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I just had a titration study done in my home,  I was on a pressure of 15, and the titration study showed 13.5.

 

Can the pressure change after a year?  And, can the wrong pressure (too much) cause problems?

I am very fatigued all day and feel like I did before cpap. 

 

During my titration study I felt better.

 

Does this make sense?

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Yes, many times we will see that the initial titration needs will fall after the body gets used to CPAP. A person should have some type of re-evaluation within 6 months to a year after beginning sleep therapy for this reason.
Too much pressure can by itself cause arousals. While arousals are not as serious as desats they will wreak havok on your sleep and healing process.

Apnea causes two immediate problems. O2 desats and EEG arousals. If both are not corrected you will not ever get any benefit from your PAP treatment. Fixing your sleep sometimes takes a little more effort than just putting a mask on and going to bed.

j n k said:
The idea behind APAP is that pressure needs may vary from night to night and even during the night each night. Some need different pressures during allergy season, for example. Others do well on one straight pressure all night, every night, all year round.

For someone with strictly OSA and no other serious conditions, too high of a pressure should not be a problem medically, as I understand it, but it may raise comfort issues. Too low of a pressure is more serious, though, since that would allow the airway to close or narrow in ways that could affect the quality of sleep and how much oxygen is in the blood.

jeff
The way I understand it is that too much pressure can cause pressure induced apneas, worth researching and talking to your doctor about .

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