pressure changes

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Sharhamm
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pressure changes

Post by Sharhamm » Mon Mar 02, 2015 7:16 am

Orig. dx. in a sleep study AHI's over 100. Since being on my bipap I have asked for my pressure to be lowered twice. I am now at 12/16. I am learning, slowly, by following this forum, how to try and read the graphs. I have had no OA's or CA's since two weeks after starting the therapy on 12/16. I am also on O2 at 2L. I had an oximitry done a few weeks ago and they decided to continue and perhaps maybe deleting it on my appt. on the 23rd. My charts show only UA's and Hypoxia. Very few hypoxia and 5 to 6 UA's. When I look at the charts the UA's are only when my mask pressure is not good but I'm not showing leaks on my summary. I do adjust my nasal mask often by pulling it away from my face and replacing. I am an active sleeper and I can feel leaking and it awakens me. This is where the UA's are showing.
Question 1: Am I correct in assuming that my UA's with mask pressure are the reason for the UA's.
Question 2: Since I am showing no obstructions or CA's do you think I could ask for my pressure to be reduced again? My average AHI cumulative for the period 1/21/15 to present is 1.93.
I would like to be able to act like I know what I am talking about when I speak to them again.
Question 3: If you think I could lower my pressure and the doctor says "no" will this affect my Medicare which is still in the 90 day compliance but ends on 3/16. I guess my question is do I have to rely on the doctor for changes or can I do it myself without jeoparding my Medicare and supplement insurances?

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VPAP
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Re: pressure changes

Post by VPAP » Mon Mar 02, 2015 10:04 am

Hello. I want you to know that as the owner of the PAP therapy device, you ARE IN FULL CONTROL, of your pressures, and your settings. If you want to change your settings, because you feel that they are too high, or too low, YOU HAVE EVERY RIGHT, to change your settings.

Medicare cannot take your PAP therapy machine away from you, if you change your pressures. If you know how you are to change your pressures, AND YOU THINK YOU NEED TO CHANGE YOUR PRESSURES, THEN, I SAY, PLEASE DO IT. You have every single right. Medicare can't do a single thing about it. I change my pressures every day, like when my muscles get weak, I increase my IPAP up as high as 25 at times to really augment my spontaneous breathing effort.

At night,I go back to IPAP of 15 and an EPAP of 11 to sleep on.

but these settings are your settings.

If you know how to change these settings, then PLEASE DO IT IF YOU NEED TO.

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archangle
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Re: pressure changes

Post by archangle » Mon Mar 02, 2015 9:34 pm

Somewhere in the original Medicare process, the doctor has to sign off on something to the effect that you are using the CPAP machine 4 hours a night, and that the treatment is "effective."

I guess it's possible that some doctor with delusions of grandeur could become incensed that you committed heresy by changing his divinely inspired pressure settings and refuse to sign.

It shouldn't happen, but the medical mafia members often do strange things.

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Sharhamm2

Re: pressure changes

Post by Sharhamm2 » Tue Mar 03, 2015 8:51 am

Thank you for the replies. Can someone answer question 1 for me?

Sharhamm2

Re: pressure changes

Post by Sharhamm2 » Tue Mar 03, 2015 2:47 pm

I am trying to figure sleepyhead out. My mask pressures show flat at the time of the ua's. Am I safe in assuming that the UA's are attributed to me adjusting my mask or leakage? Sorry that I didn't explain that question clearly.

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Jay Aitchsee
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Re: pressure changes

Post by Jay Aitchsee » Tue Mar 03, 2015 4:59 pm

Sharhamm, without seeing your charts, it's hard to know for sure, but I think it is quite reasonable that the UA's (unclassified apneas) are a result of pulling the mask away from you face or at a time when the leaks are greater than can be compensated for by the machine.
ResMed's ResScan Manual wrote:Unknown Apnea: An apnea during which a leak higher than 30 L/min occurs, precluding accurate determination of whether the apnea is obstructive or central.

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palerider
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Re: pressure changes

Post by palerider » Tue Mar 03, 2015 6:27 pm

Sharhamm2 wrote:I am trying to figure sleepyhead out. My mask pressures show flat at the time of the ua's. Am I safe in assuming that the UA's are attributed to me adjusting my mask or leakage? Sorry that I didn't explain that question clearly.
what leak rate are you having when you see UAs? pressure doesn't matter.

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Sharhamm
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Re: pressure changes

Post by Sharhamm » Wed Mar 04, 2015 7:48 am

I can[t figure out how to post my graphs. I went to imgur.com, downloaded and followed the instructions. BUT how do I get it to post in reply box? Sorry, I am not so great with this stuff.

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Sharhamm
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Re: pressure changes

Post by Sharhamm » Wed Mar 04, 2015 8:23 am

Image
Think I figured it out. This is last nights events. Could it be mouth breathing causing these UA's? The first sleep session I was using a full face mask. The next two I used my nasal mask.

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palerider
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Re: pressure changes

Post by palerider » Wed Mar 04, 2015 10:25 am

I don't see much leaks, so, I dunno,

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Pugsy
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Re: pressure changes

Post by Pugsy » Wed Mar 04, 2015 10:40 am

Do you happen to have ResScan available?
Or are you using a Mac and can't use ResScan?
I am wondering if ResScan would call those UAs...OAs. I had this happen with someone else I was helping but it was for a different Resmed machine than you are using.
If you are using a Mac and can't use ResScan....can you get me a copy of your SD card? Do you know how to do that?
If you are using Windows...and need ResScan send me a private message.

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Re: pressure changes

Post by Sharhamm2 » Wed Mar 04, 2015 10:57 am

I have rescan. What graphs do you need me to post?

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Pugsy
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Re: pressure changes

Post by Pugsy » Wed Mar 04, 2015 11:05 am

Sharhamm2 wrote:I have rescan. What graphs do you need me to post?
Just the AHI breakdown statistics and the events graph showing the little boxes above each event (that's duration in seconds) and make sure to include the legend on the left.

Though really my main thought was to look to see what ResScan is calling those events you are wondering about.
Is it calling them UAs or is it calling them OAs...you should be able to tell real quick.
If ResScan is calling them OAs...then it's just a little SleepyHead bug calling them UAs.
If ResScan is calling them UAs then it's the S9 that can't determine exactly what they are and we can't blame it on leaks so then I don't know why it can't figure out what they are. Maybe zooming way in on one of the UAs might give us a clue but it also might not.

But before I would do anymore worrying about them I would verify with ResScan.

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southern
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Re: pressure changes

Post by southern » Wed Mar 04, 2015 11:11 am

What works for me:
Pressure 5 mm water
Mask: Resmed Mirage Activia LT (small)

Sharhamm
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Re: pressure changes

Post by Sharhamm » Wed Mar 04, 2015 11:13 am

I haven't really gone into Rescan much so I don't know how to pull up the breakdown of the AHI's. Can you help me out there? All I can pull up is Statistics and Summary graphs.

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