Why shouldn't you always use the maximum CPAP pressure?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Wulfman...
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Re: Why shouldn't you always use the maximum CPAP pressure?

Post by Wulfman... » Sun Mar 18, 2018 5:49 pm

prodigyplace wrote:
Sun Mar 18, 2018 5:41 pm
PaulKTF wrote:
Sun Mar 18, 2018 5:10 pm
You get a sleep study, find out what the right pressure setting is, and make sure the doctor knows that and sets it properly. if he isn't doing his job, you fire him and find a better one. You have to take charge of your own health care.
Not always. I got my doctor to recommend a sleep study. Insurance said I could only do what they call an in home study.

Basically you wear a battery powered pack and have a rubber finger cover and a nasal cannula to detect your breathing. From that data they determine if you have OSA and need CPAP. No recommended pressures are involved.

It is possible if the home study data was inconclusive that they would have approved a sleep study.
You point out more examples of why users NEED to take charge of their own therapy........in home sleep studies, bad (one night) in-lab studies, lousy sleep doctors, inconsistent night-to-night sleeping results, etc, etc., etc.


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palerider
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Re: Why shouldn't you always use the maximum CPAP pressure?

Post by palerider » Sun Mar 18, 2018 5:50 pm

PaulKTF wrote:
Sun Mar 18, 2018 5:10 pm
LSAT wrote:
Sun Mar 18, 2018 5:08 pm
PaulKTF wrote:
Sun Mar 18, 2018 4:47 pm
This is why you have a doctor set it at the proper level and you do not monkey with it! :)
Unfortunately, the majority of doctors set the machines at dafault...4/20.
You get a sleep study, find out what the right pressure setting is, and make sure the doctor knows that and sets it properly. if he isn't doing his job, you fire him and find a better one. You have to take charge of your own health care.
This site is about self help, why are you here spouting the 'party line'?

As to your 'sleep study' fantasy:
They may be "The GOLD Standard", but they are, in many ways, woefully inadequate if you think about it.

You're in an artificial environment, all wired up and less comfortable than normal.
It's *one night* and likely only part of that night. reading any titration report, you'll see that "oh, your good pressure was 12cm, you slept for 45 minutes at that pressure!"

It's a simple fact that sleep varies from night to night, you'll have better and worse days with the same exact settings. Yet the "gold standard" is a small number of minutes tested on one night.... a brief photograph taken during the marathon run that is your sleep.

It's not surprising that sleep studies are sometimes quite wrong, what's surprising is that they're ever right!

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Matt00926
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Re: Why shouldn't you always use the maximum CPAP pressure?

Post by Matt00926 » Sun Mar 18, 2018 6:06 pm

It's helpful to determine an appropriate min and max pressure range. We don't sleep the same two nights in a row, so having room for the machine's algorithm to work is a good thing. If you have a drink or two, eat a big meal, are sick, have congestion, roll onto your back, or many other things, you could indeed need a higher pressure that night.
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Goofproof
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Re: Why shouldn't you always use the maximum CPAP pressure?

Post by Goofproof » Sun Mar 18, 2018 8:15 pm

PaulKTF wrote:
Sun Mar 18, 2018 4:47 pm
This is why you have a doctor set it at the proper level and you do not monkey with it! :)
The Doctor is the fool that sets it 4 cm to 20 cm. :lol: Jim
Use data to optimize your xPAP treatment!

"The art of medicine consists in amusing the patient while nature cures the disease." Voltaire

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Re: Why shouldn't you always use the maximum CPAP pressure?

Post by prodigyplace » Mon Mar 19, 2018 6:15 am

Wulfman... wrote:
Sun Mar 18, 2018 5:49 pm
prodigyplace wrote:
Sun Mar 18, 2018 5:41 pm
PaulKTF wrote:
Sun Mar 18, 2018 5:10 pm
You get a sleep study, find out what the right pressure setting is, and make sure the doctor knows that and sets it properly. if he isn't doing his job, you fire him and find a better one. You have to take charge of your own health care.
Not always. I got my doctor to recommend a sleep study. Insurance said I could only do what they call an in home study.

Basically you wear a battery powered pack and have a rubber finger cover and a nasal cannula to detect your breathing. From that data they determine if you have OSA and need CPAP. No recommended pressures are involved.

It is possible if the home study data was inconclusive that they would have approved a sleep study.
You point out more examples of why users NEED to take charge of their own therapy........in home sleep studies, bad (one night) in-lab studies, lousy sleep doctors, inconsistent night-to-night sleeping results, etc, etc., etc.


Den

.
1. Health providers "in network" with an insurance company many times refuse to quote treatment for user pay if they know that are in-network with your insurance. I have had that happen.

2. IF you can find somebody to provide the service, you need the available funds to pay the price which has been inflated to to lack of non-insurance competition.

I really had to push to get the study & treatment I ended up with.

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Re: Why shouldn't you always use the maximum CPAP pressure?

Post by prodigyplace » Mon Mar 19, 2018 6:16 am

Goofproof wrote:
Sun Mar 18, 2018 8:15 pm
PaulKTF wrote:
Sun Mar 18, 2018 4:47 pm
This is why you have a doctor set it at the proper level and you do not monkey with it! :)
The Doctor is the fool that sets it 4 cm to 20 cm. :lol: Jim
Actually, I think my Lin(don't)care DME set mine. :( :x

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Re: Why shouldn't you always use the maximum CPAP pressure?

Post by PaulKTF » Mon Mar 19, 2018 6:21 am

prodigyplace wrote:
Mon Mar 19, 2018 6:16 am
Goofproof wrote:
Sun Mar 18, 2018 8:15 pm
PaulKTF wrote:
Sun Mar 18, 2018 4:47 pm
This is why you have a doctor set it at the proper level and you do not monkey with it! :)
The Doctor is the fool that sets it 4 cm to 20 cm. :lol: Jim
Actually, I think my Lin(don't)care DME set mine. :( :x
They shouldn't have. It isn't their place to do it. They are the supplier, not a medical professional.

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prodigyplace
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Re: Why shouldn't you always use the maximum CPAP pressure?

Post by prodigyplace » Mon Mar 19, 2018 7:57 am

PaulKTF wrote:
Mon Mar 19, 2018 6:21 am
prodigyplace wrote:
Mon Mar 19, 2018 6:16 am

Actually, I think my Lin(don't)care DME set mine. :( :x
They shouldn't have. It isn't their place to do it. They are the supplier, not a medical professional.
Apparently my DME is the one filing for insurance preauthorization for continued CPAP & supplies too.

The whole thing is a racket, IMHO.

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Re: Why shouldn't you always use the maximum CPAP pressure?

Post by palerider » Mon Mar 19, 2018 11:09 am

PaulKTF wrote:
Mon Mar 19, 2018 6:21 am
. wrote:
Mon Mar 19, 2018 6:16 am
. wrote:
Sun Mar 18, 2018 8:15 pm
PaulKTF wrote:
Sun Mar 18, 2018 4:47 pm
This is why you have a doctor set it at the proper level and you do not monkey with it! :)
The Doctor is the fool that sets it 4 cm to 20 cm. :lol: Jim
Actually, I think my Lin(don't)care DME set mine. :( :x
They shouldn't have. It isn't their place to do it. They are the supplier, not a medical professional.
So far, everything that you've said in this thread

has been wrong.

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Re: Why shouldn't you always use the maximum CPAP pressure?

Post by Goofproof » Mon Mar 19, 2018 12:31 pm

PaulKTF wrote:
Mon Mar 19, 2018 6:21 am
prodigyplace wrote:
Mon Mar 19, 2018 6:16 am
Goofproof wrote:
Sun Mar 18, 2018 8:15 pm
PaulKTF wrote:
Sun Mar 18, 2018 4:47 pm
This is why you have a doctor set it at the proper level and you do not monkey with it! :)
The Doctor is the fool that sets it 4 cm to 20 cm. :lol: Jim
Actually, I think my Lin(don't care) DME set mine. :( :x
They shouldn't have. It isn't their place to do it. They are the supplier, not a medical professional.
Correct, The Doctor would have to order and pressure change, but Lin(don't) care, might not care. It's just their liability in the mix. They set mine when it was new to the Doctors script, after that I set mine with my doctor's blessing. He wishers all his patients were as successfully proactive, and well treated. Jim

Been controlling my treatment 13 years, and Injecting insulin too.
Use data to optimize your xPAP treatment!

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Re: Why shouldn't you always use the maximum CPAP pressure?

Post by D.H. » Mon Mar 19, 2018 12:43 pm

Here are some reasons that you might to set a max lower than the machine capacity.

• Clear Airway (or “Central”) events that are not happening (or not happened as much or as long) at lower pressures.
• Excessive leaking at higher pressures (not experienced at lower pressures).
• Pain or discomfort from the higher pressures (including being awakened by the higher pressures).
• Headaches or dizziness (if not experienced at lower pressures).
• Dryness or irritation not experienced at lower pressures.

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WRX03
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Re: Why shouldn't you always use the maximum CPAP pressure?

Post by WRX03 » Tue Mar 20, 2018 6:20 am

Random Rambling: There is a common problem with patients becoming ventilator depended. Basically as I understand it is because during inhalation you lungs are suppose to be negative pressure but the vent is blowing in air so the lungs are under positive pressure, so the pressures in the lungs are backwards. The sensors in your lungs get screwed up and how the diaphragm works is also effected? An RT needs to pipe in on the details how patients become depended. PAP's are pressure limited but I wonder if it's best for you to get by with the minimum pressure possible for some of the same reasons??? Your diaphragm contracts during inhalation, blowing air in means your diaphragm doesn't have to work as hard? The diaphragm relaxes and you breath out, but with a pap on you have positive pressure pushing back on the lungs and diaphragm. It just seems like an unnatural thing to do to the body. So is it better then to use the least amount of pressure necessary because PAP isn't how our body works and the higher the pressure the more it varies from how we naturally breath? Remember I started with Random Rambling so don't chew me a new one. :lol:

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Re: Why shouldn't you always use the maximum CPAP pressure?

Post by Pugsy » Tue Mar 20, 2018 6:45 am

WRX03 wrote:
Tue Mar 20, 2018 6:20 am
Remember I started with Random Rambling so don't chew me a new one. :lol:
Okay...I won't chew you a new one but you start off with one rather flawed rambling...that it's "common" to become ventilator dependent but you forget that these cpap/apap/bilevel (unless the high end ones) aren't ventilators. They don't force you to do anything that you wouldn't be doing anyway and you aren't on the machine 24/7 for days, weeks, months or years where the machine actually is a ventilator. Instead you only use the machine while asleep so even those special high end machines that can function like a real ventilator...we only use those while asleep.

It might be rather common for people who are actually on real ventilators to become dependent when they are on them for weeks, months or years 24/7 instead of just while asleep but the bulk of these cpap/apap machines aren't ventilators anyway.

So the rest of your rambling doesn't hold water. :lol: :lol:

Maybe under some very special circumstances with a person on a real ventilator for a real medical problem not related to sleep apnea and they are on the real ventilator for months, weeks, etc day in and day out and awake and asleep... it might hold some water.

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Re: Why shouldn't you always use the maximum CPAP pressure?

Post by jnk... » Tue Mar 20, 2018 7:06 am

My name is Jeff, and I'm an airaholic. I haven't been able to go more than two minutes or so without it from birth. I also have a nightly sleep dependency that is closely related to my air addiction. And for the last several years, I have had a machine right next to my bed that has developed a consistent pattern of enabling both of those dependencies all night long every night. In fact, I have two backup machines hidden behind some musical equipment on the top shelf of my bedroom closet.

Just had to get that off my chest. I thank you all for listening.
-Jeff (AS10/P30i)

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palerider
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Re: Why shouldn't you always use the maximum CPAP pressure?

Post by palerider » Tue Mar 20, 2018 7:37 am

jnk... wrote:
Tue Mar 20, 2018 7:06 am
My name is Jeff, and I'm an airaholic. I haven't been able to go more than two minutes or so without it from birth. I also have a nightly sleep dependency that is closely related to my air addiction. And for the last several years, I have had a machine right next to my bed that has developed a consistent pattern of enabling both of those dependencies all night long every night. In fact, I have two backup machines hidden behind some musical equipment on the top shelf of my bedroom closet.

Just had to get that off my chest. I thank you all for listening.
*chorus* Hello Jeff.

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