One month Dr visit and change in pressure

Mr Snuffy · Post by **Mr Snuffy** » Sat Apr 09, 2016 2:29 pm

I finally was able to see my Neurologist and she was happy with my progress in less than 1 apnea event per hour and my great compliance. My only complaint has been I wake up and it is like I can not get enough air. No problems breathing out. Changing from pillows to nasal mask helped some but still feel my pressure was too low at 6. She agreed to up it but wanted the machine set to auto 5-10 and then she will decide after a week to 10 days to what the new pressure will be. I am posting what my last night sleepyhead showed and the past 3 nights before show a 95% rate of 9.8.

Does this mean I need to have my pressure set this high?
I sleep well with the higher pressure except the change in pressure is what is waking me up now. It is so much easier to breath around 8-9. I can't wait to get it set to one pressure again.

Any suggestions?

Julie · Post by **Julie** » Sat Apr 09, 2016 2:35 pm

Well, my 2 c's worth - your pressure does hang around 9-10 most of the time, so her setting the low to 5 seems rather pointless and makes your life a bit harder, or the machine's. I would raise it myself to at least 8, whatever you tell her eventually. But... I would also try a soft cervical collar because I think you might be cutting off your air to some extent when asleep by dropping your head and it can't hurt to try it.

palerider · Post by **palerider** » Sat Apr 09, 2016 3:08 pm

Julie wrote:Well, my 2 c's worth - your pressure does hang around 9-10 most of the time, so her setting the low to 5 seems rather pointless and makes your life a bit harder, or the machine's. I would raise it myself to at least 8, whatever you tell her eventually. But... I would also try a soft cervical collar because I think you might be cutting off your air to some extent when asleep by dropping your head and it can't hurt to try it.

what she said, especially about pressure.

Mr Snuffy · Post by **Mr Snuffy** » Sat Apr 09, 2016 3:44 pm

I was set at 6 as that is what the titration test was done at she said. I knew it was too low as I have been fighting for air.

Yes it starts at 5 and I struggle to get to sleep at that low pressure. I will try to log when I do wake up to see if it is a high or low setting time. My bet is it when low.

Wulfman... · Post by **Wulfman...** » Sat Apr 09, 2016 4:36 pm

Add me to the list of "Ditto Heads" to what Julie said.

The sooner you take control of your therapy, the better off you'll be.
Your doctor is another idiot.
The minimum pressure is the most important. It needs to be set where it prevents the majority of events.

Den

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Mudrock63 · Post by **Mudrock63** » Sat Apr 09, 2016 10:28 pm

They started my therapy at 6.0. I finally got good results at 18-20.0 cm APAP. They don't know shit. Take control of your own therapy.

madgirl · Post by **madgirl** » Sun Apr 10, 2016 9:26 am

If you are using an auto set machine, why the settings make a difference? Isn't the machine supposed to automatically adjust the pressure, i.e. increase it if necessary, so that you really do not have to worry about pressure settings? Just asking…...

BlackSpinner · Post by **BlackSpinner** » Sun Apr 10, 2016 9:33 am

madgirl wrote:If you are using an auto set machine, why the settings make a difference? Isn't the machine supposed to automatically adjust the pressure, i.e. increase it if necessary, so that you really do not have to worry about pressure settings? Just asking…...

No, an auto doesn't work quite that way. It doesn't rise to try to prevent an apnea that is happening. It will try to prevent future apneas after that. You want the lower pressure to sit near the needed pressure so it is not playing catch up all night.

Mopheus · Post by **Mopheus** » Sun Apr 10, 2016 11:18 am

Yes bump the pressure, I was at 5-15 for months of inconsistent AHI. Anywhere between 2 and 6.
After learning more than my highly edumecated Dr. I am at 10-12.5 and consistently AHI is under 1 most nights.
I had to get used to the increased pressure gradually by upping the pressure one point each week or so.
Very cool to moniter the results in sleepyhead as nights clear up.

palerider · Post by **palerider** » Sun Apr 10, 2016 12:51 pm

madgirl wrote:If you are using an auto set machine, why the settings make a difference? Isn't the machine supposed to automatically adjust the pressure, i.e. increase it if necessary, so that you really do not have to worry about pressure settings? Just asking…...

go read more answers in the other place you asked that.

Mr Snuffy · Post by **Mr Snuffy** » Mon Apr 11, 2016 9:05 pm

Just got a letter in the mail from my insurance company saying they do not accept this "home sleep study" with the auto setting. I didn't know this was a sleep study except for the Dr getting information on calculating my pressure. I don't understand them denying service or how that can be being it is being done but trying to figure out how it affects me in my care. You guys have said I need to take control of my health so looks like insurance company is forcing me to be that way.

I am not paying $1000s out of pocket for them to do what I could do. Will call tomorrow to verify whats going on but looks like I am taking control from what I see.

Wulfman... · Post by **Wulfman...** » Mon Apr 11, 2016 9:21 pm

Mr Snuffy wrote:Just got a letter in the mail from my insurance company saying they do not accept this "home sleep study" with the auto setting. I didn't know this was a sleep study except for the Dr getting information on calculating my pressure. I don't understand them denying service or how that can be being it is being done but trying to figure out how it affects me in my care. You guys have said I need to take control of my health so looks like insurance company is forcing me to be that way.

I am not paying $1000s out of pocket for them to do what I could do. Will call tomorrow to verify whats going on but looks like I am taking control from what I see.

That's interesting. Many insurance providers have been leaning towards the "cheaper route" for some time.
But, if you DO have sleep apnea and it's not too complicated with Centrals and other issues (we call that the "garden variety"), then you'll probably be better off taking control yourself.

Keep us posted and good luck.

Den

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SewTired · Post by **SewTired** » Wed Apr 13, 2016 10:33 am

I have not been cpaping a year yet, but learning a lot. Looking at your chart (and you experts are free to correct me), you spend nearly all your time above 7.5. For this reason, your minimum should be at least 7.5 (7.6 with Resmed). Since you feel you are awaking with the changes, 8 would be even better for a low. I don't have a ramp on, but since I changed my range from 8-12 to 9-11, I no longer am woken up when the pressure drops considerably. That's a huge benefit when you are pretty certain that is a problem.

FWIW, my Medicare supplemental also told me that they do not cover auto-machine titrations, but they would cover a follow-up appointment (which is covered anyway since a face-to-face meeting is required to have Medicare pay for your machine. I had an in-lab anyway because of other complications.

Mr Snuffy · Post by **Mr Snuffy** » Fri Apr 15, 2016 7:37 pm

Update: Finished with my test run and the new setting is 9.6. I knew that 6 was too low and that it needed to be higher. Will find out tonight how well I can handle being set to CPAP mode again. APAP was bugging me as the pressure would get too low and then seem to cause air leaks that woke me. I would adjust and then go back to sleep. Thanks for everyones suggestion.

One month Dr visit and change in pressure

One month Dr visit and change in pressure

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