Please Help Program New Pressure- Be Careful What You Wish F

[Crestedgal]

Well, I've been on CPAP for about 5 months now. Started at a pressure 6 after a split night study. Hated it. Struggled every night. I was more exhausted from trying to use the machine than I was before my diagnosis. After 2 months, went back to my Doc and she changed pressure to 8. Still hated it. Requested my machine be placed on AUTO since it already had that capability. Doctor said she didn't believe in AUTO. She raised my pressure to 10 but said that she would not go any higher without another sleep study. Finally, I liked the 10. I was able to start wearing it all night and for naps too. Only thing was, too many episodes when lying on my back, had to side sleep. I'm normally a back sleeper. Since my Doc already said she wouldn't change my pressure any higher, or set on AUTO to see what pressure would allow for back sleeping, I fired her and found a new Doc. New Doc agreed with AUTO with setting 6-20. I've tried it 4 nights and can't get any sleep. I don't understand what's wrong. I'm exhausted and would like to just go back to strait 10 until I see her again but I don't know how to change my settings. Can anyone please help!!! I have a huge work week coming up and need some sleep this weekend.

Machine: DeVilbiss IntelliPAP AutoAdjust DV54
Mask: ResMed Mirage Quattro (after trying like 10 differant ones)

[WearyOne]

Welcome, crestedgal. So sorry to hear you're have this difficulty, but I can definitely understand. Good going with changing docs when the first one wouldn't work with you!

I am not very knowledgeable about autos (apaps), as my machine is straight cpap. But I will say two things. Most folks say that a range of 6 to 20 on a auto is too great a range, that it needs to be narrower. Also, some people are light sleepers (like me) and are bothered the changes in pressure that an apap does throughout the night. In other words, whenever the apap changes the pressure, the person's sleep is disturbed.

I know others with much more knowledge will post and give you some terrific support and advice, and can also tell you how to change the pressure settings yourself, if that's something you'd like to do.

Pam

[6PtStar]

Crestedgal, I think I have the set-up manual for your machine that tells you how to change the settings if you will PM me your e-mail address I will be glad to send it to you. You can make the changes your self.

Jerry

[Crestedgal]

Thank you so much!!! I have learned my lesson and will order the software and everything else I've been putting off from CPAP.com I just wanted to be sure I was happy with my machine and that I wouldn't need to switch to another one before investing in things like software and battery. I plan to contact my DME this week and request to stop renting and purchase, My insurance says that's ok to do. I figure once I own it, I should be able to control the use,not them, right? I will also be ordering a back up machine for travel.

I can't believe that in a few months I've gone from crying at night in frustration and only being able to wear my masks for 5 or 10 minutes, to being totally freaked out about the thought of falling asleep without air running up my nose!

Seems crazy, but here I am.

[moombeam]

Crestedgal
if you can the manual to change your pressure this is my suggestion
Set you min pressure at 10 at least. that is the one that gave you best results
on straight CPAP . Either set the Max 4 pts higher to catch the episodes on your back.
or leave it on 20 and let the machine find the max. Either way obviously 6 is to low to start for you.

Good sleeping Moonbeam

[Crestedgal]

Thank you. That makes sense to me. I'm waiting for the instructions with great anticipation. I am hopeful that the change will work and be the answer I was looking for when I requested the auto setting. I already have the head of by bed up on a double high set of risers. My only hope for sleeping on my back is a higher setting. I have a problem hip and all this side sleeping agrivates it, causing pain and sleep loss from that, of course.

[GaryG]

I think getting software for your machine is a must. It would be interesting to see what the pressure was when you're experiencing your apneas, and having the software would enable you in making good decisions in tweaking the pressure. I'd be inclined to do an AUTO starting from 8-15 or so. If you need the pressure, the machine will adjust to it. I've found for myself that although I have no difficulty tolerating higher pressures, I get about the same benefit at lower pressures, and I don't seem to need higher pressure, with the bonus of having less leakage.

[Crestedgal]

Thanks for the suggestions. I WILL get the software for sure.

I'm still tweaking so many details.

This is most definitely a process. I had no idea when I went to get my machine for the first time, how naive.

[Janknitz]

Well, you're going to get a lot of opinions about where the pressure should be set (and without data, it's only guesswork), but the bottom line is that the wide open pressure settings of 6 to 20 are a problem.

First, the low pressure is too low and contributes to your discomfort--you may feel like you're not getting enough air at 6. Also, the machine's response to events is not instant. It takes some time to analyze the event and respond to it, meanwhile more events occur while your machine is increasing pressure from the very low 6 cm. So if the starting pressure is too low you're going to have too many events. The machine is always chasing the events instead of proactively preventing them.

Secondly, if there's no ceiling or the ceiling is too high, as the events pile up the machine is going to put out more pressure than needed. The big changes in pressure disturb your sleep and may even fully wake you. Plus they may cause your mask to leak, since the contrast between your starting pressure where you adjust your mask is so different from the pressure you have later. That wakes you too, even if you are not fully aware of coming awake. Too much pressure may also result in "pressure induced centrals" which contribute to feeling lousy.

So while APAP may very well be the answer for you, you need software to see where the pressure settings should really be. I agree with increasing the lower pressure, perhaps to 8 or 9, not all the way to 10 until you have data to back that up. The ending pressure should be lowered to narrow that range and let your machine work more efficiently. I'd suggest maybe 13 as the top pressure, but then you'll want to look at data pretty quickly to make sure you're not "bumping against the ceiling" of your pressure when you are on your back.

[Pugsy]

Janknitz...This was old thread resurrected by spammer and I think I removed it while you were composing.

[Janknitz]

Oops, did not see the dates!

That's been a frequent MO lately.

[DoriC]

Janknitz, I'm glad you had an "oops" moment, you gave me another great explanation of auto settings which I seem to need from time to time.