New sleep study required???

[hjjsnell]

Well they must be psychic at my dr's office because I just posted that I would be talking to her today and my phone rang! LOL I will be getting an autopap loaner. I pick it up today and return it next week and they will adjust the pressure on my machine accordingly. So I don't get an autopap to keep, bummer, but at least something is being done about my increase in AHI (at least I don't think I get one to keep unless they change my script for a new machine and I trade it out with my current machine...which I highly doubt since all the insurance paperwork has been filed and accepted...my insurance isn't the greatest).

[roster]

The autopap will be a loaner from what she says and I think they'll go from the data in that to set my CPAP to the adjusted pressure. But I should be talking to her today though, so I'll check with her on whether it's a loaner or not.

Heather,

Chances are very high that they will not be able to prescribe an optimal pressure with the autopap study through no fault of their own. You need your own machine to look at reports daily and "tweak" the therapy. You will be monitoring, analyzing and responding to daily reports showing apneas, hypopneas, snores and mask leaks. You will make small changes and then watch the data to see what happens.

So, do whatever it takes with the doc's office and your insurance company to get a "fully-data-capable" autopap of your own. If you get your own machine you can later buy a card reader and software and optimize your pressure over several days (or weeks, Slinky ).

Good luck,

[Slinky]

Gotchya, Rooster. Thanks.

[hjjsnell]

Heather,

Chances are very high that they will not be able to prescribe an optimal pressure with the autopap study through no fault of their own. You need your own machine to look at reports daily and "tweak" the therapy. You will be monitoring, analyzing and responding to daily reports showing apneas, hypopneas, snores and mask leaks. You will make small changes and then watch the data to see what happens.

So, do whatever it takes with the doc's office and your insurance company to get a "fully-data-capable" autopap of your own. If you get your own machine you can later buy a card reader and software and optimize your pressure over several days (or weeks, Slinky ).

Good luck,

Well she told me to tell her if I like the autopap better than my own machine when I return it and if so then they'll look into either adjusting my pressure or giving me an autopap, it will all be based on the data they download from the smartcard when I return it on Monday (which I don't think is enough time but hey I'm not the dr). She loaned me the Respironics Remstar Auto w/ A-Flex, is that a fully data capable one? A good one? Because if so then I will request it if they give me an option of adjusting my pressure or going with an autopap.

[roster]

........She loaned me the Respironics Remstar Auto w/ A-Flex, is that a fully data capable one? A good one? ........

All of the machines have their faults, but given that, the A-Flex is an excellent choice and is "fully data capable". Insist on getting one.

If they try to give you something that is not fully data capable, decline it and let them know you will go home without a machine if you don't get the one you want. Most insurance companies provide a benefit for the first machine and will not pay on another one for five years or more. So if you get the wrong one initially, the next one may be at your expense. Believe me, it happened to plenty of the current members here.

Good luck,

[Slinky]

Yup, yup, Rooster is right on.

[rested gal]

she told me to tell her if I like the autopap better than my own machine when I return it

Heather, I'd try everything possible to keep the Respironics REMstar Auto with A-Flex. Yes, it's a good one, and yes, it's a "full data" recording machine. Encore Viewer software was created by Respironics for patients to buy, if you want to do your own Smart Card downloads at home.

An autopap can be set to work like a straight CPAP if that suits you better. Two machines in one.

Here's a link with names of machines that record full data (AHI and leak info) and those that don't -- as of October 2008:
viewtopic.php?p=307168#p307168

[hjjsnell]

Well first night on the AutoPAP and it set my average (according to the data on the machine) pressure at 15, much higher than the 7 I was originally prescribed!! I could definitely feel the difference when I was TRYING to breathe last night. I had quite a bit of leakage with my Liberty due to such a high pressure so I need to readjust the headgear for this amount of pressure...I'll do that while laying down to get the best fit...with it on of course. That's the best way right?? My AHI was under 5 so that's a plus, lower than it's been in about 2 weeks even with a high leak rate! So we'll see how well it goes down over the next 2 nights.

Heather

[roster]

Isn't it great to have a fully data-capable machine? When you get your own machine and software you will appreciate it even more.

.........I need to readjust the headgear for this amount of pressure...I'll do that while laying down to get the best fit...with it on of course. That's the best way right?? ..........
Heather

I have had excellent success doing it another way. I sit my machine (careful not to drop it or tilt it so the humidifier water spills into the machine) on the bathroom counter in front of the mirror. Then I put the mask on and adjust it.

The next step is to hook the hose to the machine and turn the machine on to a pressure near my therapeutic pressure. Then I listen for leaks in the mask and tilt my head back, forward, and to both sides still listening for leaks. If there are leaks I adjust the headgear with the machine running and then of course repeat the leak-check procedure.

Remember, a common mistake when we are just beginning is to adjust the mask too tightly. The masks are designed to work better when they are adjusted lightly.

Another tip is to check that corresponding straps are adjusted to the same length. This helps to center the mask on the face.

I use the Hybrid mask with the chin flap removed and this makes it similar to the Liberty. Here, viewtopic.php?t=14422&highlight= , are some tips on adjusting the Hybrid that may help with the Liberty adjustments.

You are making rapid progress. Don't get discouraged should you have a bad night. It is quite common for this to happen during the learning and adjusting process.

When this settles out and you have your optimum pressure (or pressure range) figured out, just for fun (I am easily entertained ) we should discuss that in-lab titration night again.

Regards,

[rested gal]

I could definitely feel the difference when I was TRYING to breathe last night.

Heather, is A-Flex turned on, or did they set it for just C-Flex?

Everyone's different, but for me, A-Flex makes breathing feel a lot more natural than does just C-Flex. I like A-Flex at 3 for the most exhalation pressure relief it can give.

What pressure range (minimum/maximum pressures) is your autopap set for?

Given that they got you up to at least 7 cm on that misbegotten CPAP titration, I'd set the autopap range at 7 - 20, if it were me.

Tip: if you wake up during the night with what feels like a hurricane blowing, you can hit the "ramp" button, and the machine will drop back instantly to the minimum pressure in your range -- even if you have not set a "ramp." That's easier, if you want to start over, than turning the machine all the way off and back on again.

[hjjsnell]

I could definitely feel the difference when I was TRYING to breathe last night.

Heather, is A-Flex turned on, or did they set it for just C-Flex?

Everyone's different, but for me, A-Flex makes breathing feel a lot more natural than does just C-Flex. I like A-Flex at 3 for the most exhalation pressure relief it can give.

What pressure range (minimum/maximum pressures) is your autopap set for?

Given that they got you up to at least 7 cm on that misbegotten CPAP titration, I'd set the autopap range at 7 - 20, if it were me.

Tip: if you wake up during the night with what feels like a hurricane blowing, you can hit the "ramp" button, and the machine will drop back instantly to the minimum pressure in your range -- even if you have not set a "ramp." That's easier, if you want to start over, than turning the machine all the way off and back on again.

I'm honestly not sure if A-Flex is on or not. I will have to try it tonight but I'll run and check on that now. I did feel like I had a hurricane blowing that first night but it was MUCH better last night. The seal was better, even though one of my pillows kept popping out of my nose until I adjusted the strap differently to hold it up better (too much force with the pressure it reached I guess). My AHI average for the 2 nights so far is 6.0, it was under 5 that first night so it was higher last night. I have GOT to get this under control. I do feel better though after using the APAP with the higher pressure, that has to account for something!! Thanks for the tip about the ramp feature Rested Gal! I never even thought to do that, now I know!

[hjjsnell]

AFLEX was on for my last night and it was MUCH better!! I could notice the difference when exhaling. I used CFLEX to start with when I first starting using nasal pillows and it helped for a few nights until I got used to the pressure and then it was more of a hindrance than a help...so with that being said I don't think I'd need AFLEX all that much after the first few nights but then again I've not slept for more than a few nights with a higher pressure like I've had the past couple nights. All I can say is that I've had the best sleep I've had in a long time!! I'm still a little tired but I feel so much better...and on the verge of being rested. This higher pressure suits me!

[Slinky]

Congratulations! I'm delighted to hear of the improvement for you!