Why won't cpap raise the pressure?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
AMESS

Re: Why won't cpap raise the pressure?

Post by AMESS » Tue Sep 12, 2017 2:54 pm

Talk to your doc. He has control of pressure on your machine and only he can raise it. This machine sends data to the insurance company and dr. Everybody knows whats going on.

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AMK
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Re: Why won't cpap raise the pressure?

Post by AMK » Tue Sep 12, 2017 2:58 pm

Thanks, AMESS. I am familiar with the clinician settings and have made adjustments in the past. Trust me when I say nobody cares.

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WearyOne
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Re: Why won't cpap raise the pressure?

Post by WearyOne » Tue Sep 12, 2017 3:09 pm

AMESS wrote:Talk to your doc. He has control of pressure on your machine and only he can raise it. This machine sends data to the insurance company and dr. Everybody knows whats going on.
Actually, we all have the ability to change the pressure on our machines. And I can take the modem thing off the back of mine and it doesn't send anything anywhere. (My old machine didn't even have the capability to send data anywhere.) I leave it on, though, because it's easier for my doc when I do see him once a year. And I don't believe the insurance company has access to the actual uploads, just the DME provider (maybe?) and physician. My sleep doc is fine with me changing my settings any way I feel is beneficial because I have the reports to back up it up.

AMK, I sure hope you get this figured out soon. It's really weird!

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kteague
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Re: Why won't cpap raise the pressure?

Post by kteague » Tue Sep 12, 2017 3:20 pm

AMK wrote: The last time I saw my sleep nurse, last December, I asked her about this, because I am worried that there is something wrong with the machine, and she simply announced that it was obviously Sleepyhead misreporting the data. I asked the DME and she linked to the wireless connection and said it was fine.
(emphasis mine)
Just for future reference, the best way to pin down discrepancies between what we're seeing and what the provider says is to ask them for physical copy of the report they are basing their determination on. If your sleep nurse thought it was obvious Sleepyhead was the issue, what data made that obvious? And what does "it was fine" even mean? Maybe Sleepyhead is the issue. And maybe your machine is fine. But after years of dealing with disjointed communications and little resolution, I've come to value seeing everything in black and white. It's too easy for them to blither-blather with no concrete basis. Sorry I'm no help in finding your answers, but good luck with things.

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Guest

Re: Why won't cpap raise the pressure?

Post by Guest » Tue Sep 12, 2017 3:28 pm

just a thought here:
you do change your filters? (double check them - also that they do fit correctly)

how old is your machine? the machines are reporting the actual pressure - not the pressure they are trying to apply. maybe the blower just got dirty and is no longer capable of applying the needed pressure?

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AMK
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Re: Why won't cpap raise the pressure?

Post by AMK » Tue Sep 12, 2017 4:32 pm

Kteague, yes, if this reboot/factory default routine doesn't work, then I will print out all relevant data. Not sure who I will show it to since my sleep nurse really does not care. I know from experience that if she can't pin it on Sleepyhead then she'll pin it triumphantly on my weight. Problem is I was 17 pounds lighter when I got this bad hour. Wonder what she'll pull out of her ass to blame now.

Guest, my machine is 2.5 years old. I change the filter monthly. I found that I do not like the special "hypoallergenic" filters. They leave an odd smell in my nose that lasts the whole day, almost like wet wood. I prefer the default Resmed air filters. Though I change them monthly no matter what, they never look dirty when I take them out. The machine itself looks clean when I peer into it. I keep my mask/humidifier/etc clean. I checked my sleepyhead data and this problem goes back to when the machine was new. But back then I would only get maybe ten bad minutes, and I was fiddling a lot with the settings. I never saw a full bad hour like this before. I haven't changed my settings in a long time. A year maybe?

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palerider
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Re: Why won't cpap raise the pressure?

Post by palerider » Tue Sep 12, 2017 4:45 pm

I'm a little surprised nobody has caught this... from the manual:

AutoSet for Her Mode:
Treats apneas up to 12 cm H 2 O and continues to respond to flow limitation and snore up to 20 cm H2O.

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palerider
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Re: Why won't cpap raise the pressure?

Post by palerider » Tue Sep 12, 2017 4:46 pm

Gryphon wrote:one side note - it may be nothing but, Are you using a inline bacteria filter?
If they get really dirty they can lower the delivered pressure to the mask - which would cause apnea to not be treated properly and grow worse. With the built up pressure on the other side it and the filter acting as a muffle could interfere with the machines ability to detect events and compensate.

Just a thought. If your not using such a filter then continue with the other posters advice and keep checking. Very odd.

Best of luck!

Gryphon
That wouldn't change what the target pressure at the machine is.

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palerider
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Re: Why won't cpap raise the pressure?

Post by palerider » Tue Sep 12, 2017 4:47 pm

AMESS wrote:Talk to your doc. He has control of pressure on your machine and only he can raise it. This machine sends data to the insurance company and dr. Everybody knows whats going on.
Take this kinda noise out and don't peddle it here.

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ChicagoGranny
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Re: Why won't cpap raise the pressure?

Post by ChicagoGranny » Tue Sep 12, 2017 4:58 pm

AMESS wrote:Talk to your doc. He has control of pressure on your machine and only he can raise it. This machine sends data to the insurance company and dr. Everybody knows whats going on.
You don't have a clue. My insurance company has no idea what settings I am using. My sleep doctor asks me at my annual visit what pressures I am using and what changes I made during the year. My sleep doctor is fully supportive of me managing my own therapy and my own machine settings.

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AMK
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Re: Why won't cpap raise the pressure?

Post by AMK » Tue Sep 12, 2017 5:35 pm

palerider wrote: I'm a little surprised nobody has caught this... from the manual:

AutoSet for Her Mode:
Treats apneas up to 12 cm H 2 O and continues to respond to flow limitation and snore up to 20 cm H2O.
Oh hey thanks! This is an interesting tidbit! So does this mean that this is the wrong machine for me? Or wait, I can set it on the regular AutoSet mode. Huh!

I'm not totally clear on why I had apneas with no flow limitations. I thought an apnea was by definition a flow limitation, other than centrals of course.

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ChicagoGranny
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Re: Why won't cpap raise the pressure?

Post by ChicagoGranny » Tue Sep 12, 2017 6:17 pm

AMK wrote: I thought an apnea was by definition a flow limitation, other than centrals of course.
In the context of CPAP machine algorithms, flow limitations are flattening of the inspiratory flow contours. (Apneas are total stoppage for at least ten seconds.)

Example of flow limitations:

Image

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Pugsy
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Re: Why won't cpap raise the pressure?

Post by Pugsy » Tue Sep 12, 2017 6:35 pm

palerider wrote:I'm a little surprised nobody has caught this... from the manual:

AutoSet for Her Mode:
Ahhh...crap. I didn't even look at the second image...so I totally missed that.

The for her algorithm is different and likely explains the problem.

So...switch it back to the regular apap mode tonight and let's see what happens. I am betting it will respond as expected.

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Re: Why won't cpap raise the pressure?

Post by jagzoo » Tue Sep 12, 2017 6:35 pm

I noticed this "problem" with the Res Med for Her algoithim. My pressure wouldn't rise above 12 even with a run of OAs. I solved the issue by switching over to the "regular" APAP setting and now the machine responds to any run of OAs with whatever pressure is needed to halt the run. No more issues. I am assuming your machine is set on the For Her setting. If so, turn it off. Easy Fix, it's just set on the incorrect algorithm setting for this issue.

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AMK
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Re: Why won't cpap raise the pressure?

Post by AMK » Tue Sep 12, 2017 6:42 pm

You guys rock...it might take me a while to have another bad night to see if this works, but I'm excited about turning off "for her." In 2.5 years this never occurred to me or any of the "professionals." I returned all other settings to what I had before so that this is the only variable that I'm changing.