Can patients safely alter the settings to come up with good results

[palerider]

Well, you know I'm not much for long explanations, I'll try to remember to make this one a faq.

seriously, do that. it's an important underpinning of the basic function of an apap machine.

http://cpaptalk.com/wiki/index.php/Cpap ... an_APAP.3F

How's that?

I took out the bit about quacks in training.

[palerider]

. . . the pillow police might come get you.

What a shame if the pillow police made a raid on the exact same night as the dreaded dream police!

https://youtu.be/F3C19k80d_0

And personally, I think every bass player should wear a lab coat and stethoscope when playing that song live.

That said, a 12-string bass is just WRONG without a prescription and proper supervision.

How about Rick Nielsen's 9 headed monster

I don't think his arms are long enough to properly play it.

[palerider]

Rick Nielsen's 9 headed monster

Not the sort of guy I'd want setting up my autobilevel, that's for sure!

Thanks for bumping up Pugsy's important thread. She's too modest to make her own thread a sticky.

Of course, but you didn't need to thank me, since we both did just that.

Suppose, I should share what I think. The short answer is, yes, if the patient is capable of doing it right, if not, then they probably shouldn't. Can the machine itself hurt the patient with the wrong settings? I don't know, and regardless, the therapy won't be effective, and that could be a problem.

Even ineffective therapy is almost always better than no therapy.

[palerider]

And finally there's the CPAPTalk's own Zonker!
Have any of you ever been welcomed into a doctors waiting room with the same enthusiasm as Zonker welcomes new members here? Absolutely not.

I DO miss the good old days when he'd come around the corner pushing the cart with the squeaky wheel and hand out cookies...

Oh well, what can you do.

[Pugsy]

Ok, how's this for reading your mind?

Hey...you are dialed in on my husband's mind for sure. Every single day of winter I hear him whining about moving to some place like Hawaii or Tahiti or the Caribbean. He hates winter.
Me...kinda depends on what we are seeing....typical woman...I change my mind easily and often.
I love the snow unless I have to go somewhere.

[zonker]

Well, you know I'm not much for long explanations, I'll try to remember to make this one a faq.

seriously, do that. it's an important underpinning of the basic function of an apap machine.

http://cpaptalk.com/wiki/index.php/Cpap ... an_APAP.3F

How's that?

I took out the bit about quacks in training.

looks good indeed. would like others to look at it too. my main goal is to not confuse the newbie further than they already are. i may be tainted by my time here, so i don't necessarily trust my judgement. but it looks simple enough to me.

side question: what is NREM?

[chunkyfrog]

. . .
side question: what is NREM?

Not REM.

[palerider]

side question: what is NREM?

Sleep is broadly divided into two types... REM (Rapid Eye Movement) and NREM, or Non-Rapid Eye Movement... (clever, huh? don't blame me, I didn't come up with it).

NREM is further divided into N1, N2, and N3, (used to be a N4, but they combined that into N3.. N1 is just barely asleep, N2 is your 'usual plain sleep', and N3 is 'deep, restorative' sleep.

Any other questions from the audience?

[zonker]

. . .
side question: what is NREM?

Not REM.

iswydt.jpeg

[zonker]

side question: what is NREM?

Sleep is broadly divided into two types... REM (Rapid Eye Movement) and NREM, or Non-Rapid Eye Movement... (clever, huh? don't blame me, I didn't come up with it).

NREM is further divided into N1, N2, and N3, (used to be a N4, but they combined that into N3.. N1 is just barely asleep, N2 is your 'usual plain sleep', and N3 is 'deep, restorative' sleep.

Any other questions from the audience?

uhhhh.......

nope!

[raisedfist]

It's almost a necessity for many people to take control over there therapy. My perspective is from being a respiratory patient. If I didn't learn things myself I truly believe I would be at best on invasive ventilation at night and maybe 24/7, at worst dead.

When bi-level ventilation started being used in the home about 30-40 years ago, it was taught that pressures should be low to moderate for people with serious breathing issues because you didn't want to risk barotrauma, a collapsed lung, or whatever other supposed risk. Over time and currently it's generally accepted that higher pressures when needed equals improved pulmonary function, less hospitalization, and slower progression of chronic illness. Meaning people were set up to decline and die faster because the people in charge of their care were wrong. People get used to higher pressures over time if they are needed because it makes the person feel better by actually treating the issue. As the smart people here say, the machine doesn't even deliver enough pressure to blow up a balloon so a lot of it is mental games.

This shift in attitude and research is mostly accepted in the emergency setting and in research, but in sleep labs most technicians only have experience with OSA, if that. Many labs don't calibrate their capnography regularly if they even have it, don't have lab protocols for respiratory patients, don't realize that maybe the person isn't breathing in REM sleep due to muscle weakness and not because their airway is closed.

I still remember the one time I was "titrated" in the lab with a PS of 5. I went home and wore my pulse oximeter and recorded myself desaturating below 88% for huge chunks of time. My average tidal volume was something like 220 mL and I woke up with a nasty headache from carbon dioxide retention.

Every sleep physician I've ever seen just defers to the DME or home respiratory therapist to set up the machine and deal with the actual workings of the machine. They have always just played the part of writing the prescription. I am not sure exactly what the hell they learned in school to become board certified in sleep medicine then.

[turbo]

. . . the pillow police might come get you.

What a shame if the pillow police made a raid on the exact same night as the dreaded dream police!

https://youtu.be/F3C19k80d_0

And personally, I think every bass player should wear a lab coat and stethoscope when playing that song live.

That said, a 12-string bass is just WRONG without a prescription and proper supervision.

How about Rick Nielsen's 9 headed monster

I don't think his arms are long enough to properly play it.

The struggle is real

[Wulfman...]

To answer the question in the Subject line of this thread..............ABSOLUTELY!!!
I'm living proof of it. I kicked my sleep doctor to the curb after about a month and took control of my own therapy.


Den

.

[sleepingwhileawake]

Yes. My first settings just felt wrong, so I "hacked" into the machine and changed them. I called my Dr. just to check, and told him what I did. His response? "We LOVE it when our patients do that! Saves so much time!"

I've managed my own settings ever since. My only advise would be, don't make big changes. Small changes, and sleep test them, then adjust again if necessary. Been doing this for 21 years.

[turbo]

Rick Nielsen's 9 headed monster

Not the sort of guy I'd want setting up my autobilevel, that's for sure!

Thanks for bumping up Pugsy's important thread. She's too modest to make her own thread a sticky.

Of course, but you didn't need to thank me, since we both did just that.

Suppose, I should share what I think. The short answer is, yes, if the patient is capable of doing it right, if not, then they probably shouldn't. Can the machine itself hurt the patient with the wrong settings? I don't know, and regardless, the therapy won't be effective, and that could be a problem.

Even ineffective therapy is almost always better than no therapy.

Good point my friend, and I do agree with you. I guess what I was thinking is that some people can't even adjust their own headgear properly, much less adjusting the machine