Afraid to ask, but ...

[ziggytosh]

Ok, so I am a CPAP NOOB and I've already been given something of a talking-to on another forum where I suggested the possibility of adjusting my own pressure. I understand that this makes me a bad person and that, in all likelihood, I will spend eternity in Hell (not to mention the fact that I will get there faster when I ramp up the volume to 11 and my cranium goes pop ... ). You are welcome to remind me of my moral failings.

But anyway, I'd like to do some self-experimentation, and I'm wondering if anyone can give me some advice on how to do this as responsibly and effectively as possible. I'm the type of guy who likes to know what is going on in my own treatment and to manage it myself where I can. I've spent a lot of time living overseas, in places where medicine is still pretty 19th-century. I'm going to continue doing that for my career and I think I'm better off being as self-reliant as possible. So without further ado:

I picked up a ResMed Elite II about a week ago. It was titrated at 7 cm. I didn't have any trouble at all sleeping with it -- in fact, I really enjoy the easy rush of air into the lungs. But at the same time, it doesn't seem that it's as effective as I'd hoped.

On average, I'm getting an AHI of about 10-12 each night. Usually, the AI component of that is right around 1. So that means my hypopneas are still around 10.

I want to increase the pressure to see if I can reduce the hypopneas, but I'm not sure how to go about it. In what increments should I increase it? How much time should I stay at a given level before I can be sure I'm getting a good picture of how I respond to that particular pressure? If I raise it to, say, 9, and the first night shows no change, should I go right to 10 the next night, or should I wait a few days and see what happens?

Any advice would be greatly appreciated!! Thanks

[Babette]

First off, I'm glad the Nazis steered you over here to The Free World.

Second, the "accepted wisdom" on this board is to change ONE THING ONLY, and leave that setting for a week. Then tweak ONE MORE THING, leave it for a week.

Yeah, I'm ADD and that doesn't always work for me.

I do recommend you not change too many things all at once, or you'll never pinpoint what the problem or solution might be.

Damned glad to have you here, keep posting!

Cheers,
B.

[deerslayer]

Welcome ziggytosh ! i like your logic,you've come to the right place. whatever you do-take baby steps when adjusting your machine and keep settings for several days before changing . here's a link that may help you http://www.cpap-supply.com/Articles.asp?ID=130 be sure to check the yellow light bulb at the top of the page here for the knowledge base info. good hunting ! tim

[stacia123]

Hi ziggy, looks like you and I left that other board at the same time! Good luck with your settings, I hope you find something that works for you.

[ziggytosh]

Oh wow. I can already see I made the right move. This place is great. I'm going to go ahead and add an avatar and remove that other place from my bookmarks. Thanks!

So I guess my next question is, how optimistic should I be? Is it common for those AHI numbers to be a little stubborn coming down at first? Is it likely that a few increases of pressure and some patience will do the trick? I sure do like the idea of a good night's sleep.

And thanks again for the warm welcome. Someone needs to fix Google so it sends the noobies here first.

[Wulfman]

I understand that this makes me a bad person and that, in all likelihood, I will spend eternity in Hell....

Welcome to "Heaven", ziggytosh and stacia123.

You'll find more of a focus on user education and taking control of one's own therapy on this forum.

Den

[hobbs]

They left S8 programing info up for three full days before censoring the posts.

[bdp522]

Patience first, pressure changes may be needed later! Give it a few weeks. As your body adjusts to all of this your AHI may improve. Be sure you have as few leaks as possible. Be sure to practice good sleep hygiene. Get the software and card reader for your machine so you can see just what's going on. Be sure to post any questions so we can help you.

Brenda

[sleepycarol]

Hi and Welcome to the Forum!!

A free world it is and we are a great group of hoseheads that believe in freedom!!

Ask questions, vent, cry, laugh, share success and know that we are family here.

[Craig-Tx]

One thing I would recommend... If you had a sleep study titration done (Where they put a mask on you and determine the pressure that *should* work for you), I would ask your sleep dr for a copy of the FULL report. Should be several pages of data. (Mine was about 5 or 6).

With that in hand, I would study every aspect of it before adjusting your pressure. Determine what pressures they had you at, and specifically how your body reacted. One critical thing to look at would be CA (Central Apneas). If your sleep study showed many centrals, I might be hesitant to change your pressure drastically. If on the other hand, you might find that they titrated you up to a pressure of 10, you slept great at 10, and someone screwed up and prescribed 7. You never know.

I would also second the recommendation to get the software and card reader for your machine. Looking at nightly averages is helpful, but until you can see the details over the full night, you don't have a full picture as to what is going on.

Good luck, and don't worry when a user know as thedean (aka Guest) adds his standard comment about not changing your pressure until you talk to your Dr.

-craig

[Goofproof]

welcome, you have meant some, now for me! The facts are Resmed tends to score HI's too high. I wouldn't be as concerned with them. Try to get you OA's down as low as possible. Keep leak rates as low as possible especially for Nasal masks.

Any changes need to be made in small steps, allow at least 4 days data, before making any other changes, unless it's a Train Wreck! It's easy to chase perfection and run off the Cliff. Getting the software and reader are important in making your treatment work. Also you have to add how you feel into the equation. It sometimes take time to feel better even when you get it right. Jim

[2girlsmom]

I think I know who are are and which forum you are speaking of. I found that one first and they were a huge help in supporting me with starting therapy a year ago. But I know what you mean. Talk of changing pressure there is not liked.

I remember your post I think, and I was very confused as to why the dr even Rx'd you 7 cm. I think you said you went up to 11cm at the study. I don't think it would hurt to inch it up a bit as long as leak rates are good. You might be able to get your leak rates even lower--I seem to remember us talking about that too. We have the same exact setup with our equipment so I think I am remembering your post correctly.

Keep posting here, it's a great place and people here are way more accepting of changing things on the machine. They will even tell you how to here.

I changed my pressure and I'm just going to log #'s until I see my sleep dr. She had my data downloaded already so I might as well "play" and learn what I can before seeing her. I'm trying to make a case for an APAP myself.

[Songbird]

Oh, boy, Ziggytosh and Stacia, have you ever found the right place! You are very welcome here. I've been hanging out here for three months and continue to be amazed at the knowledge level AND overwhelming generosity of the members. And it seems that the ones who have been here the longest (and therefore, one would think, would be sick and tired of saying the same things over and over for we noobs) are the most generous and the happiest to help in whatever way is needed. If this forum had a theme, it would be "I'm the one who has this condition, so I must and will be actively involved in my therapy."

Many others are more knowledgable about the nuts and bolts, and some have already posted here. Let me encourage you with this... I was titrated at 9 cm h20, but my AHI kept jumping all over the place; sometimes down to 2.7, sometimes as high as 18. After studying (and I do mean studying) many posts here and having some conversations, I gradually moved my pressure up by 1 cm at a time, with 4 to 7 days in-between. I'm now consistently getting an AHI of below 1 -- usually 0.3 or so -- and I even had two nights in a row at 0.0. It took time. It was worth it. And my cranium didn't even pop!!

As others have already said, don't be afraid to ask any question here. Also, there's a wealth of information in the Our Wisdom section (yellow lightbulb @ the top). I'd suggest going there, then right down to the bottom and selecting Expand All to get an idea of the articles that have been stored.

Again, welcome!
Marsha

[Snoredog]

On that machine;

1. Make sure your leak is under acceptable levels for your mask type and pressure used. Flow chart comes
with all masks, so just find your pressure determine the leak you are supposed to have for that pressure, then
compare to what the machine displays. Machine displays leak in Liters per second, chart that comes with
the mask plots it in Liters per minutes, so take the value from the machine and divide by 60 and compare to chart.

2. Observe your AI and HI individually, as you know the SUM of both make up AHI.
3. You have to get AI down first before you can do anything with HI, so ignore HI until
you get it down to 1 (some report they can get it down to .8, .6, etc.) then observe HI. If HI is at 10,
bump pressure by .2 to .5 cm until it gets down below 5 and you are done.

Note: On the AutoSet models you have to manually titrate once you get to 10 cm as AutoSet doesn't
respond to apnea >10 cm, only responds to snore and flow limitation. This is by design so AutoSet
doesn't cause centrals.

[jules]

we accept all refuges wanting political asylum from that other place - you have found a haven with little if any censorship and you are free to discuss leaks, pressure changes and more without asking your doctor to do it for you