CPAP Settings

[sterobinson]

Hi,

What settings are people generally on with CPAP ?

Ive recently been increased from 7.5 to 8.5 thinking this was high but reading various forums I note some people start on much higher ?

My CPAP Nurse will only increase in half increments and occasionally by 1, which she has done for me on this instance. I this normal ?

Ive noticed that since being increased to 7.5, I'm having to take an occasional deeper breath in the mornings when Im not on the mask. Assuming that this is my lungs adapting.

Thanks

Steve

[Sleep2Snore]

Hi steve,
Yes will only increase your pressure by small amounts. This is due to the machine being set up for the pressure you need, however I had to have my pressure increased a few times until I reached the ideal pressure I needed.
This is over twice what you are on.
I had to push quite a bit before they would increase it, but it worked for me.

I have never noticed that I need deep breaths in the morning and I don't think I do. Your breathing tract will get drier due to using a CPAP machine, perhaps this may have something to do with it?
I don't know but keep and eye on it and if you notice it more see your Gp for advice or if you don't get and answer from ask the Sleep Clinic for advice. They may have come across this before. Sorry I can't help more.
Maybe some others will have come across this before.

[Fredxx]

I'm on 16, which is at the higher end of CPAP pressures. The machines usually do between 4 and 20, and from the bits I know about it, pressures around 8-9 are fairly common.

The deep breaths... I am guessing your chest is a little tight. When you use a CPAP machine, you are having to work a little harder when breathing. The muscles involved in this get a little tight at first, as do any muscles when you start exercising them. You get used to it pretty quickly.

There is another possibility though - mild chest infection. If it doesn't stop after a week or so, see your doc about it.

[Sparticus]

Im on Auto (APAP) so I dont need my pressure set as the machine will compensate for my apneas. Most night my pressure is usually round the 9-12cm range.

[sterobinson]

If an APAP automatically adjusts to what you need (anything between 9-12 in your instance), why is not everyone offered an APAP ? Why should someone have to go to the NHS, be put on CPAP with a relative low pressure and then only over a period of time be offered small increments. In theory, my apneas could stop with a setting of 11, but it could take 6-12 months to get it raised to that level from my current setting of 8.5.

Steve

[Sleep2Snore]

That is a good question.
Why is everybody not given an APAP?

I was tested at the local hospital before being dispatched to Edinburgh for a full test. I had to get them to set its minimum pressure up a bit so it stopped hunting around, then I got some sleep, but still woke up now and again due to rising pressure. I suppose I would have got used to it but prefer the CPAP on a constant pressure.
I suppose there would be a cost factor involved?

Maybe someone from this site could tell us if cost is a factor?

There are more APAP machines around now, I suppose you could always ask to try one if they have them where you were issued with your machine.

[Fredxx]

I suspect price is the prime consideration - typically Auto machines are around £500 compared to the equivalent CPAP at £300.

That having been said, there are advantages to the CPAP route. Auto users can often be found on here talking for instance about the issues of the machine ramping up and blasting them with gales in the middle of the night, therapy being made less effective by the "wide open" 4-20 range rather than a more targetted range based on the 95% pressure.

I know for me, CPAP works just fine, so it is doubtful I would get any better therapy if I switched to APAP. If the clinic gave it me because of the cost, I have no problem, because it works.

[Tom @ Intus]

That is a good question.

Maybe someone from this site could tell us if cost is a factor?

There's that, and the fact that they're simpler. An APAP will cost between 50-100% more than the CPAP equivalent.

Plus, as Fredxx said, they're easier to use. Just switch it on, and away you go. An APAP introduces some things which may be problematic, such as the pressure increasing to a level that is uncomfortable, or the changing pressure causing distractions and inhibiting sleep.

Both of these can easily be resolved by changing settings, but that means another trip to the clinic, and more clinician time being used up. So it's probably easier for them to just give out a regular CPAP so as not to have any additional settings done soon after.

[Sparticus]

For me it wasnt cost as I am also on the NHS at Edinburgh, it was simply because I was put on it first and after a few weeks I was use to it as APAP feels quite different to cpap. They tried to put me on cpap after a few weeks but I told them I was having trouble adjusting so they put me back on apap. As for problems yes the ramping up can be very annoying but this hasnt happen to me in over a year now so I am very happy and settled on it.

[Tom @ Intus]

In the long term, we do feel that APAP is the better option. If your weight changes, if you drink alcohol one night, if any other factors occur that change the pressure you require occur then you will always receive the correct pressure.

On a CPAP, if you were to have any change in your condition then your CPAP would not reflect this until you go back to your clinic.

With an APAP, you will experience lower pressures on average during the night. A CPAP is usually set at the 95th percentile from your time on an APAP. This means for 5% of the time it is insufficient, and for 95% is is either just right, or higher than required. It is a very effective compromise, but a compromise none the less.

So yes, long term an APAP is less problematic, but for clinics who are short of time, a CPAP is easier to manage with fewer initial issues and reduces the likelihood of a prompt return visit.

[portlanders]

Rather than start a new thread it seem applicable to add to this one. I've been on CPAP for only a week and half, my pressure was set at 10. But i'm only getting on average 3 hours with the mask on before waking and then panicing cause of the mask and taking it off. Discussing this fustration with my wife this morning, she tells me that i'm still snooring with the mask on....ahh the bell inside my head rings and the thought that the pressure not being high enough could be the problem. I've just telephoned the hospital to speak to the nurse to see if it could be this, but there are no nurses in till Thursday, so i have to phone back in 2 days time.
Do you think a pressure increase is needed? I'm obviously very anxious to get the 4 hours 'mask on' duration that i've been targeted, though it's not till the end of April that i have my oximetry sleep study to see what an effect the cpap has had.

Thanks

[Gizmo2005]

Once you get the pressure right and you sleep all the way to the morning a few times you should notice the effects very quickly. For me and a lot of people it seems, its a very positive result. I've been on it since August and no longer suffer from daytime sleepiness and tiredness. if I fall asleep in a meeting now - its because I'm bored

[portlanders]

That post must have done the trick as last 3 nights have slept with the mask on for over 5.5 hours each night, but yet still feel tired in the day

I have since spoken to the nurse who has talked me through increasing the pressure to 11 on the machine, if that don't work i have to phone back for plan b.....whatever that might be

[martin]

Plan B is putting bees in the humidifier...joke

Tweaking is life with cpap .. pressure , a comfy mask, where the tube goes etc, listening to a spitfire to drown out the the sound (you know who you are).

I'm on year 2 and still working out bits and some nights i want to kill the wee beast, but its a great therapy when you get the hang of it so hang in there. 5.5 hours of good sleep beats 10 hours (including naps) of awful (paraphrase) sleep and 3 good nights per week whacks the heck out of the alternative.

[symmit]

Hopefully plan b is an Automatic adjusting machine, which will help you get to the right pressure all the time throught the night.

If you are still snoring then either your pressurr is too low, mask isnt sealing right or you are using a nasal mask but breathing through your mouth.

To get used to the mask and stop the panic attacks use it in the day, grab a tv, radio or book and spend a few hours sat or lay in bed before bedtime with the mask on. What will eventually happen is you will condition your mind that you can breathe with it running. I went to bed two hours early for the first few nights.