How many of you have changed your prescription on your own??

[skroll116]

I am new to CPAP so I'm wondering if this is something people do to get things dialed in.

I was doing OK with everything until I tried switching from the Amara View to the Dreamwear. I found I was quite the mouth breather so ordered a chin strap to go with the Dreamwear and although I liked it, I had really bad aerophagia so I switched back to the Amara FFM. Well the 3-4 nights I had on the Dreamwear has turned me more into a nose breather so even with the FFM I am getting bad aerophagia. So I took a few nights off for things to clear.

My machine is set as CPAP with a pressure of 13. I had played with patient settings before making the mask switch and as mentioned things were good, but now I can't even have the mask on for 2 hours without the uncomfortable bloat.

I had a scheduled follow-up with my Doc for last week, but had to change it and it is now booked over a month out. I felt I had to do something as I didn't want to wait over a month to get back on the machine.

So, I found out how to get into the "Therapy" setting and changed it from CPAP to APAP with an Min of 6 and a Max of 13. Tried it last night with these new settings and had a much better night with regards to the aerophagia and my 90% was 9.0.
My AHI went from an average of 6 or 7 to 2.8. I know this is only one night, but I have not seen my AHI that low since I started nearly two months ago.

Was I wrong to go in and make the changes I did without consulting my Doc? I want to get more nights under my belt with these settings, but also want to make sure I not breaking a cardinal rule.

Thanks

[MaxINTJ]

If it's not working the way it is, I doubt there is any harm in changing the settings. I think I lasted a week (maybe) before changing things.

Started on APAP at 7-12 (?) and am now on 12-17. Never changed from my Dreamwear mask though. Although I still get crappy sleep, I don't have any bad side effects from xPAP - I just don't really have any good ones either.

[grayghost4]

a better question would be : How many have NOT change the settings of there machine.

[KenM]

exactly grayghost4,
who here HASN"T changed settings

Download Sleepyhead
Read the PDF
tweak settings based on chart readings over several nights
adjust further on how you feel in the morning (still tired?)

I was prescribed 16-25 cmh2o
my machine is now set to 12-21 cmh2o
I average 14-19 cmh2o
could probably get the numbers closer but I kept the PS at 5
average AHI is 1.4

[Goofproof]

Around here the Cardinal doesn't Rule, however you do have to keep a lookout for the XPAP Police. Most of us just barricade the bedroom door, and reset our machines to what works best for, BUT, we use machines that collect full data, and use the software so we can make smarter settings.

It's more likely the bloating is from the pressure than the mask type. Also you might raise the head of your bed 4 to 6 inches. Jim

[zonker]

hi skrol116! no you are perfectly fine in making your own adjustments. some doctors don't like it, some are okay with it. in the end, it is YOUR therapy and you can and should make your own decisions on what to do.

just keep coming back to the forum if you have any questions. there are SO many knowledgeable people here, willing to help.

[chunkyfrog]

My first machine was full data, but not an auto.
I suffered for 9 months with constant pressure 3 cm higher than needed, and the bloat to go with it.
I would not wish this on (almost) anyone.

[ChicagoGranny]

By all means, control your own CPAP settings. It's best to learn how to use Sleepyhead to analyze and tweak your CPAP process.

I found out how to get into the "Therapy" setting and changed it from CPAP to APAP with an Min of 6 and a Max of 13.

You have a single-pressure machine in your equipment profile.

[kteague]

You are actually in a good position to see how your doctor is going to be about things. You have a perfect excuse - can't get in soon to see the doctor and didn't want to just quit using it so made some adjustments to hold you over till you could get into the office. Mention that your numbers and air in the belly are both better, and my guess is they will tell you to continue as you are.

[chunkyfrog]

The DME is more likely to be possessive about adjustments,
but doctors are often more willing to let stuff get delegated.
Doctor gets paid the same--DME might feel a pinch in the wallet . . .

[Pugsy]

When you get a chance you might change the machine you have chosen in your profile to avoid confusion later.
Your current choice DreamStation CPAP isn't the right choice if you have apap mode available.
The correct choice would be DreamStation Auto CPAP machine.

For the aerophagia you might also investigate your Flex exhale relief options if you aren't using it.
The higher the Flex setting the greater the exhale relief which can often help reduce the aerophagia issues.

Do you have the manual that explains about Flex and other features?
If not you can request it here.
http://www.apneaboard.com/adjust-cpap-p ... tup-manual

Aerophagia is a fairly common symptom.
wiki/index.php/Aerophagia
Sounds like you found a workable solution though. And yes, lots of people here have changed settings.

[palerider]

How many of you have changed your prescription on your own??

Technically, only your doctor can change your prescription.
Most of us, as others have said, have changed the machine settings.

Was I wrong to go in and make the changes I did without consulting my Doc?

People who take charge of their therapy and make their own adjustments based on the data and current conditions have better results.

[Okie bipap]

When I first started, I was prescribed 20 - 25 IPAP with PS of 5. After much experimenting, I have found I am doing quite well with IPAP of 12 - 20, even though it never goes over 14. Last night my AHI was less than 1. I noticed that what ever range I set my machine at, I basically stayed at the lowest setting all night. I decided to see what the machine thought I needed, and set my machine the same as my wife's machine. My pressure never exceeds 14 while hers frequently bumps against the upper limit. As soon as we have her appointment next month, I will try raising her upper limit and see how she does with it. To me, the idea of adjusting my own pressure is no different than a diabetic adjusting his insulin dose to match his sugar level which can vary greatly from day to day.

[zoocrewphoto]

I am still using my original prescription settings as they really turned out to be correct for me. I have a range of 11-17, and I spend most of the night between 11 ans 13. I will have a few spikes to that go up to 15 or so, and maybe two spikes to 17 or close.

I tend to roll back onto my side when the pressure goes up, so the spikes don't last long.

That said, I had raised my minimum when I have a cough. If I leave it at 11, and I have a coughing spasm; I feel like I am suffocating and rip the mask off, much like most people would at a pressure of 4. If I start at 13, I can have a coughing fit and continue without removing my mask. I still prefer the start of 11, so when the cough is gone, I go back to 11.

Also, back when I helped my mom test her current prescription, I let her use my machine since hers did not have data. We did a partial night at 10, her prescription, then another night, we did a partial night of 10-13. I wanted to see what it would do without it bothering my mom. I printed both reports and the doctor prescribed a new machine with the setting of 10-15.

[chunkyfrog]

I believe that in SOME clinics, overtitration is the rule.
CYA fails to consider comfort.
At the very least, we need to be able to check our ever-changing pressure needs--if only at home.