Hello? Is This Thing On???

MandoJohnny · Post by **MandoJohnny** » Wed Aug 23, 2006 6:19 am

Can CPAPs lose pressure output? Or can a user just get very used to the pressure?

When I first got my CPAP, an S8 Elite, my pressure was 10 with a 15 min. ramp and the EPR was set at 3, the highest setting. I felt like a baloon being blown up and I thought, "Could I ever get used to this?" After a few weeks, though, I kind of went the other way. I felt I was not getting enough pressure and that the EPR was taking too long to switch between inhale and exhale. Also, my AHI's were around 8. So my doc had me bump the pressure up to 11 and take the EPR down to 2. My AHI's dropped into the 2-3 range immediately and I felt better also. Eventually, with the doc's concurrence, I switched off EPR and ramp altogether.

Now, my AHI's are always in the 2-3 range, my leak stats are always in the 0.2-0.3 range and my delivered pressure usually says 11.2. The mask vent is putting out a strong flow of air. I sleep like a log and I feel pretty good during the day, much different than before CPAP. The issue is that sometimes I will wake up in the middle of the night, not short of breath or anything, but I have no sensation that I am getting any air blown my way. I think, "Did I forget to turn the thing on?" But when I check it always is on and air is coming out.

My question is this: Is it possible to get so used to the pressure that you just don't notice it, or is it possible that the machine is not putting out the advertised pressure for some reason? And if the pressure had dropped, would the other stats still be good? Is it worth buying one of those pressure output gauges?

wahooker · Post by **wahooker** » Wed Aug 23, 2006 6:30 am

I am in the same situation myself.

I know at least part of it is due to my getting used to the pressure.

However.... I was titrated at a 15. Went for several months with the machine set at a 15.

I went back to the Sleep Doc for a followup visit, and they checked the machine, hooked it to a pressure gauge. (Forget the technical term for it...)

Although my machine was displaying 15, according to them the actual pressure it was putting out was 16. Thus, they backed it down to display = 14, actual pressure = 15.

So... If A machine can have a variance of pressure above what is displayed, it only seems to reason that it could have a variance below what is displayed also.

The down side is that I don't have any way to see/download data with my machine. All I can see is hours of use and compliance information. Once my new insurance kicks in next month, I'm going to see about getting a new Auto Respironics Series M. I'll get it out of pocket if I absolutely need to.

oldgearhead · Post by **oldgearhead** » Wed Aug 23, 2006 6:50 am

Mando.....,
Your breathing is just getting on the same time as the machine.
I think all of us have been curious about that same sensation.

DreamStalker · Post by **DreamStalker** » Wed Aug 23, 2006 7:40 am

[quote="MandoJohnny"]Can CPAPs lose pressure output? Or can a user just get very used to the pressure?

When I first got my CPAP, an S8 Elite, my pressure was 10 with a 15 min. ramp and the EPR was set at 3, the highest setting. I felt like a baloon being blown up and I thought, "Could I ever get used to this?" After a few weeks, though, I kind of went the other way. I felt I was not getting enough pressure and that the EPR was taking too long to switch between inhale and exhale. Also, my AHI's were around 8. So my doc had me bump the pressure up to 11 and take the EPR down to 2. My AHI's dropped into the 2-3 range immediately and I felt better also. Eventually, with the doc's concurrence, I switched off EPR and ramp altogether.

Now, my AHI's are always in the 2-3 range, my leak stats are always in the 0.2-0.3 range and my delivered pressure usually says 11.2. The mask vent is putting out a strong flow of air. I sleep like a log and I feel pretty good during the day, much different than before CPAP. The issue is that sometimes I will wake up in the middle of the night, not short of breath or anything, but I have no sensation that I am getting any air blown my way. I think, "Did I forget to turn the thing on?" But when I check it always is on and air is coming out.

My question is this: Is it possible to get so used to the pressure that you just don't notice it, or is it possible that the machine is not putting out the advertised pressure for some reason? And if the pressure had dropped, would the other stats still be good? Is it worth buying one of those pressure output gauges?

Snoozin' Bluezzz · Post by **Snoozin' Bluezzz** » Wed Aug 23, 2006 8:10 am

MandoJohnny wrote:Can CPAPs lose pressure output? Or can a user just get very used to the pressure?

I suspect that you are getting used to the pressure. It doesn't feel like anything at all to me but when I pull the interface away I certainly know that there is air blasting out at me.

I did buy a Manometer and found that my APAP is dead-on at multiple pressures and my older Remstar Pro CPAP is .5 high at multiple pressures. I have been told that the acceptable variance on xPAPs is +/- 1cm H2O.

There is a thread on here somewhere about how to make a homemade Manometer using a ruler with cm markings, plastic tubing, and a cork. It is clever and should be precise.

David

Guest · Post by **Guest** » Wed Aug 23, 2006 8:40 am

It's pretty rare for an xpap to lose much, if any, pressure over the course of just a couple years. There are always exceptions of course.

If you are curious, just contact your dme and ask if they will let you bring the unit in for a pressure check. The device is called a manometer. The most common type being a water column manometer.

There will always be exceptions, but for the most part if your unit is running well enough that the noise doesn't keep you awake, it's probably going to be highly accurate pressure-wise.

MandoJohnny · Post by **MandoJohnny** » Wed Aug 23, 2006 9:05 am

Thanks for the replies. Very helpful, I will look for that "home-made manometer" thread. That sounds interesting.

Having the DME check it is the logical answer, but you would have to know my DME to understand why that gave me laugh. My DME RT is so bad (the crowd says, "How baaaad is he?!"), I am not exaggerting here, I know exactly what he would do. I'd bet money on this. He would start the machine and hold his hand in front of the outlet and say, "It feels fine to me." If he even owns a manometer, he probably wouldn't be able to find it in his messy office. With what I've learned in nearly 5 months of CPAP and reading up about it online, I think I could do his job better than he could.

christinequilts · Post by **christinequilts** » Wed Aug 23, 2006 10:21 am

Yep- you do get use to the air blowing after a while. I think just about everyone goes through the 'it must be broke' panic the first time they can't feel the air, but a quick lift of the mask usually assures you it is still working just fine. Its kind of like a ticking clock- after a while, you don't notice the sound, but if you got a different clock, the ticking can drive you crazy at first.

Snoozin' Bluezzz · Post by **Snoozin' Bluezzz** » Wed Aug 23, 2006 11:00 am

Here is the link to the Manometer thread.

Homemade Manometer

David

TerryB · Post by **TerryB** » Wed Aug 23, 2006 11:12 am

If you pay close attentiion when you remove the mask while you feel like there is no pressure, you'll probably notice that you feel you are working some to make the first inhalation after the mask comes off. The hard work sensation disappears a lot quicker for me than the disappearance of the breathing against pressure when starting the night. I noticed this sensation on night 1 in the lab titration. I also noticed a strong scent of laundry detergent/freshener/anti static aroma after removing the filtered air supply from my nose.

TerryB

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