do i need apap or auto, my hi's are always above 35-40

[spottydogspot]

I am in my third month of cpap, and i feel like crap still. my ai's are real low, with my hi being anywhere from 35-45, with under .40 leak rate.
this is at a pressure of 12 with epr at 2. why am i not getting it right? boy, i didn't use cpap for 3 nights straight and i crashed and burned today, could NOT get out of bed till this after noon, so i know it is helping a bit.

i am still renting my resmed II elite cpap, so i think if i need another or different machine i could do it now or soon. i am just so frustrated. i finally have gotten to where i can wear the liberty all night with a bandaid on my nose, but still the hi's.

please tell me what i should do!! do i need to go back , or give ti some time. If i wait and in a few months after my insurance has paid for my machine, and i need a new one, will they pay again? yikes!!

thanks for listening.

[robertmarilyn]

I am in my third month of cpap, and i feel like crap still. my ai's are real low, with my hi being anywhere from 35-45, with under .40 leak rate.
this is at a pressure of 12 with epr at 2. why am i not getting it right? boy, i didn't use cpap for 3 nights straight and i crashed and burned today, could NOT get out of bed till this after noon, so i know it is helping a bit.
i am still renting my resmed II elite cpap, so i think if i need another or different machine i could do it now or soon. i am just so frustrated. i finally have gotten to where i can wear the liberty all night with a bandaid on my nose, but still the hi's.
please tell me what i should do!! do i need to go back , or give ti some time. If i wait and in a few months after my insurance has paid for my machine, and i need a new one, will they pay again? yikes!!
thanks for listening.

Do you own the software and reader? I suspect that you don't since you don't own the machine, but you really need to be able to see the daily details to have a better picture of what is going on. You may feel better with your settings adjusted but once again, you really need the software to have a any chance of making educated changes.

I own my machine...I'm not positive if it is the one that I will continue using and won't know until after more tests (it's a long story and has it's own thread)...but I own the software and reader for my machine and even if I don't use this brand of machine in the future, I consider the money spent to get the reader to be very well spent...without knowing how well or not well I was doing on this machine, I'd have no way of knowing much of anything about what was going on with me.

I understand frustration, believe me...I don't know for sure if your insurance will provide another machine if this one isn't the right one...in my case, if I need a different machine, my insurance will provide it because I will have gone through a slew of tests to prove this machine doesn't work. But I'm not doing the tests to get a new machine...by the time I'm done, my deductible on the tests would have probably paid for a new machine so I would have been better off buying my own machine than doing a bunch of tests to get a new machine.

Oh...keep using your machine until you get it figured out...as you already noticed, not using it isn't going to help and it could hurt. You've come to the right place to get set on the road to feeling better.
mar

[OutaSync]

Have you tried raising your pressure to see if that helps? Do you have a copy of the reults of your overnight study?

[Wulfman]

I am in my third month of cpap, and i feel like crap still. my ai's are real low, with my hi being anywhere from 35-45, with under .40 leak rate.
this is at a pressure of 12 with epr at 2. why am i not getting it right? boy, i didn't use cpap for 3 nights straight and i crashed and burned today, could NOT get out of bed till this after noon, so i know it is helping a bit.

i am still renting my resmed II elite cpap, so i think if i need another or different machine i could do it now or soon. i am just so frustrated. i finally have gotten to where i can wear the liberty all night with a bandaid on my nose, but still the hi's.

please tell me what i should do!! do i need to go back , or give ti some time. If i wait and in a few months after my insurance has paid for my machine, and i need a new one, will they pay again? yikes!!

thanks for listening.

Are you tweaking your own therapy pressures?
What was your prescribed pressure? A pressure of 12 with EPR of 2 is giving you a pressure of 10 to stop apneas. If your prescribed pressure IS 12, you need to bump it up 2 cm.
A leak rate of .40 is considered "high". Do you have the right mask selected in your machine?

You don't "need" an Auto. You need to get your therapy "tweaked"......mask, pressure, settings, leaks controlled, etc.


Den

[track]

A pressure of 12 with EPR of 2 is giving you a pressure of 10 to stop apneas.

Does that hold true for all M series machines that use c flex and a a flex too? Doesn't the pressure increase to 12 on the inhale and then lower on the exhale. Isn't the inhale the part that keeps the throat open and prevents the apneas? Are you saying that a pressure of 12 is really only a pressure of 10 if any sort of exhale relief of 2 is used?

Larry,

C-Flex is just a "comfort" option with different settings for degrees of exhale relief. It's NOT SUPPOSED TO have any effect on your therapy as far as allowing more "events" to occur.



Den

[Wulfman]

A pressure of 12 with EPR of 2 is giving you a pressure of 10 to stop apneas.

Does that hold true for all M series machines that use c flex and a a flex too? Doesn't the pressure increase to 12 on the inhale and then lower on the exhale. Isn't the inhale the part that keeps the throat open and prevents the apneas? Are you saying that a pressure of 12 is really only a pressure of 10 if any sort of exhale relief of 2 is used?

Larry,

C-Flex is just a "comfort" option with different settings for degrees of exhale relief. It's NOT SUPPOSED TO have any effect on your therapy as far as allowing more "events" to occur.



Den

EPR and C-Flex are different technologies. I was referring to EPR in that it actually drops pressure on exhale, all the way through the exhale cycle. C-Flex drops the pressure slightly at the beginning of the exhale process and provides "some" support pressure to (hopefully) prevent apnea events from occurring. C-Flex relief is also "relative" to the person's exhale effort, too. I presume that A-Flex is somewhat similar from reading the literature about it. I've never had a machine that had it, so I can't comment from personal experience.
EPR settings are similar to Bi-Level settings. You set the EPAP (exhale pressure) to a pressure that eliminates as many apneas as possible. (because, presumably, many apneas do or can occur on exhale)

Den

[mdbarthe]

I'd been experiencing a higher than desirable apena index each night for about the past month and one-half. My leak rate was practically flat each night, but my auto was set 10-20 cm. My original titration was at 13, but a second study about a year later was at 12 cm.

I decided to bump my pressure range up to 13-20 cm and keep my EPR at 3. I did that about four nights ago. Each of the subsequent nights my AI has dropped to 0.1 to 0.5 and my AHI (which includes the questionable counting of HIs) is usually around 6.5 - 8.0

It's amazing how much difference the change in the range made.