Using CPAP At An Altitude of 12,500'

[jilliansue]

I have not taken my machine camping, but...I live at 7700 feet and my AHI has been consistently below 5 for quite some time now, usually it is in the area of 3.
Good luck!
Jillian

[BullwinkleMoose]

Hey,
Just got off the phone with a tech-support guy at Covidian...used to make and sell PBs. He said that it might work, but the little blower in that machine you use will be running at its max RPMs. Also said if your mask has a high volume (liter/min.) then that would be a problem. I told him a Swift FX with 35 liters a minute at 10 cm/H2O and he said that was pretty high. Then asked about a PB Breeze nasel, and he said a lot better since it has such a tiny hole for the exhaust. He also said turning up the pressure was not going to help since the machine couldn't keep up with a pressure of 10 cm/H2O as it is. Asked for any advice, to which, he replied [paraphasing the conversation] do you have an older machine, something big and clunky with a really big blower in it, like (unsure here) a 417A. I think that was the reference he made, the 420 E replaced it. He also didn't think it would burn up, since they were designed to run at full output, continuously.

Hope this helps and have fun.

[moresleep]

A few additional thoughts:

At a high altitude where the atmospheric pressure is significantly lower, you may need less Cpap pressure to provide the "air splint" required to prevent OSA. Not sure how this plays out, or if anyone has done studies.

Assuming the Cpap is able to compensate for the altitude and produce the prescribed pressure, does that mean the user is less susceptible or more susceptible to "altitude sickness" than without the Cpap? Since the percentage of O2 in the air mix remains essentially the same at high mountaintop altitudes, with just the quantity changed due to the lower pressure, Cpap at night, providing pressurized air to breath, may actually help prevent "altitude sickness."

Does anyone know?

[plr66]

Hey,
Just got off the phone with a tech-support guy at Covidian...used to make and sell PBs. He said that it might work, but the little blower in that machine you use will be running at its max RPMs. Also said if your mask has a high volume (liter/min.) then that would be a problem. I told him a Swift FX with 35 liters a minute at 10 cm/H2O and he said that was pretty high. Then asked about a PB Breeze nasel, and he said a lot better since it has such a tiny hole for the exhaust. He also said turning up the pressure was not going to help since the machine couldn't keep up with a pressure of 10 cm/H2O as it is. Asked for any advice, to which, he replied [paraphasing the conversation] do you have an older machine, something big and clunky with a really big blower in it, like (unsure here) a 417A. I think that was the reference he made, the 420 E replaced it. He also didn't think it would burn up, since they were designed to run at full output, continuously.

Hope this helps and have fun.

BullWinkle, thanks so much for going out of your way to check out this question with Covidian! Very kind of you. Interesting feedback about the mask volume being an issue. I use a FFM and unfortunately no longer have the preferable option of using nasal pillows with mouth tape.

Thanks also to you, Jillian, for your input. I have been surprised that there has been no response from anyone who may actually live at elevations above the highest tested/approved for our machines. Where are all the other Colorado people on cpap?!

[greyhound]

I used my M Series at 13,500 feet without any problem that I'm aware of.

[TheDuke]

I haven't used my machine at 12,500' elevation, but I have used it for several weeks at about 10,500' with no difficulty at all. The displayed pressure on its digital readout was the same as at home where elevation is about 350'. This machine is a now aging rather basic Respironics BiPAP Plus operating at 14"/10". And I felt fine every night.
Just a comment however, my previous machine was a Sullivan (ResMed) BiLevel and it died during the first night at the same resort. My DME felt that its failure was simply due ti its advanced service life of over 6 years and over 15,500 service hours, but I have always wondered if the high altitude did have som sort of ill effects.

TheDuke

[plr66]

A few additional thoughts:

At a high altitude where the atmospheric pressure is significantly lower, you may need less Cpap pressure to provide the "air splint" required to prevent OSA. Not sure how this plays out, or if anyone has done studies.

Assuming the Cpap is able to compensate for the altitude and produce the prescribed pressure, does that mean the user is less susceptible or more susceptible to "altitude sickness" than without the Cpap? Since the percentage of O2 in the air mix remains essentially the same at high mountaintop altitudes, with just the quantity changed due to the lower pressure, Cpap at night, providing pressurized air to breath, may actually help prevent "altitude sickness." Does anyone know?

Moresleep, I'm not clear about your reasoning in your first paragraph. Can you explain? And my immediate response to your second paragraph is that since the symptoms of altitude sickness and OSA without proper cpap treatment can be very similar, one would certainly feel better with cpap than without it. (Add Diamox for further prevention of altitude sickness). Is the O2 percentage really the same at high altitudes, and just decreased quantity due to lower pressure? I wouldn't have guessed that since O2 supplement rather than just increased air pressure is required by climbers, fliers, etc at high altitudes-- but I have no idea about the fact. So I would like to know the answer to your question as well, and wish the techies here would chime in.

[plr66]

I used my M Series at 13,500 feet without any problem that I'm aware of.

Thanks for your input, greyhound. For how long did you use it at this altitude? I take it you didn't check your data, but just describe how you felt?

[Roger2]

Hi plr66,

I was just in Buena Vista Colorado filling in for an absent pastor at an altitude of 8200 feet and did not make any alterations to my cpap machine although I did have to set my concentrator to an 8 liter flow to maintain a 92% oxygen saturation level. I don’t know how to change the settings on my cpap but I seemed OK after two days at that altitude. We live at an altitude of about 5200 feet which is where my cpap has been set up. I did not really feel any difference in my daily activities than I have at home.

Perhaps the Holy Spirit was watching over me there.

Roger

[plr66]

Hi plr66,
I was just in Buena Vista Colorado filling in for an absent pastor at an altitude of 8200 feet and did not make any alterations to my cpap machine although I did have to set my concentrator to an 8 liter flow to maintain a 92% oxygen saturation level.
Roger

Can you give details about your use of the O2 concentrator level before and during the altitude increase?

[moresleep]

A few additional thoughts:

At a high altitude where the atmospheric pressure is significantly lower, you may need less Cpap pressure to provide the "air splint" required to prevent OSA. Not sure how this plays out, or if anyone has done studies.

Assuming the Cpap is able to compensate for the altitude and produce the prescribed pressure, does that mean the user is less susceptible or more susceptible to "altitude sickness" than without the Cpap? Since the percentage of O2 in the air mix remains essentially the same at high mountaintop altitudes, with just the quantity changed due to the lower pressure, Cpap at night, providing pressurized air to breath, may actually help prevent "altitude sickness." Does anyone know?

Moresleep, I'm not clear about your reasoning in your first paragraph. Can you explain? And my immediate response to your second paragraph is that since the symptoms of altitude sickness and OSA without proper cpap treatment can be very similar, one would certainly feel better with cpap than without it. (Add Diamox for further prevention of altitude sickness). Is the O2 percentage really the same at high altitudes, and just decreased quantity due to lower pressure? I wouldn't have guessed that since O2 supplement rather than just increased air pressure is required by climbers, fliers, etc at high altitudes-- but I have no idea about the fact. So I would like to know the answer to your question as well, and wish the techies here would chime in.

My reasoning for the first one is that, Cpap provides increased pressure inside the airways, essentially holding them open against the lower outside pressure. This effect would be increased at high altitudes where the outside pressure is even lower. Remember what happens when certain fish with internal air balloons living in very deep waters are brought to the surface--the air sac expands against the lower pressure, with disastrous results for the fish. I would expect this effect to exist to some extent for humans using Cpap who travel to high altitudes; I'm just don't if it's significant.

As for the mix of O2, yes, because O2 and nitrogen molecules weigh about the same and wind currents keep the lower atmosphere mixed up nicely, the mix stays almost constant at roughly 20% 02 vs. 80% N2 from sea level to the top of Mt. Everest (I'm using even numbers and ignoring the other, trace gases). However, because of the difference in air pressure, or air densisty, on the top of Mt. Everest, it probably takes something like three breaths to deliver the same amount of 02 to the lungs as one breath at sea level.

[plr66]

moresleep, Thanks for your clear explanation just above. This is getting more interesting all the time! I've learned a lot here, and it will be really great to sort out all the seemingly conflicting, but considered ideas presented, once I get where I'm going. I wish my trip could be next week rather than next year!

Roger2, still hoping you'll chime in again, as I am curious about the details of your use of supplemental O2 even though I do not use it.

[Roger2]

Can you give details about your use of the O2 concentrator level before and during the altitude increase?

I normally have it set at hom on 4 if I am not moving around much and about 5 or 6 if I am depending upon my exertion level. The concentrator will go up to 10 but like most, is not really efficient if it is set above 8 or 9. Since I need to return to Buena Vista later this afternoon, I am a little concerned about leaving my cpap set where it is at since I am not at all sure how much it should be increased, even if I knew how to do that. I was at that altitude for two days but only one night and did not feel any different when I woke up yesterday morning.

I will take the cpap in when I return to NJ to see my sleep doctor and let them show me how to set it for higher altitude, or for that matter if I really need to increase any settings at all.

Roger

[plr66]

AHA!!--So you thought this thread would finally disappear quietly to the 2nd page and on to the archives without a whimper! Wrong!

I received a creative thought by pm from someone who preferred not to be named. He suggested: "I was thinking about what the tech-support guy said to BullwinkleMoose about a bigger blower, and it struck me that if you got a "Y" fitting and connected your hose to two small machines, effectively doubling the size of the blower, with 10cm/H2O on each then they should maintain 10cm/H2O at higher altitudes."

Now if I could manage a whole suitcase devoted to carrying 2 machines & the associated cpap supplies, this idea sounded interesting, but maybe with different numbers. My regular pressure at 3000' is 12.

If I had 2 machines and set each of them to 7 or 8 (rather than 6, to try to approximate a rough adjustment for the extra elevation of 4500' the machines don't go to), at their highest altitude adjustment of 7500'---would I have greater chance of not over-working the 2 machines than with just one machine? And is any of this logical?

Physics Majors and Techies, please comment, and please be kind....

[Roger2]

plr66, I got back from the high country a couple of hours ago again and it is now winter up there and worse in the passes getting there. In any case I spent my second night at higher altitude last night in preparation of delivering a service this morning on behalf of our Lord and Savior Jesus Christ. Like two nights ago I did not change my cpap settings (as you will remember, I don't really know how to do that) and felt fine when I awoke this morning, again. Perhaps that is too short of a time period to make a good comparison, I don't really know. As before, I did have to keep the O2 turned up to 8 to 10 at the slightly increased altitude while in the parsonage and church. Ditto in my Jeep although I had a 100 pound lox tank strapped down in the back with an air hose and cannula hooked into that while driveling. The passes were a real wooly-buger Thursday night and Friday morning coming back as well as yesterday going over again. Cumming back this afternoon however was very nice.

I downloaded the information from my cpap this afternoon for last week and there did not seem to be a marked difference in the readings while at higher altitude but then perhaps the difference between where I live (about 6000 feet) and Buena Vista at 8200 feet is not that great so as to make a difference.

Hope that was informative.


Roger