Did I really change the pressure?

[btesterman]

I've been using my machine for 2 1/2 mos. now and getting over some of the initial problems. I was reading through the clinical manual info today re a different issue and found this:

Updating Settings on a Flow Generator
You can create new treatment settings and transfer them to a Data Card via a
ResMed PC application. A patient can then use the Data Card to update the
settings in their S8 Elite II. If you mail the Data Card to the patient, send it in the
mailback envelope. If you need the Data Card sent back to you for verification,
use a postal envelope to mail the mailback envelope and its contents to the
patient.

My initial pressure setting was 6 but because I felt like I was suffocating I THOUGHT, at least, that I had upped the pressure to 7 - went into the clinical menu, settings, change, upped it to 7, clicked on whatever okays it etc. Now I am wondering if I really changed the setting or if this has to be done through the Data Card. Since I doubt that I would have immediately felt the difference in pressure (and I also switched from size small to medium nasal pillows) I have no idea if I'm on a pressure of 6 or 7. When I look on the patient menu it says pressure 5.6 and it has never been on a 5.6 pressure level. The ramp (which I turned off) says 5 and I believe that is where it was set before I turned it off. The pressure setting in the clinical menu says 7. Maybe the deal with changing seeings via the data card is so that patients won't know how to go into the clinical menu ???????

I'm now scheduled to go to a "CPAP clinic" with my doctor's tech (whom I did NOT get along with initially). I'm sure he'll not be happy that I go into the clinical menu to get my AHI info. (He'd told me that I bring the card in and HE would get the information) He'll probably put duct tape on my mouth to keep me from sharing any info with the other patients!!!!

Barbara

[DreamOn]

I was reading through the clinical manual info today re a different issue and found this:

Updating Settings on a Flow Generator
You can create new treatment settings and transfer them to a Data Card via a
ResMed PC application. A patient can then use the Data Card to update the
settings in their S8 Elite II. If you mail the Data Card to the patient, send it in the
mailback envelope. If you need the Data Card sent back to you for verification,
use a postal envelope to mail the mailback envelope and its contents to the
patient.

My initial pressure setting was 6 but because I felt like I was suffocating I THOUGHT, at least, that I had upped the pressure to 7 - went into the clinical menu, settings, change, upped it to 7, clicked on whatever okays it etc. Now I am wondering if I really changed the setting or if this has to be done through the Data Card.

Hi Barbara,

It's not necessary to use the data card to change settings. The settings can be changed right there on the machine, via the Clinical Menu (accessed by pressing and holding the Right and Down keys simultaneously).

When I look on the patient menu it says pressure 5.6 and it has never been on a 5.6 pressure level. The ramp (which I turned off) says 5 and I believe that is where it was set before I turned it off.

Look in the Review Menu, which is accessed by pressing and holding the Left and Right keys simultaneously. Navigate to Settings. You'll see two pressures there. One is the "Start CPAP" pressure, which is the starting pressure for Ramp. This number will be there whether Ramp is set to on or off. The other pressure shown in that menu is simply called "CPAP". This is your set therapy pressure. Does that say 7? When you're actually using the machine, what pressure shows on the LCD screen?

I'm not exactly sure where you saw the 5.6 pressure. It may be a therapy results number, rather than an actual machine setting. If you're using EPR (exhalation pressure relief), then it's possible that 5.6 is your average pressure for the night, which takes EPR into account. A set pressure of 7 with an EPR setting of 2 reports as a nightly average of 5.6.

I hope that helps. If not, let me know and I'll try to assist further.

~ DreamOn

[btesterman]

Thanks - I'll check the pressure tonight when it is running. My AHIs are still too high, I think. I haven't averaged it (I'm sure the machine does that for you somewhere) but it seems to run in the 6 - 7 numbers. My original AHI at my first sleep study was 14.3 so that is better but if I'm going to have to use this contraption, I'd like to see the numbers lower. I feel a little better but still have too many days when I just want to crawl into a corner and go to sleep. I saw my pulmonologist today and he's sending me to the "CPAP clinic" (see previous post on my thrill over that). Frankly, I'm not sure my pulomonologist knows a great deal about the machines - he thought that the card went in when you begin using the machine and it stays in. At any rate, I'm wondering if I should try just turning off the EPR (or step down from the 2 it's at now). At my pressure, it doesn't seem difficult at all to exhale. I could always turn it back on. The leak rate is in the teens usually and my AHI doesn't seem to have ANYTHING to do with the leak number. I hadn't thought about the AVERAGE pressure but that certainly makes total sense. I'd read previous info about setting pressure higher to account for the EPR but since I'd already raised it from 6 to 7, I hadn't thought more about it. If the average is 5.6, then that isn't even up to the 6 which is what it took to control the apneas during my sleep study. I've also gained about 4 pounds (ugh!!!!) since the study which hasn't helped.

It's kind of funny - now that I've been on this for even a few months it's interesting to read posts from people just beginning and seeing the same problems, same frustrations etc. that I went through - one today about feeling like they were suffocating and ripping the mask off...... Been there, done that! The forum is such a blessing, just to have someone say, "Yes, I hear you. That's normal. It will get better." Or give possible solutions. Thanks for your help!

[dtsm]

As a newbie who went through some of the same trials and tribulations, my suggestions are:

1. Get the software and card reader to download the daily (nightly) data.
2. Write down your current settings and daily data, eg pressure, EPR**, leaks, ai, ahi (you can do this before the actual software and card reader arrives - see pm on the way to you).
3. Don't change too many variables at one time; tweak things slowly. For instance, if you change pressures, give it 5-7 days before tweaking something else.
4. Once the software/reader arrives, view the images/graphs, and you post on-line, it might be as simple as a 'leak'.

PS: **jumping ahead, EPR does affect the pressure. I have been told by resident experts (rested gal) that a pressure of 10 and an EPR of 2 is more like a pressure of 8. I can't find the detail thread on this...do a search for EPR vs. C-Flex and you should be able to find a very good detail explanation. They are correct, my tweaking of EPR was also needed. I was originally at 3 and eventually dropped to 1.

[DreamOn]

AI (apnea index) is the most important component of AHI (apnea-hypopnea index). What is a typical AI result for you?

You can certainly turn off or reduce the EPR and see how that works for you. Some people prefer it, while others do better when it's off. Your pressure of 7 isn't very high, so you likely won't have any difficulty breathing against the pressure now that you're used to the machine.

~ DreamOn

[rested gal]

B, if you're using EPR, that could account for the lower-than-what-you-set-it-at pressure you're seeing.

When I use a ResMed machine and turn on EPR, I personally like to raise my therapeutic pressure (with a CPAP) or my minimum pressure (with an autopap) approximately the same number of cms that I plan to have my EPR drop to when I exhale.

In other words, if I want my therapy pressure to be 8 and I plan to use EPR set at "3" (for a 3 cm drop), I'll set my therapy pressure at 10 or 11 and EPR at "3."

That's just me, though, and what I do..I'm no doctor.

When I use a Respironics machine with C-Flex or A-Flex, I don't do that "compensation" thing.

Cflex 1-3 Levels - topic started by jucs
January 2, 2010
viewtopic.php?p=436272#p436272
Although that topic starts out about C-Flex, my posts go into EPR, too.