New Member back on CPAP...

[ADream]

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Hello everyone

Started back on CPAP two months ago after having been diagnosed five+ years ago(could't stand using it)....I basically slapped some sense into myself.I was experiencing intermittent full blown Panic Attacks in the middle of the night; heart racing/BP peaking at 170/115(even though I'm on a BP Med)and finally waking up feeling completely exhausted.My symptoms: feeling somewhat depressed and anxious: trouble focusing at times and being short tempered in stressful situations. Throw in weight gain of twenty five pounds. Some attributable to my Apnea? I am guessing YES.

I had an old Respironics M2 Autoflex and just picked up a Airsense 10 after reading up about it here on this site(Thanks for all the info). Finally after the first month of struggling(some nights 3-4 hours of using it then taking it off: AHI:16) I finally am getting solid nights of use and feeling much better. My new GP put me on a low dose anti-depressant/anxiety med:been on it for a month now. I also I had my first appt with a new Sleep Specialist(MD) who has ordered a sleep study since my original one is way too old; my insurance sucks(Illinicare: Ambetter from the ACA Exchange). Doctor agreed to order a home study for me after I found out the one night Sleep Center cost is billed for $6400 and my deductible is $5400: of course Ambetter will adjust the price but after several calls and finally talking to a supervisor, she said they couldn't tell me what I would owe until the procedure is billed......WONDERFUL.I know the Home study is not as comprehensive as the Lab study but I would love to hear peoples opinions if they felt the Home Study gave them enough information to help them towards successful treatment? Thanks in advance.

Here's my first night's use with my Airsense 10 attached:

[palerider]

...I finally am getting solid nights of use and feeling much better. ... Doctor agreed to order a home study for me ...I know the Home study is not as comprehensive as the Lab study but I would love to hear peoples opinions if they felt the Home Study gave them enough information to help them towards successful treatment? ....

Hi, please remove the 'mask pressure' graph. and the snore graph, make the others larger.

I'd suggest setting your pressures to a min of 6, max 20.

As it is, you're already doing good enough.

Why do you want a sleep study? You've already got a machine, and you're already getting good results.

[zonker]

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Hello everyone

welcome! if you are comfortable making changes to your machine yourself, there really isn't any need to go back to the sleep doctor. the large majority of forum members make their own adjustments.

having said that, yes, you will want to increase your lower pressure to at least 6. many people(i'm tempted to say ALL) find breathing difficult when the machine is set at a lower pressure of 4.

good luck!

[bonjour]

Agree and you do not need a Sleep Study, especially if you have financial concerns. Everything here says that you are doing well

[ADream]

Thank you so much to everyone for your help and responses.

Will correct my Graph so it's easier to read.Thx!

I will definitely change the settings: have no problem doing it myself.Have one question about EPR setting: it's currently set to 'Ramp Only': better to have it on 'Full Time'? I Read that their can be some concern for 'Central Apnea'....advice appreciated.

The sleep doctor mentioned I'll need the new study to get supplies through insurance but the more research I've done I can get hose, mask parts, filters on my own. Suppliers through MD's submit double the price and then insurance brings it 'out of pocket' back down to just about what I'd pay for purchasing it on my own, which is sometimes less; maybe someone can elaborate on this? Definitely agree: Why the hell do I need another study when I'm feeling much better and I have this wonderful community here to help.?!

I am curious how often people replace their masks and tubes? I am a daily mask,reservoir cleaner and every other day with the heated tube. Also, roughly, how often should the machine filter be replaced?

Again, can't thank everyone enough.

Have a great weekend.

[zonker]

Thank you so much to everyone for your help and responses.

Will correct my Graph so it's easier to read.Thx!

I will definitely change the settings: have no problem doing it myself.Have one question about EPR setting: it's currently set to 'Ramp Only': better to have it on 'Full Time'? I Read that their can be some concern for 'Central Apnea'....advice appreciated.
<snip>
I am curious how often people replace their masks and tubes? I am a daily mask,reservoir cleaner and every other day with the heated tube. Also, roughly, how often should the machine filter be replaced?

Again, can't thank everyone enough.
Have a great weekend.

glad to hear that you can be hands on with your machine.

as to centrals and epr, i believe that isn't the case but for a few people. but i'll let my betters come along to answer that!

you'l find that the veteran users here don't exactly adhere to a rigid schedule. they think (and i agree) that too much washing can actually cause things to wear out faster. probably the best thing you can do for you mask is to wipe it daily with unscented baby wipes. do that when you first get up to help cut down on facial oils building up.

i've already forgotten your mask, but on my P10, i can go months without washing it. when i do, i use dawn dish washing liquid. and i wash the straps whenever i feel they are getting loose. this helps tighten them up.

i've never cleaned a tube. in three years +, i haven't had to replace one.

filters? there i admit, i'm busted! by the time i think to check them, they are already well past their sell by date! but so far, i haven't gotten any infections or anything, so i'm not too worried.

and lastly, you're welcome!

[Pugsy]

I change the filter about once a month. It's really the only maintenance I do on any sort of regular basis.
The reason I change the filter is because where I live and the old farmhouse I live in...it just gets yucky looking fairly quickly. Lots of dust and stuff floating around.
Now someone living in a nice clean fairly new apartment or house in the city and not such a dusty environment may not need to change their filters very often.
So mainly it's "when it gets dirty enough to bug you".

I don't replace anything unless it gets broken for some reason. No reason to replace anything unless it doesn't function like it is supposed to. For masks...the headgear is actually the first to go for me.
I do keep a spare hose handy...and a spare mask and a spare water chamber just in case something happens...like the water chamber goes flying out of my hands and breaks...or the dog or cat decides my mask or hose is their favorite new chew toy.
Anytime I have every had a need to replace anything...it was always on a Friday night and my DME doesn't do weekend hours.
I had a heated hose with over 14 K hours on it...finally retired it because I changed models and the old hose wouldn't fit on the new machine. Currently have over 1 1/2 years on this current heated hose and I use it year round. I have never washed it. It doesn't get dirty.

As for washing stuff...I do it when I think about it and I don't think about it very often.
I tell people to do whatever gives them peace of mind about their cleaning routine.
When I first started therapy I did the weekly thing...that got old real fast...washing everything once a week. Gradually over the first 6 months I adopted the "whenever I think about it" philosophy. You get to decide whatever routine you want to adopt for whatever reason you might have.

[nobody]

I've been using the same mask, headgear and cushion for several years. I wash the cushion every night with either Dr. Bronner's soap or a fragrance free baby wipe.

I would not recommend putting the top end of your autoset to 20. You might bump it up a couple notches, but you're already getting a good result and having it too high can disrupt sleep. If it were me, I'd set it on 6-9 and see how that goes.

[palerider]

Thank you so much to everyone for your help and responses.

Will correct my Graph so it's easier to read.Thx!

I will definitely change the settings: have no problem doing it myself.Have one question about EPR setting: it's currently set to 'Ramp Only': better to have it on 'Full Time'? I Read that their can be some concern for 'Central Apnea'....advice appreciated.

A fairly small fraction of the population has issues with the extra ventilation that EPR provides (basically a limited bilevel function).

Are you in that group? who knows. Try it and see... central apneas are unfairly vilified, they're nothing to be scared of, and a few here and there are completely insignificant. If EPR makes you sleep better (and it does for many people), then use it.

The sleep doctor mentioned I'll need the new study to get supplies through insurance but the more research I've done I can get hose, mask parts, filters on my own. Suppliers through MD's submit double the price and then insurance brings it 'out of pocket' back down to just about what I'd pay for purchasing it on my own, which is sometimes less; maybe someone can elaborate on this? Definitely agree: Why the hell do I need another study when I'm feeling much better and I have this wonderful community here to help.?!

DMEs are ripoff artists. Your doctor is wrong about needing a new study to get supplies, all you need is a *prescription* to get supplies (technically, all you need one for is complete masks, mask PARTS don't need a Rx). Hoses, water tanks, filters, also non-prescription. Anybody that can write a prescription for anything can write one for cpap and supplies. (dentists, nurse practitioners, etc)

I am curious how often people replace their masks and tubes? I am a daily mask,reservoir cleaner and every other day with the heated tube.

When they wear out. The more often you clean them, the more often they wear out. I'm one of those that never cleans my hose, it doesn't get dirty. I've had it for four or five years now.

Also, roughly, how often should the machine filter be replaced?

When they're dirty. If you read the clinical manual for your machine, it says "Every six months, or as needed."

[palerider]

I would not recommend putting the top end of your autoset to 20. You might bump it up a couple notches, but you're already getting a good result and having it too high can disrupt sleep. If it were me, I'd set it on 6-9 and see how that goes.

This is bad advice for most people.

All that 'advice' is doing is possibly preventing the machine from doing it's job.

The only real reason to lower the max pressure is if one is dealing with aerophagia.

[nobody]

I would not recommend putting the top end of your autoset to 20. You might bump it up a couple notches, but you're already getting a good result and having it too high can disrupt sleep. If it were me, I'd set it on 6-9 and see how that goes.

This is bad advice for most people.

All that 'advice' is doing is possibly preventing the machine from doing it's job.

The only real reason to lower the max pressure is if one is dealing with aerophagia.

Did you look at the image posted? OP currently has an AHI of 1.24 with a range of 4 -7. There was no advice to lower the max pressure. You were the one that gave questionable advice to put it way up to 20, which is excessive given their low AHI with a max of 7. Really they don't need to change where they are at all as long as they continue to get such a good result on the pressure range they are on. They made no complaints about the 4 either. I know many have trouble breathing at that low pressure, but maybe the OP doesn't. If they want to tweak it and see if they can get an even better result, then my advice 6-9 stands. I know from experience that having a really wide range like you suggested can cause arousal problems even when there's isn't aerophagia.

[Pugsy]

I know from experience that having a really wide range like you suggested can cause arousal problems even when there's isn't aerophagia.

The range doesn't matter if the machine doesn't go anywhere near the max. It becomes a moot point.
The machine won't increase the pressure without a good reason per the algorithm.
People often blame arousals on the pressure increasing but maybe it was whatever the machine was wanting to kill with more pressure that caused the arousal and not the pressure change.

If someone never goes above 8 cm...then it doesn't matter what the maximum setting is because it simply won't go there.
Could be 10 or 20 or even 100 even the machine could go that high. Doesn't matter what the max is set at if it doesn't go there.
Now if it increases or wants to increase ....there's a reason why and maybe that reason is what is causing the arousal that the pressure gets blamed for. Pressure changes on apap machines don't happen in the blink of an eye...they take several minutes to climb up and then to go back down. Nothing sudden about it.

[nobody]

I know from experience that having a really wide range like you suggested can cause arousal problems even when there's isn't aerophagia.

The range doesn't matter if the machine doesn't go anywhere near the max. It becomes a moot point.
The machine won't increase the pressure without a good reason per the algorithm.
People often blame arousals on the pressure increasing but maybe it was whatever the machine was wanting to kill with more pressure that caused the arousal and not the pressure change.

If someone never goes above 8 cm...then it doesn't matter what the maximum setting is because it simply won't go there.
Could be 10 or 20 or even 100 even the machine could go that high. Doesn't matter what the max is set at if it doesn't go there.
Now if it increases or wants to increase ....there's a reason why and maybe that reason is what is causing the arousal that the pressure gets blamed for. Pressure changes on apap machines don't happen in the blink of an eye...they take several minutes to climb up and then to go back down. Nothing sudden about it.

When I had a wide range, I saw for myself in the Encore reports my machine increasing pressure because it thought it needed to. It's not like these machines are perfectly smart. When I found the sweet spot for mine (short range, no higher than 9.5), my AHI went down to less than 1. I still would not recommend setting a wide range. It's not like you can't change it if you still have problems. Take my advice or not. Find your own best pressure.

[palerider]

I would not recommend putting the top end of your autoset to 20. You might bump it up a couple notches, but you're already getting a good result and having it too high can disrupt sleep. If it were me, I'd set it on 6-9 and see how that goes.

This is bad advice for most people.

All that 'advice' is doing is possibly preventing the machine from doing it's job.

The only real reason to lower the max pressure is if one is dealing with aerophagia.

Did you look at the image posted? OP currently has an AHI of 1.24 with a range of 4 -7. There was no advice to lower the max pressure. You were the one that gave questionable advice to put it way up to 20, which is excessive given their low AHI with a max of 7. Really they don't need to change where they are at all as long as they continue to get such a good result on the pressure range they are on. They made no complaints about the 4 either. I know many have trouble breathing at that low pressure, but maybe the OP doesn't. If they want to tweak it and see if they can get an even better result, then my advice 6-9 stands

They spent a good part of the night smack up against the absurdly low max pressure. Absent other pressing needs, it needs to be raised.
Your "advice" is poor, and will do nothing more than delay getting the OP to an even better nights sleep.

. I know from experience that having a really wide range like you suggested can cause arousal problems even when there's isn't aerophagia.

Don't try shoving your "experience" down other people's throats, they are not you.

And, there's *absolutely* nothing wrong with a 'wide range', the issue, 90% of the time is that the minimum is too low, and/or the max is too low.

[palerider]

I know from experience that having a really wide range like you suggested can cause arousal problems even when there's isn't aerophagia.

The range doesn't matter if the machine doesn't go anywhere near the max. It becomes a moot point.
The machine won't increase the pressure without a good reason per the algorithm.
People often blame arousals on the pressure increasing but maybe it was whatever the machine was wanting to kill with more pressure that caused the arousal and not the pressure change.

If someone never goes above 8 cm...then it doesn't matter what the maximum setting is because it simply won't go there.
Could be 10 or 20 or even 100 even the machine could go that high. Doesn't matter what the max is set at if it doesn't go there.
Now if it increases or wants to increase ....there's a reason why and maybe that reason is what is causing the arousal that the pressure gets blamed for. Pressure changes on apap machines don't happen in the blink of an eye...they take several minutes to climb up and then to go back down. Nothing sudden about it.

When I had a wide range, I saw for myself in the Encore reports my machine increasing pressure because it thought it needed to. It's not like these machines are perfectly smart. When I found the sweet spot for mine (short range, no higher than 9.5), my AHI went down to less than 1. I still would not recommend setting a wide range. It's not like you can't change it if you still have problems. Take my advice or not. Find your own best pressure.

Best advice is "not" on that 'advice'.

The machines increase pressure purely because of breathing events. not just because 'it thought it needed to'.