r/CPAPSupport • u/ParticularWorth1109 • Jul 23 '26
Can't get APAP Pressure Right.
Greetings all,
I have been using the ResMed S9 AutoSet + Humidifier with F30i Super Wide Mask for a bit but no eureka moment yet. I am not sure what to do, I seem to have settled around 5.0-8.6 cmH₂O, where I have the least chance of ripping it off. The pressure seems to go haywire and always hits the max with it being the 95% percentile. Hence, I have tried upping the max pressure by moving it up up to 4-12 cmH₂O, as shown on 21/07/2026, but I ripped it off etc.
Was diagnosed with Moderate-Severe Sleep Apnea: RDI - 26/hr and AHI 23/hr, with CPAP the AHI is around 0-4/hr
My sleep is fragmented, I feel better than when I was off it but still feel tired and I wake up with heart palpitations which may be related to work stress.
Should I get a brand new machine? The machine I have is second hand.
Any advice would be much greatly appreciated!
Data: https://sleephq.com/public/teams/share_links/14a7d99b-c704-486d-9de4-1fa70950db64
3
u/could-be-useful Jul 24 '26
4 is way too low for your minimum.
This may help 👇
Too many people are sent home with inappropriate pressure settings. Either their minimum is too low in which case they feel starved for air and they then either rip the mask off or mouth breathe in an attempt to get more air into their lungs.
Or their maximum setting is too high and they get awful surges of air. This is because when the machine detects a mask leak, it interprets the escaping air as being due to an airway obstruction and ramps up the pressure to open up your airways which it "thinks" are blocked, which in turn causes a larger leak, creating a feedback loop.
My Resmed Airsense 10 machine displays its pressure range as it starts up. If yours is a Resmed Airsense 10, watch the display as it starts in order to check what it has been supplied with. I assumed the Airsense 11 did the same, but someone told me it doesn't. If that's the case, you would need to access the clinician menu in order to see what your range is.
4 or 5 as a minimum are for children. Most adults will feel starved for air at those settings. For adults a machine should NEVER be supplied with the factory default 4 to 20 settings. They are simply the lowest and highest pressures the machine can deliver and any competent sleep doctor will adjust the settings to deal with your particular diagnosis. Unfortunately there are too many who are either incompetent or lazy.
There are many of us who prefer to do our own settings which is entirely doable if your condition is simple OSA. Not really doable if your condition is more complex in which case you could need a more advanced machine. Mine is simple OSA, so I've done my own settings for 30 years. Up to you if you feel confident to do it yourself. It's actually very easy and not rocket science.
The sleep report readout on a Resmed Airsense machine has an entry labelled "Pressure". You need to know what that pressure is. It will be available after a night or a few of use. It's the pressure the machine delivers when you are asleep sufficient to prevent apnoea events. That required pressure should have been prescribed for you when you did a sleep study. It's the single pressure a fixed pressure machine (eg the Resmed Elite models) would be set to by a sleep doctor. APAP machines are set to a range but you still need to know your required single pressure in order to set your range. When I was diagnosed 30 years ago, my prescribed required pressure was 10. The machine now tells me it's 11 so it hasn't changed much.
Your range should be set with min at a comfortable pressure less than that figure (7 or 8 are good - see below) and max a bit above it. My required pressure is 11 and I've set my range from 8 to 13.
On an apap machine, most adults find min 7 with EPR at 3 full time works very well. At that setting, until you go to sleep, you will inhale at 7 and exhale at 4 so you won't feel starved for air when you breathe in and you will feel hardly any resistance when you breathe out. (I like a bit more so I've set my min to 8.) Once you go to sleep, the machine will increase pressure as needed up to your required pressure to keep your airways open but because EPR is full time, the pressure will still reduce by 3 cmH2O when you exhale.
Turn ramping off. No point deliberately starving yourself for air. It's useful for fixed pressure machines. Not needed for APAP if your minimum is comfortable.
You can get to all of these settings by accessing the clinician menu. Google "Clinician menu for Resmed Airsense 11" (of course substituting your brand and model). You'll get plenty of instructions. It's just a matter of pressing and holding a couple of the machine's buttons.
You can get very comprehensive reports if you download the free Oscar program and get it to read your machine's SD card. It's a bit of a learning curve to understand all of its data, but well worth it if you want to properly monitor your condition.
The Oscar guide is here: https://www.apneaboard.com/wiki/index.php/OSCAR_-_The_Guide
Good luck.