APAP to CPAP?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Sleepysuz
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APAP to CPAP?

Post by Sleepysuz » Tue Sep 16, 2014 10:37 am

Getting most severe aerophagia. Have tried suggestions from forum re sleep position, changing sleep position, inclined sleep position, increasing EPR to max. Left a message w doc about perhaps changing range for APAP. It is currently 4-20.
I average 8 but go up as high as 18. Looked at graph and I'm all over the place.

Got message back that she usually uses APAP just first month to pick a constant pressure. Any suggestions as to what I should tell her I'd like to try that might be less extreme change?

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RicaLynn
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Re: APAP to CPAP?

Post by RicaLynn » Tue Sep 16, 2014 12:23 pm

The beauty of the autoset is it can be used to actually titrate your pressure range, IF your doc and/or RT are reading and reflecting on your data. I started PAP on 8/13 and my RT (at my DME) told me they would use the days from the first month or so to narrow the range from "4-20" by zeroing in on what was most effective for me. After my first consult two weeks in, he narrowed it to "6-11" based on my data (because that's where the majority of my therapy time was spent) and said we'd likely eventually settle on something around 7-8 continuous. I never even noticed a difference in performance after the first tweak, but ymmv.

Aerophagia is also quite common during the adjustment period, and mine virtually disappeared once the adjustments were made

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Re: APAP to CPAP?

Post by Wulfman... » Tue Sep 16, 2014 12:31 pm

Sleepysuz wrote:Getting most severe aerophagia. Have tried suggestions from forum re sleep position, changing sleep position, inclined sleep position, increasing EPR to max. Left a message w doc about perhaps changing range for APAP. It is currently 4-20.
I average 8 but go up as high as 18. Looked at graph and I'm all over the place.

Got message back that she usually uses APAP just first month to pick a constant pressure. Any suggestions as to what I should tell her I'd like to try that might be less extreme change?
I understand what she's trying to do, but a wide-open pressure range is "nuts". It takes the machines too long to get to a pressure that is beneficial and in cases like yours, it can be disastrous.
If you haven't already, I'd suggest starting with telling her that you're having aerophagia from the changing pressures. It's PROBABLY going higher than the threshold that is causing your aerophagia and you need to limit the pressure. If she isn't willing to listen to you, then I'd suggest starting to make changes yourself. It would be too hard for you to continue without making some changes.

If you're using software to monitor your therapy, you may be able to see what pressure eliminates most of your events and possibly where the threshold of your aerophagia is.


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Sleepysuz
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Re: APAP to CPAP?

Post by Sleepysuz » Tue Sep 16, 2014 12:48 pm

Have spent the last couple of hours trying to figure out How to understand my numbers. Last night my AHi was 8.92. The max pressure was 14.7the median was 10.2 My event breakdown is about 55 %. OA
I have so many event flags I can't count them. They are in 3-4 clusters per night usually 3.

Last night after a cluster of events the machine stayed at about 13 for a long time. Then I was pumped up

The night before last AHI was 6.90. Max was 11.7 Median was 7.3. I had 3 very prolonged clusters of events and the machine responded by staying around 10.

Any tips on what I should be looking for? Thanks again

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Re: APAP to CPAP?

Post by Sleepysuz » Tue Sep 16, 2014 12:53 pm

PS not sure what you are advising about "figuring out the pressure that eliminates most of the events" I can just see what the pressure is after I have them.
Thanks again.

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Re: APAP to CPAP?

Post by Nick Danger » Tue Sep 16, 2014 12:55 pm

I would try a pressure range of 9 to 15, if it were me. That may help avoid those clusters - which may be occurring because the airway collapses at the lower pressures and it takes a while for the APAP algorithm to work its way up to the pressure you need for therapy to be effective. You may find that increasing your minimum pressure will also lower your maximum pressure. If your median is 10, it doesn't make a lot of sense to start at 4.

Ahh... you added some more info while I was typing - 4 definitely seems too low for the minimum. If you are a patient patient, then give the doc a chance to do it his/her way. If, like me, you tend to be an impatient patient, you might want to increase the minimum above 4 - it isn't clear what it should be given the results on different nights. Usually something a little below your median is a good choice.

It would be helpful if you could post some of your Sleepyhead graphs - we have a few people on the forum who are good at reading them and making suggestions based on what they see.

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Re: APAP to CPAP?

Post by Wulfman... » Tue Sep 16, 2014 1:14 pm

Sleepysuz wrote:PS not sure what you are advising about "figuring out the pressure that eliminates most of the events" I can just see what the pressure is after I have them.
Thanks again.
What I was referring to is to look at the reports to see if there is or are a single pressure or range where you have few (or no) events.......particularly looking for somewhat of a flat line of pressure.

I would suggest trying a fixed pressure of 10 cm. (CPAP mode or APAP mode with both minimum and maximum set to the same pressure)
If, after a night or two, you still experience some aerophagia at that pressure, move it down a bit. If you don't, then maybe move it up a bit. Aerophagia also suggests some possible level of "GERD" condition. Sleeping on one's left side may help alleviate/minimize it to some degree.

You mention EPR, but that is a ResMed exhale relief. Your profile is showing a "PR System One REMStar 60 Series Auto CPAP Machine" which would have the "Flex" options. Is your machine a ResMed S9 or a PR System One Auto?


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Sleepysuz
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Re: APAP to CPAP?

Post by Sleepysuz » Tue Sep 16, 2014 1:36 pm

Brain fog. I have been reading so much I got the terms mixed up. Yes flex relief
Will get my info posted.

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Sleepysuz
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Re: APAP to CPAP?

Post by Sleepysuz » Tue Sep 16, 2014 2:08 pm

Have never posted screenshots. Went to imgur as instructed in other posts and got a BBCode But don't know how to attach this
Please advise Thanks!


Image

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Sleepysuz
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Re: APAP to CPAP?

Post by Sleepysuz » Tue Sep 16, 2014 2:13 pm

It cut off the part with the graphs.

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Re: APAP to CPAP?

Post by palerider » Tue Sep 16, 2014 2:22 pm

Sleepysuz wrote:It cut off the part with the graphs.
no, they're there, you just need a bigger screen.

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Re: APAP to CPAP?

Post by palerider » Tue Sep 16, 2014 2:29 pm

couple suggestions, for your next screenshot, click the ^ next to the date to turn the calendar off, and hit f8 to turn off the right panel.

then, when you're posting from imgur, you can pick the 'linked bbcode' like this one:

Image

to make it even neater, you can put a .png just before ][IMG and a l right before the .png that's towards the end of the string, so it looks like this:

Image

(hit reply to see the strings that were actually pasted in here.)

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Sleepysuz
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Re: APAP to CPAP?

Post by Sleepysuz » Tue Sep 16, 2014 2:48 pm

Image
Image

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Re: APAP to CPAP?

Post by Sleepysuz » Tue Sep 16, 2014 2:52 pm

couldn't figure out the .png thing to shrink it down.


Just got a message that the DME is switching me to try a constant 15 tonite as per doctor's order. Hope I don't explode like Mr. Creosote who ate one too many Thin Mints in Monty Python's the Meaning of LIfe.

They said if that doesn't work I'm getting a Bipap. Seems like it might be overkill for mild OSA. They were on the fence in the beginning if I even needed a machine at all! This is getting crazier.

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Re: APAP to CPAP?

Post by RicaLynn » Tue Sep 16, 2014 2:54 pm

Sleepysuz wrote:couldn't figure out the .png thing to shrink it down.


Just got a message that the DME is switching me to try a constant 15 tonite as per doctor's order. Hope I don't explode like Mr. Creosote who ate one too many Thin Mints in Monty Python's the Meaning of LIfe.
But it's only wahfer theen!

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