After my previous post about the difficult CPAP titration, I have acquired a little more perspective from others.  As I related in the post, my pressure was increased to find the point at which breathing will restart.  It increased to where bi-level was necessary.  The pressure was increased until I could not fall back to sleep.  Sleeping was already difficult before that.  I chose to end the study about 2 ½ hours early as the tech offered no better results.

I talked to a knowledgeable acquaintance since then who said experienced technicians will, instead of increasing the pressure until breathing is restarted, go back to a lower pressure to find the optimum sleep pressure.  This may only reduce the number incidents but it will result in more restful sleep as opposed to a higher pressure causing more awakening.  I was also told that in time, CPAP will improve breathing even at lower pressures.  Anyone else have thoughts on this?

CPAP is a treatment, it provides no lasting effects on the body.  To say that "breathing will get better in time" is not correct from CPAP standpoint alone.  Other body changes not related to CPAP could have some effect, but not the CPAP.  We'd all like CPAP to be temporary but the therapy is life-long.  Sleep without and your apnea is in full force just like you've never used the mask.

I don't know of any studies, though there may have been some, that quantify what reducing apneas, say, by half, means to overall health?  From what I've read, and I am not a doctor, an AHI above 5 is still causing damage.

I do agree that if someone requires a high CPAP pressure, and is unable to tolerate it in the beginning (most everybody I think!), then starting with a lower CPAP pressure can be very helpful.  Regardless of whether that pressure provides any therapy or not, starting lower and gradually increasing the pressure will make it easier to adjust to.    My current pressure is just 14 and there is no way I could have started with it, I felt like 8 was a gale!  So I started with 8, and now that I'm at 14 it feels strong at first, but later on during the night it is hardly noticable.  

The mask makes a great deal of difference in tolerating the pressure, at least in my case.  I have a mask now that makes 14 seem like the air is not even on, whereas my earlier masks made it feel very uncomfortable.

Taking Ambien, Lunesta, Sonata or other short-term apnea-friendly sleep aid can also help to overcome the initial 'alertness' and wakefulness so many experience when starting with a mask and machine.

You will adjust in time, though if your pressure is very high you may need to ease into it.  You may have had apnea for a long while; taking 6 months with no real therapy, just to get up to correct pressure, is but a drop in the ocean when compared to keeping your health for the rest of your life once you're compliant and the pressure is correct for you.

Blessings,
--pseudonym

The “knowledgeable acquaintance I was referring to is sleep technician with 12 years experience who also scores studies.  This technician’s 12 years experience is with a sleep clinic that has a doctor on the staff.  I should have gone to this clinic, but I didn’t know better at the time.

The only thing I can think of, that your tech was referring to, was perhaps that you will feel like you breathe "more freely" once you get used to the CPAP.  I find the air soothing myself, I have mild asthma and my lungs feel better the next day after CPAP.

This feeling has nothing to do with curing the apnea or allowing you to reduce your pressures, however.  If your tech really meant that it would cure apnea in full or in part, well, that person may be a good sleep tech but needs further education in related areas.

You certainly don't have to take my word for it!  There are many articles published in well-respected medical journals all over the 'net, you can read up on it for yourself.

Blessings,
--pseudonym