apap, is range too narrow

[Imacpaper]

I started with cpap set at 10cm. I few weeks ago the doctor switched me to apap because I was still having apnea increases if I rolled onto my back. I started off with a range of 8cm to 12cm. I started having a lot of VS so I raised the lower limit to 9 and now I'm up to 10. 10cm seems to minimize the VS and my 90% is 11. I still hit 12cm (my max) a few times during the night but just a quick spike.

My question is "is 10cm/12cm too narrow of a range?" So many here have broader ranges. I could switch back to cpap at a higher pressure but isn't better to have your pressure as low as you as long as you can?

Just looking for some thoughts.

[Autopapdude]

I'd raise the upper setting to 13 or so, to give you some headroom in case of a spike. In fact, if it were me, I'd go for 9-13, depending on what your 90-95% pressure is. IMHO, 10-12 is a little narrow, but I like some headroom in case of rogue apneas.

[JohnBFisher]

Agreed on the 10-12cm H2O being a bit too narrow a range. You might even want to put the low end at one 1cm below. A little high and a little low. So perhaps 9-13cm H2O. But keep it close to your optimum range. You might loose a little weight. Or pehaps just have a great day and snore less or ... Some headroom allows the machine to move, but quickly so, to optimize your therapy.

[TSSleepy]

I've been using APAP range 10-12 for about 11 months and it's perfect for me. I spend the majority of the night at 10, but it spikes up to 12 for awhile in REM sleep. My AHI is under 2.

The reason APAP helps me is that when I am on CPAP all night at 12...I end up swallowing too much air and have painful gas in the morning. So leaving me at 10 for non-REM and bumping up to 12 occasionally in REM keeps the overall pressure for the night much lower.

And if I left it in APAP at 10-20...it would occassionally "runaway" and drive the pressure up to 16 or 18 and my mask starts to leak and wakes me up.

So 10-12 works perfect for me!

[Hawthorne]

10.5 to 13 works well for me - AHI - almost always below 1. My 90% is almost always 12 cm and I only reach 13 on occassion and for a very short period of time (mere minutes and even that little time, not many nights). I am at 11 and 12 cm almost every night. The vast majority of my night, every night, is at 11 cm.

I also find the narrow auto setting means I do not get the painful gas I get with straight cpap at 11 cm.

That little bit of room makes a great deal of difference for me as well.

[Captain_Midnight]

Range too narrow?

Well, it depends. I've read several posts over a few years suggesting that (generally) the narrower the range the better; and these observations came from trial and error. I think what you want to avoid is having the upper pressure spike to the point where it forces your mouth open, or your mask off, or wakes you with something akin to overinflation. However, if your therapy might need a wider range; and, if you can tolerate a little wider range, life's good.

I used to have a 2 cm range, but eventually widened it by a whole half cm to 2.5 cm. (My current range is 9.5-12).

Good luck range-finding.


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[torontoCPAPguy]

[quote="TSSleepy"]I've been using APAP range 10-12 for about 11 months and it's perfect for me. I spend the majority of the night at 10, but it spikes up to 12 for awhile in REM sleep. My AHI is under 2.

The reason APAP helps me is that when I am on CPAP all night at 12...I end up swallowing too much air and have painful gas in the morning. So leaving me at 10 for non-REM and bumping up to 12 occasionally in REM keeps the overall pressure for the night much lower.

And if I left it in APAP at 10-20...it would occassionally "runaway" and drive the pressure up to 16 or 18 and my mask starts to leak and wakes me up.

So 10-12 works perfect for me![/quote]

My wife tells me that the gas is much more painful for her than it is for me in any event. It's the whistling when I go into REM sleep and my lips part that drives her nuts. I woke up the other night to find her gently trying to close my lips with her fingers and I gave her heck... "How do I know where the heck those fingers have been before on my lips?". Now she just pokes me if I start to whistle.

I have my APAP set similar to yours and find it just great. My card reader AND USB cable/adapter should be on the doorstep anytime now and the one from CPAP.com has already arrived at our maildrop in Buffalo where we will pick it up next weekend when we hit the casino again (our last trip was a bonanza and we left with the trip and much of the gear paid for courtesy of the Fallsview Casino). If you get there, stay at the Hilton and try the Brazillian restaurant. Outstanding. I can hardly wait to see and analyze the data we get off the APAP. Am thinking seriously of selling off our Escape and getting another Autoset or perhaps an Elite (ResMed S8 Elite II), to put beside the couch in the family room/den for when I plop down to watch TV. Might as well have a spare that serves a purpose. I intend not to be without CPAP/APA ever again until it is not needed. Both will be on UPS's so that should the power fail I can either sleep through it or in the alternative I can have the UPS alarm and wake me up comfortably without having my blood pressure skyrocket so I wake up in a cold sweat with a pounding heart.

I am actually set for something like 9 - 14 and I find that this works well for me. Gotta order some more wee accessories like hose holder and maybe a heated hose.... I woke up with a pounding headache this AM and attribute it to lack of humidification and cold air blowing into my nose.

Anyway, gotta love the APA machine.... so far superior to that Escape.

[Imacpaper]

12 seems to be fine on the topside. I could raise it, because I do hit it a few times a night, but my OA are fine at this setting (last night my OA=.8 AHI=1.5)

The low end started at 8cm but I was snoring. This not only bothered my wife but I think it was keeping me from sleeping well. I was feeling worse than I felt at straight 10cm. I moved the bottom up .5 at a time and can really feel the difference at 10cm, and the numbers shows that there is a difference.

This is stupid but is it more healthful to have a wider range or better for the machine?

I've been using APAP range 10-12 for about 11 months and it's perfect for me. I spend the majority of the night at 10, but it spikes up to 12 for awhile in REM sleep. My AHI is under 2.

I helps to know that I'm not alone and maybe this is what will work.

[Autopapdude]

Well, it depends. I've read several posts over a few years suggesting that (generally) the narrower the range the better; and these observations came from trial and error. I think what you want to avoid is having the upper pressure spike to the point where it forces your mouth open, or your mask off, or wakes you with something akin to overinflation. However, if your therapy might need a wider range; and, if you can tolerate a little wider range, life's good.

I think widened range helps if one tends to occasionally spike an apnea or two every now and then that requires additional pressure. Also, for me, I do get the occasional bad night, where I may be doing some back sleeping, or have been generally restless. So, for me, a range of 4-5 cm works best in dealing with the "rogue apnea" spikes, and restless occasional nights. My AHI is lower that way, and I also feel better.

[Muse-Inc]

Doc agreed with my choice of 6-15 when I went to an APAP. My 95thcentile is usually around 10.x but I have woken up and seen anywhere from 6.9 to 14.5 on the LED. Because off & on congestion is my major challenge that unpredictably narrows my airways, this wider range works for me. I have bumped lowere pressure up to 6.8 to see if my numbers improved. YRMV.

[OldLincoln]

The machine will only go as high as needed to clear the event. You could set it to 20 and it will probably never get there. The lower number is what counts to prevent events from occurring and I would set it comfortably high. That's the point below starting of bloating while sleeping well.