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General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Tahera11979
 
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Re: Will we ever adjust?

Postby Tahera11979 on Sun Mar 19, 2017 8:31 am

Hi there, thank you so much for sharing the video.

An update from our side is that the Cpap ended up not having the APAP option. It was mentioned in the booklet but was not available on the devise.

We put up the pressure to 12 last night and snoring was less but still present. It was some kind of a groaning snore. My dh also complained that he woke up and couldn't breathe well as the airflow was limited. Apparently it happened once before.

Do you guys think that we are on the right track?

Greetings from a very very tired wife. :cry:

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Pugsy
 
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Re: Will we ever adjust?

Postby Pugsy on Sun Mar 19, 2017 8:40 am

Check the run hours on your machine. Not the therapy hours...the run hours or total machine hours whatever the term is.
See if the total machine hours match up with the therapy hours.
What options do you get for "mode" when you scroll through all the choices besides "cpap"?

We don't expect to totally eradicate all snoring to consider the therapy optimal...just keep the snores to a random snore here or there and no dense clustering.

Tahera11979 wrote:My dh also complained that he woke up and couldn't breathe well as the airflow was limited.


Not sure what is going on with this complaint. Common complaint at pressures 6 cm and below but not at the pressure your husband is using. Unless maybe there was some sort of flow limitation or apnea event trying to happen or did happen.

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Tahera11979
 
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Re: Will we ever adjust?

Postby Tahera11979 on Sun Mar 19, 2017 9:13 am

Hi Pugsy,

Thanks so much again for your help.

I am looking at therapy hours and it gives me 7.1 for one day, 6.9 for 7 days and 6.6 for 30 days. The three night summary is 7.1 and Therapy hours 361.1 and Blower hours 361.7 (Not sure if this is what you were referring to.

The main menu gives me following options:

My info: Usage information which I mentioned above
Preheat: Off
My Provider: Devise info
My Setup: Ramp, Flex (Off), Humidification (Fixed), Mask Type, Tube Type

That's about it really unless I am not seeing other aspects of it.

The pressure is currently on 12 and we thought of using it for a few days to see if it improves the snoring at all and to see what the report says.

Is there anything you recommend us to do?

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Pugsy
 
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Re: Will we ever adjust?

Postby Pugsy on Sun Mar 19, 2017 9:22 am

I was trying to figure out why you don't have the auto trial mode available.
I think it is because you aren't in the clinical setup menu when checking to see which modes are available.
You have to be in the same mode as when you are able to change the pressures.

Matching blower hours and therapy hours...just means someone else hadn't used up the auto trial mode...which by the way I think we can reset those 30 days but that's a different topic.

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Hannibal 2
 
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Re: Will we ever adjust?

Postby Hannibal 2 on Sun Mar 19, 2017 9:24 am

Tahera11979 wrote:My dh also complained that he woke up and couldn't breathe well as the airflow was limited. Apparently it happened once before.


Are you talking about exhaling, inhaling or both? Maybe resolved with EPR (Exhalation Pressure Relief) if that setting is available on your machine?

Do you guys think that we are on the right track?

Definitely!

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Tahera11979
 
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Re: Will we ever adjust?

Postby Tahera11979 on Sun Mar 19, 2017 9:29 am

Thanks so much for the both of you. It's really great to have your support!

I will have to check both shortly when my husband is at home as I am not sure how to change the pressure so I best wait for him as I don't want to change the setting accidently.

Resetting the auto trial mode sounds really interesting! I want to know more once we find the setting. :-)

We spoke about it yesterday and technically all CPAP could be used as APAP but I suppose is money making so people buy the more expensive devises. A shame really as from my understanding many people would benefit from using an APAP.

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Pugsy
 
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Re: Will we ever adjust?

Postby Pugsy on Sun Mar 19, 2017 9:43 am

If you aren't in the clinical set up mode then you won't be able to change modes.
I am hoping that you just weren't in clinical setup mode when you tried. If you don't know how to get into the menu where the pressure can be changed then you likely were in the regular mode when you attempted to find auto trial mode.
How to get into clinical setup mode.
http://www.apneaboard.com/dreamstation- ... structions

Since therapy hours and blower hours match then the lack of auto trial mode can't be blamed on your getting a machine used by someone else who used up the auto trial hours. You got a brand new machine.

Resetting...involves erasing all the previous therapy data which obviously you don't want to do right now as long as the DME might need compliance information for insurance requirements.
Past Respironics machines with auto trial mode available would allow 5 resets(erasing all therapy data) before the option became permanently unavailable. I am assuming the DreamStation is the same in that regard.

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Re: Will we ever adjust?

Postby Hannibal 2 on Sun Mar 19, 2017 12:09 pm

Just checked, EPR is called C-Flex+ on your machine:

"The DreamStation Pro features C-Flex+ to help increase therapy comfort. Like regular C-Flex, it will lower pressure on exhalation, and in addition will soften the transition between inhalation and exhalation."

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Tahera11979
 
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Re: Will we ever adjust?

Postby Tahera11979 on Mon Mar 20, 2017 8:29 am

@ Pugsy, noted. Will make the change as soon as my dh is back at home.

Hannibal, you got me lost. :D EPR: C-FLEX is equivalent to APAP? :?

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Julie
 
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Re: Will we ever adjust?

Postby Julie on Mon Mar 20, 2017 8:53 am

No - C-flex on one machine is equivalent to EPR on the other machine. Nothing to do with C- or Apap modes, but settings for exhalation relief.

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Hannibal 2
 
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Re: Will we ever adjust?

Postby Hannibal 2 on Mon Mar 20, 2017 8:55 am

Tahera11979 wrote:@ Pugsy, noted. Will make the change as soon as my dh is back at home.

Hannibal, you got me lost. :D EPR: C-FLEX is equivalent to APAP? :?


C-Flex+ is a switchable feature that reduces the pressure by up to 3cm on every exhalation, it helps some with breathing out at higher pressures.

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Re: Will we ever adjust?

Postby Pugsy on Mon Mar 20, 2017 9:45 am

Exhale relief on a Respironics machine (either AFlex or CFlex) is similar to EPR on a ResMed machine but not exactly the same.
It isn't a per cm drop of pressure per setting like EPR is.
Instead it is a drop in pressure during exhale that depends on the flow rate or how forcefully a person breathes.
The greatest amount of drop is 2 cm at the setting of 3 and that is only if a person breathes rather forcefully. If they tend to be a shallow breather the amount of reduction during exhale is even less.

So the amount of reduction during exhale is dependent on flow...it's flow based and not a straight per cm drop like it is with ResMed machines.
There is also a bit of a timing thing...timing for when the pressure drops for exhale and starts to increase for inhale.
I usually tell people to try all the settings available for any Flex relief and pick the one that feels most comfortable to them in terms of matching their own respiration.
So try the 3 settings and also try it with Flex turned off.
When I experimented with the various Flex relief settings...CFlex...couldn't tell any setting made any difference so I turned it off. When I tried AFlex I found that the setting of 1 seemed a bit slow like I was breathing too slow and the setting of 3 made me feel like I was breathing too fast but the setting of 2 matched my own respiration pattern perfectly...so I elected to use AFlex set to 2.

I don't think that AFlex is available in cpap mode...I think that is only available in auto mode.
CFlex was the very first flow based relief...then AFlex was introduced a little later.

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Re: Will we ever adjust?

Postby Pugsy on Mon Mar 20, 2017 9:54 am

From Respironics about how Flex works. Note...the part circled in red...it won't ever exceed a 2 cm drop from inhale.

Image

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Re: Will we ever adjust?

Postby palerider on Mon Mar 20, 2017 10:20 am

Hannibal 2 wrote:
Tahera11979 wrote:@ Pugsy, noted. Will make the change as soon as my dh is back at home.

Hannibal, you got me lost. :D EPR: C-FLEX is equivalent to APAP? :?


C-Flex+ is a switchable feature that reduces the pressure by up to 3cm on every exhalation, it helps some with breathing out at higher pressures.

cflex+ is only *roughly* similar to EPR. they are not the same.

they do both provide a type of exhale relief, but not the same, and not equivalent to each other, and cflex+ doesn't provide up to 3 cm relief, more like up to 1.5-2, depending on your breathing (and what source you read), it's very vague, EPR is exact.

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Tahera11979
 
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Re: Will we ever adjust?

Postby Tahera11979 on Mon Mar 20, 2017 11:16 am

Thank you so much! My dh is travelling but as soon as he is back I will make sure to try everything you guys have mentioned.

On another note, I am looking for earplugs that can block out sound. Currently I am using silicone ones but it's still not great. Can anyone of you recommend earplugs that block out the majority of sound? This might be useful to know for the short term. I really wish i would be one of those people who can sleep through noise. Sighhh

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