BamaGramma's Therapy Thread (Was Can someone explain all this and make suggestions?)

[BamaGramma]

Here's my data for the last three nights of usage. I've had a couple nights when I didn't use the CPAP (one night I was nauseated, one my nose suddenly stopped up after about 30 minutes on the machine and I couldn't breathe, and I can't remember the rest). If someone can interpret these and offer advice I'd truly appreciate it since I'm getting no real feedback from the sleep clinic.

[palerider]

NO wonder you don't feel well, your pressure's to low and you're having way too many events, which disturb your sleep.

[chunkyfrog]

Your minimum pressure of 5 is too low--
The machine cannot catch up to apneas--it needs to get ahead of them.
Try raising it a couple cm at a time, and see how that works.
Your range was set by someone who does not understand how cpap works.
If it was you--you can learn.
If it was a provider, they should be unemployed.

[BamaGramma]

Thanks, folks.

The pressure was set by the provider and I'm guessing they were advised by the sleep clinic.

I'm headed now to find a DreamStation manual and figure out how to adjust the pressure. How will I know when it's right?

[Dog Slobber]

Thanks, folks.

The pressure was set by the provider and I'm guessing they were advised by the sleep clinic.

I'm headed now to find a DreamStation manual and figure out how to adjust the pressure. How will I know when it's right?

DreamStation Clinical Summary:
https://www.apneaboard.com/dreamstation ... structions

Request Manual Here:
https://www.apneaboard.com/adjust-cpap- ... tup-manual

YouTube video:
https://www.youtube.com/watch?v=DrNaoD783Po

I suggest increasing minimum pressure, but still downloading Clinical manual, and learning the complete features of your device.

As you change your setting, repost new graphs, describe how you're sleeping and other relevant details. You don't have to post graphs everyday, wait to see how changes style in. Others will guide you to optimal settings.

Stick to one topic (this one) so people can refer back to historical data.

Read other peoples therapy topics to see what has been suggested, the results and why.

[LSAT]

Only adjust one thing at a time and usually 1-2 cm at a time.

[BamaGramma]

Thanks again.

I'm beginning to worry about meeting Medicare compliance though. I only had 20 days of 4+ usage in the first 30 days of usage. And my second 30 days is up on the 17th of this month and there's no way I can get 21 days in by then. So that leaves the last 30 days for me to meet it.

I'm wondering though if I can be held to the compliance standard if the machine isn't set up right (meaning pressure is too low). And how would I go about proving that? My son uses a machine and mask identical to mine and he says he's never slept better. He can't understand why I struggle so much though now y'all have told me it's because the pressure is too low. And since pressure is very individualized I can't go by what he uses.

I'm gonna be one mad woman if I get dinged for the cost of this machine.

[Pugsy]

Post your usage hours overview graph.
Lower left corner....set the time frame for last 3 months so the image will be large enough to read easily.

You may have already met compliance requirements.
It is 70% of 30 consecutive nights but it's not broken down into strict 3 month increments based on when you started with the machine.

This graph...for 3 months...

usageoverview.JPG

[BamaGramma]

Here you go. According to this I'm 69.6% compliant to date. I was wondering "which" 30 days they use. For the first week or so I had a mask that was on a too-large frame, then I decided that mask just wasn't working at all correctly. I got a different mask about 3 weeks in and it's much better. And about 2 weeks ago the NP at the sleep clinic suggested using a mask liner and that's been a tremendous improvement. I can actually sleep on my side and not have the mask slip.

[Pugsy]

They can use the 30 nights starting with July 30...continue using it for at least 4 hours and you should make it by Aug 31.
Right now you only have 4 nights in that time frame where you were short. Try to avoid any more shortages.

There can use any consecutive 30 day period where you meet compliance...just has to be met at some time within the first 90 days.

And yes...I agree...you need more minimum pressure...probably around 7 ish minimum.
Hard to say for sure because the calendar is hiding some potentially useful statistics. Next time you post images turn the calendar off first so the statistics will show up better. No need to redo these images though.

[BamaGramma]

More charts - this time from the last three nights. Last night I upped the minimum pressure from 5 to 5.5. At one point in the night I woke up and I could feel a distinct difference in how the machine was affecting my breathing. There was more pressure directed to my nose. That's not very technical but the only way I know to explain it.

I also closed the calendar on the screen so I hope that shows the other data someone said was important.

[Pugsy]

What is your Flex setting?

Try 6 cm minimum tonight.

[BamaGramma]

What is your Flex setting?

EDITED: I found it. It's set at 3.

Uhm... no clue. Where would I find that?

I was going to bump it to 6 tonight.

Also, the hygienist at my dentist's office was let go without warning and has moved to another office where the dentist is certified in dental sleep medicine. My old dentist who retired a year ago would refer patients to her and I had lots of confidence in my old dentist. I'm going to switch to her for my routine dental work and also speak with her about the CPAP. She works with CPAP users to adjust the machine and mask for optimal comfort and benefit, and Lord knows I need that since the sleep clinic and DME haven't helped me.

[Pugsy]

Flex is a setting you should be seeing when in the clinical setup menu area where you change the pressure.
On the older Respironics machines it was down just a little bit from the pressure selections.

[BamaGramma]

Flex is a setting you should be seeing when in the clinical setup menu area where you change the pressure.
On the older Respironics machines it was down just a little bit from the pressure selections.

The Flex is set at 3.