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Just switched to APAP machine - pressure increasing.

Hi All,

First post so it's great to be here.

I've been using CPAP for 10 years.  Recently lost 3 stone and have been experiencing a new challenge.  I've started swallowing air as I fall asleep which then wakes me up, classic signs of pressure too high.  So, i reduce the pressure but then the therapy seems less effective (tired/anxious/stressed next day).

Anyway I had my maintainence check a couple of days ago and I've been issued with a Devilbiss Sleepcube Auto.  The range was left at 4 - 18 cm02 which just destroyed my first night so I've adjusted that to a more realistic range (11 - 18).

My undertsanding is that the APAP adjusts during the night from the lower threshold until you stop having AHI events and then increases / decreases the pressure as required.

Here's the strange thing:I start the machine and after 20 minutes of not being able to sleep,  and starting to swallow air, I look down and the machine has increased it's pressure to 13cm02 - why would it do that if I'm not asleep and not having any AHI events ?

Anyway it's only been 2x nights but I'm super struggling with the APAP so last night I set it CPAP as even though the therapy isn't as effective I'd had 2 weeks of destroyed sleep so I needed to get something.

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I don't know this machine that well, does it have EPR?  If it does turn it on, this will help with air pumping you up.

CPAPs can make mistakes with people when not yet asleep, people hold their breath sometimes when they turn and toss before going to sleep.  Sometimes I just hold mine for no reason other than I appear to want to.

You could set the RAMP so as it does not reach full pressure before you fall asleep, this might help a bit, you can start at a higher level than 4 and set maximum delay.  If you need 18 you might need more than the 11 you set it for, but there is no way the machine would know that before you fell asleep.

YouTube has a few videos if you don't know how to adjust it, but I think you already know.

Hi, and thanks for the reply. 

It has exhale relief in the form of SmartFlex and when I used it I got a semi decent night's sleep.  So thanks for the tip as it will hopefully help.

I'm gonna try it on CPAP again tonight, using a long ramp time from 11 cmh20 and once I'm stabilised I'll start using APAP again with a more realistic range I think. 

The thing about just not breathing for a little while is so true lol,  thought it was just me ;-) 

You need to be careful messing around with the pressures too much Tim, because as you've proved, when you turned them down you felt worse, which is probably because you weren't be treated well for your sleep apnoea.

It's common for the machines to raise in pressure when people are awake if they are shallow breathers, or if they're concentrating and holding their breath, which many people do without realising it.

The APAP will tell you what your AHI was and give you a clue as to how the pressure's treating you.

Also, bear in mind that APAP doesn't suit everyone.  Apart from the fact it can disturb sleep when the pressure adjust, when people have UARS (Upper Airways Resistance Syndrome) as well, then the pressures can run away with themselves.  I'd be inclined to ring the sleep clinic who issued you with the machine for professional help.

HI Kath,

Thanks for your reply and advice.

I've replied to your post via private message .


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