

5 is *usually* too low, but there are some people that it works well for, and there are even a few that 4 works for, but for the vast majority, most people do better with a higher minimum.

[cpap450]

5 is actually crap, it's like being poked with a sharp stick every 12 minutes.

In fairness to the breadth of opinions expressed here, I can't absolutely say this is true for everyone.

My pre-CPAP numbers were >40 AHI. Yet I felt great - slept all night, and didn't run out of gas during the day. Obviously, my doctors weren't happy - with the number, or with the stated fact that my snoring/events would wake the whole house.

I think I was 3.8 or 3.5 my first night of CPAP. I've never topped 4. That first night I got the lowest Resmed score I've ever gotten, something like a 70 or 75. I think I might have had the mask on upside down because it was a lousy noisy seal and I could feel my face getting sprayed with air all night.

The fact is that I've continued to sleep great every night since starting CPAP. So I was happy before and am happy now.

The only new development is that my doctor is happy - oh, and my wife is REALLY happy! I haven't snored since starting!

So, score aside, if patient is happy and doctor is happy, I'd score that as a win.

[Pugsy]

So, score aside, if patient is happy and doctor is happy, I'd score that as a win.

Add in happy wife. Double triple win.

Some people find that they need a consistently lower AHI (like below 2.0) or they feel like crap. Some people don't seem to notice minor differences in the AHI and how they feel.
Palerider has learned that how he feels is directly tied to his AHI...the lower the better so it's really important to him to not be poked every 5 minutes.
Me....I can't tell much difference myself and one of my very best days followed a night with the AHI of 10.4....go figure that one.

When we offer advice here we don't know if a person is going to be sensitive to the AHI or not....so we try to cover all the bases as best we can. Never hurts to go with a lower AHI but might hurt if someone is sensitive to those pokes.

[palerider]

So, score aside, if patient is happy and doctor is happy, I'd score that as a win.

Your opinion is noted, and dismissed.

People live with apnea for years, thinking they're fine until they realize that they've been sliding into oblivion for years. Not getting good rest takes a toll on the body whether you recognize it immediately or not, Not being able to maintain REM for any length of time, or get into deep sleep (Not REM) for any length of time, or at all, will deprive you of the recovery that sleep provides for your body to rebuild itself.

If you're happy with nothing more than a series of naps all night long, more power to you, but it is not good for the long term.

[Ht538]

So as I am just leaning about this, but it seems to me AHI is a pretty oversimplified index and that could explain the significant variation in how people are feeling...in addition to the fact that sleep quality in terms of fatigue/mood/concentration are highly subjective. There are fundamental issues with granularity that happens when averaging any occurrence over time.
While use an AHI of 5 would mean on average one ‘poke’ every 12 minutes, that assumes the pokes are evenly spaced all night and that the severity of the pokes are equal. From what I understand, many folks have poke rates that vary greatly over time. Myself for example, I have a poke rate over 25 when I am in REM sleep. But I’m any other sleep mode, it’s 7. So for a night where maybe I didn’t get as much REM or slept on my back more, the poke rate would be entirely different throughout the night and impact potentially different sleep phases. Same AHI different impact.
In addition to poke rate, the severity of the poke is also not addressed by AHI figures. Again, using myself as an example, while my nightly AHI was 8.2 during my sleep study, I had NO Apneas, zero, nada. And NO desaturations, zero, nada. So my guess is that had my “pokes” been more severe, coming with apnea or significNt desaturations, I would feel much differently in the AM even with the same AHI.
I think we have to realize that while AHI is the standard in making OSA diagnoses, in no way does it normalize the symptoms one might experience at that given AHI. It seems individual experiences of AHI are highly personalized just like PAP mask preferences.

[socknitster]

As for as the AHI score debate, I would remind you all that this is a combined score. An apnea even can be far more severe than a hypopnea event. It really depends on how much flow is restricted during a hypopnea event and whether there is oxygen desaturation as to whether a cascade of negative hormones are going to be set off that will actually affect the human body.

I don't know where that cutoff is and I doubt medical science does either. CPAP is still in its infancy as a therapy. So for some people an AHI of 5 may be absolutely horrific--but perhaps all of those are apneas or hypopneas with severe desaturation. Whereas someone could also have an AHI of 15 and feel great because that score was comprised of mostly low-level hypopneas that did not result in desaturations or hormonal responses. We have no way to measure that at home.

As a result, we have no choice but to go on the data of how we feel. Primative. But it's what we've got. No one's wrong here. But it is very personal.

[nicholasjh1]

Yeah, I always thought I was "fine" and just getting old. Now with under 2 (usually much lower) AHI, and enough time to heal, I feel like a super hero.