Newbie with questions on bloating and data monitoring

[BigWood]

Hello all! This is my first post, so I should introduce myself. My name is Anthony, and I just found this site yesterday...wished I found it several months ago! Lots of info here, and it seems to be an active community.

Brief history of my time with CPAP. Last September, I was diagnosed with what I was told was an emergency case of OSA per my sleep test (O2 saturation was as low as 58% and as many as 120 apnea episodes per hour). Needless to say, I was given a CPAP machine a few days after the sleep test. My prescribed pressure is 15, and I think this has caused the bloating/excess gas issues I've had since day 1 with CPAP. On top of that, I gained 20 lbs within the first 2 weeks of CPAP therapy even though my diet and exercise did not change (and I have been unable to lose it, of course). My sleep center has tried adjusting several things and finally provided a loaner CPAP machine with C-Flex. It seemed to help (not cure), so they have given me a PR System One REMstar Plus with C-Flex. I used the machine for the first time last night, and had great results with feeling better during the day due to fewer awakenings from the quieter machine. However, the bloating is worse today and almost to the painful point.

I've obtained Encore Pro 2.2, and I want to analyze my data to see if I could get any clues from it. The data pulls in, but I don't see any ability to view the waveforms, and I am wondering if this machine provides that amount of detail in comparison to the APAP versions. Does anyone know if the PR System One REMstar Plus with C-Flex has that detailed data logging capability? If so, how do I get it to show on Encore Pro?

Also, does anyone know if an APAP machine would help with the bloating/excessive gas? If so, does anyone have a suggestion on how to convince my sleep center to prescribe one to me (my very nice technician had to get approval for my current machine)? My insurance (Kaiser Permanente) pays 100% for the machine, but not sure how much, if any, they would pay for the APAP version. I'm guessing most here would say an APAP is worth it over my current machine with C-Flex.

Thanks for your help!
Anthony

[ozij]

I've obtained Encore Pro 2.2, and I want to analyze my data to see if I could get any clues from it. The data pulls in, but I don't see any ability to view the waveforms, and I am wondering if this machine provides that amount of detail in comparison to the APAP versions. Does anyone know if the PR System One REMstar Plus with C-Flex has that detailed data logging capability? If so, how do I get it to show on Encore Pro?

The "Plus" does not log breathing events. It only logs hours in which the mask was connected to your face.

Also, does anyone know if an APAP machine would help with the bloating/excessive gas? If so, does anyone have a suggestion on how to convince my sleep center to prescribe one to me (my very nice technician had to get approval for my current machine)? My insurance (Kaiser Permanente) pays 100% for the machine, but not sure how much, if any, they would pay for the APAP version. I'm guessing most here would say an APAP is worth it over my current machine with C-Flex.

An automatic machine machine may help, and, at the pressure you have, so may a bi-level. This is where you start complaining incessantly to your doctor that you cannot tolerate therapy at a fixed pressure of 15. Intolerance makes you eligible for a more sophisiticated machine.

American Academy of Sleep Medicine: Clinical Guidelines:
http://www.aasmnet.org/ClinicalGuidelines.aspx
http://www.aasmnet.org/Resources/Clinic ... Adults.pdf

BPAP, pressure relief, or APAP can be considered in the
management of OSA in CPAP-intolerant patients (Consensus).
While the literature mainly supports CPAP therapy, BPAP is an
optional therapy in some cases where high pressure is needed
and the patient experiences difficulty exhaling against a fixed
pressure or coexisting central hypoventilation is present (Guideline).
18,20 Pressure waveform modification technologies (such
as pressure relief) may improve patient comfort and adherence
with PAP (Consensus).19 Certain APAP devices may be initiated
and used in the self-adjusting mode for unattended treatment of
patients with moderate to severe OSA without significant comorbidities
(CHF, COPD, central sleep apnea syndromes, or
hypoventilation syndromes) (Option).

Note that the first senetence is a consensus position.

[cflame1]

and if you go to a BiPAP... don't let them try to give you a PLUS of that either.

It doesn't have any data other than compliance.

[KatieW]

I agree with the others, that a different xpap may work better for you. Continue to discuss with your respiratory tech. If you get a apap, it can be set in both cpap and apap mode. While others have found apap worked better for them, I found that cpap is better (less gas). Data capable is essential, I think.

Meanwhile, some things that helped me with gas: eating a light and non-spicey dinner, no food 3 hours before bed, OTC Gas-X capsules, liquid Maalox, sleeping with upper body elevated.

Also, this position helps to relieve gas:

http://www.the-yoga-place.com/kneestochest.html

If you do a search on aerophagia, you will find lots of discussions.

[BigWood]

Thanks, everyone. I'm going to give it the weekend to see if the bloating gets any better. If it is no better, then I'll try my luck with the tech to see if I can get an APAP or BiPAP. I think the loaner C-Flex machine they gave me must have been out of calibration and didn't provide the full therapy pressure because I feel much better (except for the bloating) with this new machine...which may explain why the bloating/excessive gas was not as bad while on the loaner.

With regards to the data reporting, this is no more than a tease! I thought I had gotten something cool to monitor my therapy, but it was no more than a compliance logger. Oh well...

Anthony

[LaCansada]

I was also given the REMStar Plus w/C-flex and my DME has agreed to swap it out with the REMStar Pro next week. There is NO data capability here with the Plus, despite the fact that they told me otherwise when the sleep center sold it to me (well, ok, sold it to my insurance company). I have found that I get less bloating and gas pain with a full face mask than with a nasal mask or nasal pillows. Now maybe I'm getting less pressure as well. I hope not, but I am not sure. So you may want to adjust your mask as well if you are using a nasal, especially the nasal pillows. I had a lot of gas with these. Best of luck to you.