Turning the air pressure up on cpap.

[mfignewton]

I have only been on cpap for a week but when i was doing the studying the tech told me my number was at 11 and after getting up in the middle of the night and using the restroom and going back to sleep, I felt i slept great for the last couple of hours. My doctor has me on a 9 and my sleep seems to be the same i toss and turn and go from my back to my side. I have the nasal pillows and they are fine. I was wondering if i turn my machine up to an 11 will that possibly help me sleep?

[Pugsy]

I was wondering if i turn my machine up to an 11 will that possibly help me sleep?

In all honesty...the answer is we don't know because we don't know what is causing you to not to be able to go to sleep.
You are assuming that is is obstructive apnea events not been optimally prevented but it might be something else.
If your machine happens to be a full data machine and has software available we could look to see for sure if the apnea events are maybe the problem.

What machine ...make and model are you using?
If a Respronics machine...look on the bottom of the blower for a 3 digit number.
If a ResMed machine tell us all the words you see up by the LCD screen.
If another brand...tell us all the words you see on it.

[mfignewton]

I have a Remstar 260p Resperonics.

[Pugsy]

I have a Remstar 260p Resperonics.

This would be the PR System One 60 Series Plus CPAP with CFlex.
This machine doesn't gather any data beyond hours of use on that SD card.
I was hoping that you had some data available so you could see if the therapy is optimal or not. With this machine we can't even evaluate the leak to see if maybe leaks are impacting therapy effectiveness.
You might want to read this about full data machines and what your options are after you realize that is what you have.
http://maskarrayed.wordpress.com/

It's only been a week....maybe you can get your DME to swap this machine out for a machine that will offer you some useful data to see if there is anything going on in the reports that may be responsible for the poor quality sleep.

Without any data to have any idea what is maybe going on it is really hard to offer any ideas why you aren't sleeping well.
I supposed you could see about increasing the pressure to see if it helps but you are going to have to rely on how you feel and sometimes that works and sometimes it doesn't.

[mfignewton]

Thanks for in the info this is what they gave me. My insurance covers most of it and all the products with it. I will check with them then. My doctor wants to meet with me in a month and he wants the card, so the only data he is going to get is the time of use huh? Thats poopy i might just try to turn up the pressure this weekend and see if it helps.

[Denial Dave]

Personally at only one weeks of use, I humbly suggest that you re-consider changing pressures without having your doctor look at your data at the 30 days appt. Or consider discussing the reasoning for changes directly with your doctor.

Your body needs time to acclimate to the CPAP therapy.

just my humble opinion

Dave

[Pugsy]

My doctor wants to meet with me in a month and he wants the card, so the only data he is going to get is the time of use huh?

That is correct. Mainly the hours of use is to satisfy insurance compliance requirement issues.
He will ask how are you doing? If you say "not so great" he will say "give it time".
If you aren't using the machine 4 hours a night...he will say "use it more and give it time"
He is going to say either or both...."you just need more hours of sleep using the machine...or...give it time".
If you tell him you still aren't sleeping well...he will say "give it time".

Eventually if enough time passes and you still aren't sleeping well he will say "hmmm...let's get another sleep study".

In the meantime even people with full data machines and have software reports that do look good on paper...well sometimes we do have to "give it time" but when not feeling as good as the reports point to things then I suggest that while we "give it time" that we also investigate other possible causes of not sleeping so great or not feeling so great because sometimes it isn't all about the AHI.
Of course the first thing we look at if we can is the software reports to see if anything screams out "fix me".
If the reports are unavailable because of the machine not collecting that data it doesn't mean that we don't have any alternatives. We can still do some detective work to maybe isolate other factors involving sleep quality and how we feel.
Some of the things to look at....hours of sleep, fragmented sleep, insomnia, pain, meds, bed comfort, leaky mask, mask comfort, general health issues, and the list goes on and on.

Often people expect to slap the mask on and from day one feel like a million bucks and while some people get that miracle most of us it takes time.

Using the mask and machine fixes one thing...sleep apnea. If there are other issues going on then the machine doesn't do much for other issues unless those other issues are directly related to sleep apnea.

Of course we want to try to at least eliminate less than optimal therapy as a possible reason for not feeling so great...hence the use of the software to evaluate things from the therapy side.
But not having those reports doesn't mean that we shouldn't evaluate the other possible culprits...Never know...there might be something in the detective work that gets found and needs work also.
Like...hours of sleep. Some people use the machine for 5 or 6 hours a night and wonder why they still feel like crap..duh..that's probably not enough hours of sleep.

So you can work on getting a full efficacy data machine if you feel it is important to you but there are still other things that you can work on also while you are "giving it time". Hurts nothing and might help.

[Kenwood]

Thanks for in the info this is what they gave me. My insurance covers most of it and all the products with it. I will check with them then. My doctor wants to meet with me in a month and he wants the card, so the only data he is going to get is the time of use huh? Thats poopy i might just try to turn up the pressure this weekend and see if it helps.

Understand one thing about your DME....they are only interested in making money and giving you the cheapest machine they can get away with. Most insurance companies do NOT care.....most only have one insurance code for CPAP (CPAP, APAP, VPAP, BiPAP, etc) and pay one amount. The only thing the insurance company wants to see is that u are using the machine (hours used) and that your are compliant. Stand firm on wanting a full data capable machine since you are just a week in and the machine can be exchanges. If need be...get the doctor to write a RX that is specific on the machine and that they fill the RX as written.

I had a month long fight for my machine to be swapped from a BiPAP to an Auto BiPAP with my DME refusing saying that my insurance company would not pay for it. I called and confirmed they were lying. Got my sleep doctor involved. My doctor finally had to personally call them and remind they that she was the DOCTOR and the DME job is supply the medical equipment that she feels will treat my medical needs. Two hours later....the insurance company miraculously approved my machine swap.

[mfignewton]

Great advise, i'm looking into trying the WISP nasal mask instead of the nasal pillows. Also i am new at all this so what is the difference between CPAP and BIPAP i only have moderate sleep apnea. Would an all data CPAP machine be a good answer and worth fighting for?

[Pugsy]

Yes, I think a full data cpap machine is worth fighting for....especially when someone feels that they aren't doing better.
If you came here and proclaimed the "miracle" and all that...probably not critical that you get confirmation that the reports show optimal therapy.

The reason we stress full data early on in therapy is because that is when a person is more likely to get the DME to swap out the machine. If you wait 3 to 6 months before pressing for it then the chances of swapping it out are going to be slim and none.

Lots of people are using brick machines that get the job done and are feeling great and have no desire to watch their reports.
Hey, that's great and I am very happy for them.

For the people who want or need verification or that are having problems, I think they should have the option of having data available or not if they want it.
When someone comes here and wondering about increasing the pressure because they are still having horrible sleep....well it may just be a matter of time but it also might be that something needs a better fix. It's kind of helpful to have a starting point to know what might need fixing.

BiPap machine...bilevel pressures.
BiPap is Respironics model name for a bilevel pressure machine
VPAP is Remed's model name for a bilevel pressure machine

You cpap machine is a fixed single pressure machine. It pretty much gives you the same pressure during inhale and exhale with maybe a minor change if using the Flex option for exhale relief. For all practical purposes..fixed single pressure.
APAPs...are cpap machines that also offer auto adjusting fixed single pressure machines. The pressure roams around between the settings as it deems necessary.

Bilevel pressure machines. Two distinct pressures are offered. One for inhale and one for exhale. They can be fixed or auto adjusting if the machine is an Auto bilevel machine.
I use a bilevel auto adjusting pressure machine. Comfort mainly is my reason. That and I feel more rested using it than I did on APAP machine. What I use is what I call a plain bilevel machine. Doesn't do a bunch of fancy stuff.

Now there are the bilevel machines that do have a lot of rather intricate settings available and they are used when a person has a lot of central apneas and they need the machine to force them to breathe. These are high dollar machines and not used for run of the mill plain jane OSA very often except by maybe Dr Krakow and that is a whole different discussion.

Why use bilevel like my machinel? Comfort mainly. Especially when someone needs to use relatively high pressures because the distinct difference between inhale and exhale offers a lot of perceived exhale relief. Let's face it..exhaling against pressure coming close to hurricane force winds (seems like even though it really isn't) isn't much fun.
Also if someone happens to have a significant problem with aerophagia then changing to bilevel pressures normally allows the person to still be able to use effective therapy pressure without the belly ending up looking like a puffer fish when it gets poked. While aerophagia is normally not a huge issue there are some people who have significant distress and if they are in pain or ill from all the excess air in the bell they can't sleep well and if we don't sleep well then we don't feel so good.
Gotta get good sleep for us to feel better. The best AHI in the world doesn't mean squat if we aren't sleeping well.

[mfignewton]

Sorry i know i have a lot of questions. Who would i contact first to switch out my machine, would i contact insurance first or the DME? What would i tell them, that I want a better and full data machine?

[Pugsy]

Contact DME first. They are the suppliers.
If you contact your insurance company all you need to find out is if they pay by model or billing code because billing code is the same for full data or bricks..read this stuff below and it is all explained.

But read this first.
http://maskarrayed.wordpress.com/

and this
http://maskarrayed.wordpress.com/what-y ... me-part-i/
and this
http://maskarrayed.wordpress.com/dont-p ... -upcharge/

[diane.ingalls@yahoo.com]

I have only been on cpap for a week but when i was doing the studying the tech told me my number was at 11 and after getting up in the middle of the night and using the restroom and going back to sleep, I felt i slept great for the last couple of hours. My doctor has me on a 9 and my sleep seems to be the same i toss and turn and go from my back to my side. I have the nasal pillows and they are fine. I was wondering if i turn my machine up to an 11 will that possibly help me sleep?