When I talked to them it seems like the people at the Sleep Center don't want me to be able to change my own setting. What's the deal with that?
Charlie
Day 5
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CharlesVer
- Posts: 62
- Joined: Mon May 11, 2009 10:51 am
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CharlesVer
- Posts: 62
- Joined: Mon May 11, 2009 10:51 am
Re: Day 5
AHI... okay, is that the CPAP pressure setting? Mine is 16. Or is AHI something else?rooster wrote: I had to make major changes and now have my AHI consistently below 1.0. The lab could not do this for me.
Re: Day 5
Anyone who likes Laverne and Shirley is OK in my book!
AHI and pressure are two different things. AHI = Apnea/Hypopnea Index. That means how many times your breathing is stopped or significantly reduced per hour over the night. You want it to be at least under 5.0.
One reason that the people at the sleep center don't want you to change your settings is because if they do it for you they can bill your insurance. Figuring out how to change your settings is kind of like the first time you used a remote for your TV. Kind of confusing, but once you figure it out why would you pay someone to change the channel for you?
Looks like you got your equipment entered, hooray! When you get home tonight, look on top of your CPAP machine and see what is printed on it so you can be sure you have the correct machine type entered. The resmeds all have the model name printed on top, so it shoud say Elite or Autoset or Escape or Vantage on it. If you need to, you can change the equipment you have listed using the same instructions I gave above.
Your problem is aerophagia. Let's compare your CPAP to the TV analogy you used. The TV you bought is a good one, its plugged in and will work fine, except the antenna needs to be adjusted. Once thats done, an evening with Cindy and Penny awaits! There are several solutions to this problem. One is to wait, as this problem will often resolve on its own as your body adapts to the CPAP. One is raising the head of the bed up so that its harder for the air to get into your stomach, which is what was already suggested. One is using Exhalation relief to reduce the pressure when you breath out and reduce the chance of your swallowing air. Another solution is to reduce your pressure a bit in the hopes that air with less pressure is less likely to be forced into your stomach. Reducing pressure carries the risk of allowing more apneas. If none of those work you may need a different type of machine.
The C-flex that was mentioned is a form of Exhalation relief, which is a reduction in your CPAP's pressure to allow you to breathe out more easily. This is a comfort feature that, at your pressure, definitely should have been enabled, and could resolve or reduce your problem with swallowing air. This feature is called EPR, or Exhalation Pressure Relief.
If it were me, if EPR were not enabled I would turn it on at 3cm and see if that made a difference. Of course, I'm not a doctor, I'm just a guy on an internet forum. If you are comfortable making these changes yourself, then press and hold the right and down buttons for a few seconds until the words "Clinicians Menu" comes up on the screen. Scroll through to find EPR settings and set it to 3, then exit out to the main screen. If you are not comfortable doing this you can ask the DME or your doc to do it for you.
If none of this works, then eventually you may need a different type of machine, either an Auto adjusting CPAP or Bi-level CPAP (APAP and Bi-PAP). Think of it like getting the right cable box! That will be a decision for your doctor to make, after exhausting the other alternatives.
Lack of sleep always makes me a little dizzy, so that could be all that is going on. Hopefully you will soon be able to get some good sleep and it will no longer be an issue. For tonight, I would recommend that you raise the head of your bed and either turn on EPR or call your doc and get the sleep center to do it. Right now you are struggling, and you need to get this issue resolved so you can begin enjoying the benefits of good CPAP therapy. I hope this helps. Keep us posted.
AHI and pressure are two different things. AHI = Apnea/Hypopnea Index. That means how many times your breathing is stopped or significantly reduced per hour over the night. You want it to be at least under 5.0.
One reason that the people at the sleep center don't want you to change your settings is because if they do it for you they can bill your insurance. Figuring out how to change your settings is kind of like the first time you used a remote for your TV. Kind of confusing, but once you figure it out why would you pay someone to change the channel for you?
Looks like you got your equipment entered, hooray! When you get home tonight, look on top of your CPAP machine and see what is printed on it so you can be sure you have the correct machine type entered. The resmeds all have the model name printed on top, so it shoud say Elite or Autoset or Escape or Vantage on it. If you need to, you can change the equipment you have listed using the same instructions I gave above.
Your problem is aerophagia. Let's compare your CPAP to the TV analogy you used. The TV you bought is a good one, its plugged in and will work fine, except the antenna needs to be adjusted. Once thats done, an evening with Cindy and Penny awaits! There are several solutions to this problem. One is to wait, as this problem will often resolve on its own as your body adapts to the CPAP. One is raising the head of the bed up so that its harder for the air to get into your stomach, which is what was already suggested. One is using Exhalation relief to reduce the pressure when you breath out and reduce the chance of your swallowing air. Another solution is to reduce your pressure a bit in the hopes that air with less pressure is less likely to be forced into your stomach. Reducing pressure carries the risk of allowing more apneas. If none of those work you may need a different type of machine.
The C-flex that was mentioned is a form of Exhalation relief, which is a reduction in your CPAP's pressure to allow you to breathe out more easily. This is a comfort feature that, at your pressure, definitely should have been enabled, and could resolve or reduce your problem with swallowing air. This feature is called EPR, or Exhalation Pressure Relief.
If it were me, if EPR were not enabled I would turn it on at 3cm and see if that made a difference. Of course, I'm not a doctor, I'm just a guy on an internet forum. If you are comfortable making these changes yourself, then press and hold the right and down buttons for a few seconds until the words "Clinicians Menu" comes up on the screen. Scroll through to find EPR settings and set it to 3, then exit out to the main screen. If you are not comfortable doing this you can ask the DME or your doc to do it for you.
If none of this works, then eventually you may need a different type of machine, either an Auto adjusting CPAP or Bi-level CPAP (APAP and Bi-PAP). Think of it like getting the right cable box! That will be a decision for your doctor to make, after exhausting the other alternatives.
Lack of sleep always makes me a little dizzy, so that could be all that is going on. Hopefully you will soon be able to get some good sleep and it will no longer be an issue. For tonight, I would recommend that you raise the head of your bed and either turn on EPR or call your doc and get the sleep center to do it. Right now you are struggling, and you need to get this issue resolved so you can begin enjoying the benefits of good CPAP therapy. I hope this helps. Keep us posted.
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CharlesVer
- Posts: 62
- Joined: Mon May 11, 2009 10:51 am
Re: Day 5
Thank you!!!
(and to all that replied.)
I am printing out that information and will see if I can reset that thingamajig you just said to '3'.
(I'm sorry, I know the technical term is the whosi-whatsi.)
You're so kind, I'll give you a trivia question.
If you already knew it, you can roll your eyes at me, I won't mind.
Q: Laverne & Shirley was a spin-off from Happy Days, but Happy Days came from what other show?
.
.
.
.
.
A: The Happy Days pilot appeared on Love American Style.
(and to all that replied.)
I am printing out that information and will see if I can reset that thingamajig you just said to '3'.
(I'm sorry, I know the technical term is the whosi-whatsi.)
You're so kind, I'll give you a trivia question.
If you already knew it, you can roll your eyes at me, I won't mind.
Q: Laverne & Shirley was a spin-off from Happy Days, but Happy Days came from what other show?
.
.
.
.
.
A: The Happy Days pilot appeared on Love American Style.
Re: Day 5
Charles -- Just want to thank you for sharing your story -- and your humor! I am going in for cpap titration tonight, and while I'm hopeful to be one of those easy adjusters, following your experience let's me know there are others who will be there for me once I get my machine. Good luck with changing the whosi-whatsi!
Starting APAP use 6/11/09 -- Looking forward to a longer, more rested life!
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CharlesVer
- Posts: 62
- Joined: Mon May 11, 2009 10:51 am
Re: Day 5
Update:
1. Talked to doctor (primary).
He said, "Go ahead and adjust your setting, until you get it where you're comfortable."
I said, "I can't. They don't let you."
He said, "Oh, okay. Let me look into this and I'll get back to you."
2. Called the people who delivered my CPAP machine.
a. Told them I want to switch to nasal mask. They'll have somebody contact me on that.
b. Asked about changing settings.
He said to have doctor fax over a prescription for new setting and they send someone out.
I said, "Why can't I change my own settings? People online say they do theirs."
We had a mini debate, short recap:
He said (many things, some that don't even go together): it's a violation of law, invalidates warranty, should only be done by trained personnel, I can ruin the software, it can be dangerous if I set it to high, etc.
I said: Ruin the software? It seems like it would be like changing channels on a television it's just a number. Dangerous if I set it too high? I want to set it lower. What if I need to adjust it several times before I get it right, someone will have to come out every time?
And my favorite exchange was this:
He: It's a violation of law.
Me: You mean the police are going to come out and arrest me if I change my cpap settings?
He: Well, it's not a violation of federal law. (????)
In the end, he said that some people have looked up the manuals online and they don't recommend I do that.
Sounds to me like, like was said here, they want more money from the insurance company. They have too many different stories for this to be a legitimate thing I can't handle myself.
1. Talked to doctor (primary).
He said, "Go ahead and adjust your setting, until you get it where you're comfortable."
I said, "I can't. They don't let you."
He said, "Oh, okay. Let me look into this and I'll get back to you."
2. Called the people who delivered my CPAP machine.
a. Told them I want to switch to nasal mask. They'll have somebody contact me on that.
b. Asked about changing settings.
He said to have doctor fax over a prescription for new setting and they send someone out.
I said, "Why can't I change my own settings? People online say they do theirs."
We had a mini debate, short recap:
He said (many things, some that don't even go together): it's a violation of law, invalidates warranty, should only be done by trained personnel, I can ruin the software, it can be dangerous if I set it to high, etc.
I said: Ruin the software? It seems like it would be like changing channels on a television it's just a number. Dangerous if I set it too high? I want to set it lower. What if I need to adjust it several times before I get it right, someone will have to come out every time?
And my favorite exchange was this:
He: It's a violation of law.
Me: You mean the police are going to come out and arrest me if I change my cpap settings?
He: Well, it's not a violation of federal law. (????)
In the end, he said that some people have looked up the manuals online and they don't recommend I do that.
Sounds to me like, like was said here, they want more money from the insurance company. They have too many different stories for this to be a legitimate thing I can't handle myself.
Re: Day 5
Charles, if your "BS detector" was screaming at you, you have good instincts.
There is no violation of law, warranty voiding or anything else. What there is may be a DME-RT (durable medical equipment provider, respiratory therapist) trying to protect their job, or perhaps (as you surmised) trying to maximize "billables".
What they should do is say something like "be careful, because if you don't know what you're doing, you could mess things up".
Granted, even though I know how to get to the menus, I've only made modest changes (crept up min pressure, turned off EPR, changed upper pressure). I'm also pretty comfortable with the idea that I could reset the machine to factory defaults and get it set back to where the doctor and DME-R/T intended it to be. But I'm not experimenting in the style of "I wonder what will happen if I change this setting...".
Guy
There is no violation of law, warranty voiding or anything else. What there is may be a DME-RT (durable medical equipment provider, respiratory therapist) trying to protect their job, or perhaps (as you surmised) trying to maximize "billables".
What they should do is say something like "be careful, because if you don't know what you're doing, you could mess things up".
Granted, even though I know how to get to the menus, I've only made modest changes (crept up min pressure, turned off EPR, changed upper pressure). I'm also pretty comfortable with the idea that I could reset the machine to factory defaults and get it set back to where the doctor and DME-R/T intended it to be. But I'm not experimenting in the style of "I wonder what will happen if I change this setting...".
Guy
_________________
| Mask: Mirage Quattro™ Full Face CPAP Mask with Headgear |
| Additional Comments: ResScan 3.5 and card reader |
Ready to fight the forces of evil, right after I finish this nap...
Re: Day 5
Guy,GuyK wrote:.........
Granted, even though I know how to get to the menus, I've only made modest changes (crept up min pressure, turned off EPR, changed upper pressure). I'm also pretty comfortable with the idea that I could reset the machine to factory defaults and get it set back to where the doctor and DME-R/T intended it to be. But I'm not experimenting in the style of "I wonder what will happen if I change this setting...".
Guy
That is a good approach.
Regards,
Rooster
I have a vision that we will figure out an easy way to ensure that children develop wide, deep, healthy and attractive jaws and then obstructive sleep apnea becomes an obscure bit of history.https://www.youtube.com/watch?v=0ycw4uaX ... re=related
I have a vision that we will figure out an easy way to ensure that children develop wide, deep, healthy and attractive jaws and then obstructive sleep apnea becomes an obscure bit of history.https://www.youtube.com/watch?v=0ycw4uaX ... re=related