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    Setting ResMed CPAP Air Pressure

    CPAP (continuous positive airway pressure) devices are the most commonly prescribed and most effective means of controlling obstructive sleep apnea. This sleeping disorder is generally simply referred to as OSA and affects millions of people with millions more going undiagnosed.

    Obstructive sleep apnea sufferers are woken numerous times during sleep as the body struggles for breath. Short pauses in breathing occur during sleep as the  muscles in the throat relax, allowing soft tissues to partially or completely block the airway.

    To combat this problem, a CPAP device delivers a steady stream of pressurized air to the nose and/or mouth, which forces the air passage to remain clear of obstruction. A CPAP device can appear complicated to first time users but soon becomes second nature in a relatively short space of time.

    Maintenance of a CPAP device is crucial but probably the most important factor in achieving successful CPAP treatment is getting the air pressure setting correct.

    Every case is different and the proper air pressure for one OSA patient may be of little benefit (or possibly harmful) to another. Changing pressure settings is not advisable unless instructed to do so by the medical professional or sleep specialist in charge.

    This is true for every CPAP device regardless of make, model or manufacturer and setting ResMed CPAP air pressure should only be done in accordance with proper professional advice.

    Proper Pressure

    CPAP devices measure air pressure in centimeters of water pressure denoted as cm H2O. The majority of devices range from 4 to 20 cm H2O with the average setting being around the nine mark. This is the “usual” air pressure setting but this does not mean it is automatically correct or the most suitable for an individual.

    If the pressure is too low or too high, there are some indicators to be aware of:

    Too Low

    Waking up not feeling refreshed

    Heavy or persistent snoring

    No noticeable improvement in blood pressure

    No improvement in apnea-hypopnea index (AHI)

    The AHI is an assessment of the number of times breathing stops or becomes shallow during sleep. This index is used by specialists to determine the appropriate air pressure setting.

    Too High

    Leakage from the mask or it is uncomfortable to wear

    Bouts of belching or gas attacks caused by the intake of too much air

    Dryness of the mouth, nose, throat or combination of these symptoms

    Difficulty in exhaling while using CPAP machine

    The proper air pressure is vital if the treatment is to be successful. If the device is functioning properly and the air pressure setting is correct, then quality sleep should be the result. If no noticeable improvement can be seen, and the problems associated with obstructive sleep apnea persist, the root cause of the issue may be a fault in the CPAP device or an incorrect air pressure setting.

    Whatever the cause, it should be investigated by a professional and adjustments made only according to his or her recommendations.

    Pressure Setting Factors

    While the average air pressure setting of 9 cm H2O may be suitable for many obstructive sleep apnea sufferers this will vary from patient to patient. This is because there are a number of factors that the sleep specialist or doctor must take into account.

    These can include:

    Anatomy. The shape and size of a person’s jaw, neck and even the tongue and tonsils play a role in determining the pressure setting.

    Body Mass Index. The body mass index, or BMI, is another crucial factor. Overweight or obese OSA sufferers tend to require a higher air pressure.

    Allergies. Nasal allergies or congestion can reduce breath capacity and an increased air pressure may be necessary to combat these issues.

    Deviated Septum. Nasal problems like a deviated septum make breathing harder and it is likely that a higher air pressure will be necessary to force more air through the nasal cavity.

    Even the normal sleeping position can have an impact on how high or how low the air pressure should be. Because of gravity, OSA sufferers who tend to sleep on their backs may require higher air pressure than those who regularly sleep on their sides. Lifestyle and habits must also be considered when calculating the correct air pressure for an individual.

    Setting the Pressure

    First time users of ResMed CPAP devices will have been advised of the proper air pressure setting and this may already be set on the machine. Some devices have some form of automatic adjustment which will regulate the pressure according to the user’s specific requirements.

    These ResMed machines include features such as:

    Ramp feature which starts at a low setting and gradually “ramps up” the pressure.

    SmartStart machines begin with the first inhalation rather than at the push of a button.

    EPR settings lowers the air pressure on exhalation making breathing more natural and easier.

    AutoSet devices automatically raises and lowers the air pressure as necessary.

    These features basically eliminate the need for any trial and error process by the user which is not recommended as an incorrect setting may not only reduce the effectiveness of treatment but can also adversely affect general health.

    If the setting is not achieving the positive result desired it is always best to consult the prescribing doctor or sleep specialist before attempting any changes. Continuous positive airway pressure therapy is intended to help achieve a good night’s rest and not cause undue stress and worry.

    When in doubt, check it out!

    Robert Koenigsberg
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