Is a set pressure more effective or a range?

I have been narrowing my pressure settings and tweaking it for optimal performance. My current range is 11 to 14.5. My question is should I settle for the medium number or continue with a range (min/max)? From my previous nights (not last night), my avg. pressure is around 12. Just wondering if I should just leave it alone or continue playing with the pressure settings.

Depends, how do you feel this morning? If you're happy with that keep it where it's at.

I would keep it on auto either way, more flexibility if things change, i.e. congestion, temperature, etc.

At your AHI number, why fix what is not broken? 5 or less is considered controlled. In my opinion, you are beating a dead horse.

rjezuit wrote:At your AHI number, why fix what is not broken? 5 or less is considered controlled. In my opinion, you are beating a dead horse.

+1 LEAVE IT ALONE

Some people do better with a fixed pressure and some do better with a range of pressures and it can be either a small range or a big range.....so it depends on what works for you the best.

Example...my OSA is about 5 times as worse in REM sleep compared to non REM sleep and when in REM sleep I would often need pressures up around 18 cm to deal with things.
Other parts of the night the pressure of 10 to 12 would pretty much take care of anything else.
I could either use 18 all night in fixed pressure to take care of the stubborn REM stuff or I could use auto range from 10 to 20 and let the machine sort it out. The pressure changes never seemed to bother me in terms of sleep quality and in fact I would never even know those 18 cm pressures even happened until I saw them on the reports.
So guess what works for me the best? I suppose I could use 18 all night but why in the world would I want to.
That's why I opted to use auto adjusting pressures....I really didn't want to deal with 18 all night and since I slept right through all the ups and downs...there's no need to.

Now some people do better with a fixed pressure for any number of reasons. Some people are just more sensitive to the least little change in anything so those people probably do better with a fixed pressure or if using auto adjusting mode maybe a very tight range of pressures.

So it comes down to what suits your own particular needs the best.
If you are sleeping well and feeling decent during the day then there's probably no urgent need to change anything but if you want to be sure about fixed pressure..you will have to just give it a try to see if you feel any better with it or the way things are now.
This is just another one of those things relating to cpap that comes with a big YMMV sticker and there isn't a right or wrong way or a "better" way. There's just what works for the individual and what works for me or the next person might not work for someone else.

I do suggest that once a person finds something that works well for them that they don't go changing things willy nilly because there is a lot of truth to the "give it time" thing. We don't sleep the same each night and sometimes we just have "off" nights where the results are just whacko and we have to ignore the temptation to "fix what happened last night" because we don't know that it will happen tonight. This is where the trends and patterns thing comes into play. If you have 9 nights where things are nice and boring and 1 night where things are ugly...don't go trying to fix that 1 ugly night with a bunch of changes. Sometimes crap just happens and if you are constantly chasing numbers then you will be going around in circles forever.

The primary goal...get the OSA effectively treated BUT keep how well you sleep and feel right up there at the top of the list. The most perfect AHI of 0.0 doesn't guarantee you squat if you don't sleep well when getting it.
Numbers are really secondary as long as they are within acceptable ranges.

There's so many variables it would be hard to give an absolute answer. I'm not one for obsessing over getting the AHI down to zero, especially of it means the higher pressure brings on other issues, like air in the belly, worse leaks, or centrals. If there are no negative consequences to the higher pressure, I see no reason to not shoot for ones personal best results. Time and experience will help you find the point of diminishing returns. If I were in your situation, I'd probably inch the lower number up a smidgen to see how it goes.Someone who has followed your data more closely might see a reason to not do so. The good thing about this is you have the freedom to make informed decisions, and then change course based on new information, so it's a win-win for you. Early on I experimented quite a bit, giving time between changes to see patterns. Right now I'm on a continuous pressure bilevel. I'm at a point of seeing a slight increase in pressure could be beneficial to my AHI, but I'm opting to not increase the pressure due to air in the belly issues. My pressure needs over the course of a night don't fluctuate enough to make an auto adjusting pressure of much, if any benefit. YMMV.

Thanks for the advice good folks.

andy2016 wrote:I have been narrowing my pressure settings and tweaking it for optimal performance. My current range is 11 to 14.5. My question is should I settle for the medium number or continue with a range (min/max)? From my previous nights (not last night), my avg. pressure is around 12. Just wondering if I should just leave it alone or continue playing with the pressure settings.

well, for one thing, the max number is completely irrelevant in your case, since pressure never hit that, you could (and I usually do) leave it at 20.

the lower pressure is good, it's enough to prevent the majority of events. an AHI of 1 or less is quite good.