New to CPAP - should my pressure be adjusted?

[fuzzyjon]

I have been using a CPAP for a little over a week now, and am heartened to find such a knowledgeable and supportive community. Adjusting to the machine has been tough, but I feel like I am making progress. Last night I managed to sleep 6 or 7 hours with the mask on.

The one week average AHI as reported by my CPAP is 11.0. While this is better than when with no CPAP (30, as reported by my sleep study), this still seems pretty high. Should I be talking to my doctor to get the pressure raised, or is this something that could improve with time?

Other possibly relevant info:
I am currently at 12 cm of water.
The leak index is apparently OK, according to my DME (32.9/min).
My sleep study reported only hypopneas, no apneas (central, mixed, etc.)

[harry33]

I hope someone can answer, as an older CPAP user Ive never had any interest in data.
with any nose only mask, your lips must be sealed to get CPAP benefits, mouth breathing leaves you with a dry mouth and tongue, regardless of whether a humidifier is used

[6PtStar]

You really need the software to tell much about what is going on. With your auto running in cpap mode why not set it to auto mode with a range 11 to 16 and see where the pressure goes. If you had mostly centrals a straight cpap is not going to do much for centrals. There are machines that do help with centrals but the machine you have won't help much.

Jerry

[fuzzyjon]

You really need the software to tell much about what is going on.

I have ordered EncoreViewer; hopefully it will arrive soon!

With your auto running in cpap mode why not set it to auto mode with a range 11 to 16 and see where the pressure goes. If you had mostly centrals a straight cpap is not going to do much for centrals. There are machines that do help with centrals but the machine you have won't help much.

My machine came locked in cpap mode. I only realized today that it had the ability to run in auto mode, but auto mode appears to have been disabled by my DME.

Also - I don't have problems with centrals, only obstructive hypopneas. (Sorry about the confusion, my original post didn't make that very clear).

[turbosnore]

With that AHI-level you would need an xPAP if you already didn't have it.
You should have a new titration. You can do it yourself as 6PtStar said.

[NEEDSTOSLEEP]

As a new to cpap person, where oh where did you get all that info from??????? I'm serious, no one has told me anything. I have no clue what you all are talking about or how to get the data or read it. BUT I want to.

[BeanMeScot]

My machine came locked in cpap mode. I only realized today that it had the ability to run in auto mode, but auto mode appears to have been disabled by my DME.

That can be changed...

[Wulfman]

My machine came locked in cpap mode. I only realized today that it had the ability to run in auto mode, but auto mode appears to have been disabled by my DME.

Nope. They just selected CPAP mode in the clinical setup and probably set it at your titrated/prescribed pressure. These instructions will allow you to adjust your settings.

HOWEVER.......
I strongly suggest staying in CPAP mode until you find your best pressure WITH SOFTWARE. There are too many obstacles in the beginning, such as mask leaks and mouth-breathing/leaking, that can mess up the numbers.......and running in Auto mode with a range of pressures can exacerbate those problems. Pressure changes can also disturb your sleep.


Den



Hold down the <- -> buttons while plugging in the little power cord in the back, wait for 2 beeps release buttons. Then press the + key to enter setup mode, use the <- -> buttons to move to the next field, use the -/+ keys to decrease/increase values, when set press the On/Off button to exit Setup.

Therapy Mode = CPAP/AUTO (If Auto is selected, there will be A-Flex or C-Flex options)
CPAP Pressure = NN (only appears in CPAP mode).
AutoMax = 20 cm (default)
AutoMin = 4.0cm (default)
C-Flex Setting = Off, 1, 2 or 3
Ramp Time = (0:05 to 0:45)
Ramp Start Pressure = 4.0cm (can be from 4cm to AutoMin pressure).
Mask Alert = On/Off (beeps on large leak, mask removal).
Auto Off = Off (turns off machine on large leak/mask removal) Suggest leaving it "Off"
Split Night Time = Off (options are Off, 120, 180, 240) Should be "Off"
Show AHI/Leak = On (enables logging to display) Suggest leaving it "On"
Patient Reminder = Off (days to remind you that you get a new mask w/Insurance).
returns to Therapy Mode
Pressing On/Off exits Setup



==========Resetting LCD Display Data====================

To reset LCD Therapy data (does NOT erase any data from SmartCard):

1. Hold down the (<-) (->) buttons while plugging in the power on the back,
wait for 2 beeps or 5 seconds, release buttons.
2. Press the (->) key and navigate to Therapy screen.
3. Press and HOLD down the (-) minus key for 5 seconds and/or until therapy data is reset to Zero.
4. Press the (->) key to scroll back to main menu, press (+) key to enter Setup or
On/Off button to exit.

[fuzzyjon]

As a new to cpap person, where oh where did you get all that info from??????? I'm serious, no one has told me anything. I have no clue what you all are talking about or how to get the data or read it. BUT I want to.

From reading this forum, of course! Searching back through the archives reveals a tremendous wealth of information.

HOWEVER.......
I strongly suggest staying in CPAP mode until you find your best pressure WITH SOFTWARE. There are too many obstacles in the beginning, such as mask leaks and mouth-breathing/leaking, that can mess up the numbers.......and running in Auto mode with a range of pressures can exacerbate those problems. Pressure changes can also disturb your sleep.

Wulfman and others, thanks for your grounded advice (and for posting instructions on how adjust my settings! I also found those with google, but am not yet bold enough to tinker with my settings). I will wait for my software to arrive and collect some data before making any changes.

Jon

[BeanMeScot]

If you don't want to change your pressure, you can change your machine to APAP mode with the top and bottom pressure the same and that effectively makes it still a CPAP BUT you get more data from the machine.

[DBoone]

Wulfman and others, thanks for your grounded advice (and for posting instructions on how adjust my settings! I also found those with google, but am not yet bold enough to tinker with my settings). I will wait for my software to arrive and collect some data before making any changes.

Jon

Good idea Jon. That's where I'm at right now. Going to chart the data for a week, maybe more as I have some kind of sinus thing going on right now. After I'm comfortable with steady data I'll start tinkering to see what works best. But we need a baseline before we should do that.

[fuzzyjon]

If you don't want to change your pressure, you can change your machine to APAP mode with the top and bottom pressure the same and that effectively makes it still a CPAP BUT you get more data from the machine.

Oh, interesting.

If I do the "plug it in while holding down the <- -> buttons" thing, will my existing settings and statistics be retained?

[DBoone]

If I do the "plug it in while holding down the <- -> buttons" thing, will my existing settings and statistics be retained?

Until/unless you change them.

[Wulfman]

The Auto machines will retain settings for APAP mode and CPAP mode separately. So, you could set it in Auto mode with a range (or min. and max. the same) and the CPAP settings will remain as they have been programmed.
About the only thing (report-wise) that you gain with the min and max setting the same (in APAP mode as opposed to CPAP mode) is a chart showing any flow limitations.


Den

[rested gal]

As a new to cpap person, where oh where did you get all that info from??????? I'm serious, no one has told me anything. I have no clue what you all are talking about or how to get the data or read it. BUT I want to.

Since this is the machine you have listed in your equipment:

Machine: Resmed S8 Vantage EPR Auto CPAP Machine

Try this:

Hold down the Right and Left arrow buttons at the same time, for about three seconds. That lets you go into the "Patient" menu. Then use the right/left and up/down arrow buttons to work your way through the Efficacy Results data menu.

You have to do that before 12 noon -- "data" is re-set automatically after twelve noon to be ready for the next session.

If doing the Right/Left button before noon doesn't work, it is probably because "Smart Data" has not been turned on for the patient menu. The setting to turn that on is in the Clinical setup menu.

Here are some links about how to access the clinical menu on ResMed machines:

http://www.cpap-supply.com/Articles.asp?ID=130

http://www.apneaboard.com/CPAP%20Adjustment.htm

Brenda's post:
viewtopic.php?t=22776

My post:
viewtopic.php?p=226375#226375