Why won't cpap raise the pressure?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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AMK
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Re: Why won't cpap raise the pressure?

Post by AMK » Tue Sep 12, 2017 6:46 pm

I might add that I was starting to notice a return of cognitive problems from all the apneas, including memory problems, and I am so relieved that this could be fixed. My only regret is that I didn't know to try this two years ago. But definitely better late than never!

amess

Re: Why won't cpap raise the pressure?

Post by amess » Tue Sep 12, 2017 6:48 pm

Your dr controls what the pressure should be. The unit is locked until he or a respitory therapist opens it and changes the pressure. The unit transmits data to the drs office and the insurance company. If you dont use the unit for at least 4 hrs the insurance company will not pay. How do I know all this? I learned it at my drs office and at the respitory therapists office. Big brother knows all.

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

Post by AMK » Tue Sep 12, 2017 6:50 pm

Amess is apparently a troll attempting to derail my thread and I would appreciate it if we could all just keep walking.

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

Post by Pugsy » Tue Sep 12, 2017 6:55 pm

amess wrote:Your dr controls what the pressure should be. The unit is locked until he or a respitory therapist opens it and changes the pressure. The unit transmits data to the drs office and the insurance company. If you dont use the unit for at least 4 hrs the insurance company will not pay. How do I know all this? I learned it at my drs office and at the respitory therapists office. Big brother knows all.
It's easy to unlock these machines. It is not rocket science..and we can make changes ourselves if we want to.
It transmits data to the DME and maybe the doctor but usually only when a person first gets the machine and they don't bother once any insurance compliance requirements have been met.
OP in this thread has been using this machine for over 2.5 years..long past any insurance requirements since it has been paid for in full for probably nearly 2 years now.
At this stage of things no one will be monitoring anything routinely. There is no need.

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Re: Why won't cpap raise the pressure?

Post by WearyOne » Tue Sep 12, 2017 7:00 pm

amess wrote:Your dr controls what the pressure should be. The unit is locked until he or a respitory therapist opens it and changes the pressure. The unit transmits data to the drs office and the insurance company. If you dont use the unit for at least 4 hrs the insurance company will not pay. How do I know all this? I learned it at my drs office and at the respitory therapists office. Big brother knows all.
We all can control the settings on our machines. Many of our doctors are fine with that. Mine is. Not all machines do a direct upload of data, and when they do, it's not to the insurance companies. The machine I had for many years didn't even have the capability to upload data and I only saw my sleep doc once a year. Plus there are many people who pay outright for their machines (therefore no insurance involved) or insurance has already finished paying for it. With my machine, I can take off the piece that transmits the data. In fact, to access the SD card, I have to take it off. I prefer to leave it on the rest of the time, though, since it's easier for my doctor to look at my data.

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Re: Why won't cpap raise the pressure?

Post by palerider » Tue Sep 12, 2017 10:46 pm

AMK wrote:
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!
yup, if you need higher pressures, then the 'for her' mode isn't for you.
AMK wrote: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.
Like Granny says, a 'flow limitation' in cpap parlance is a restriction on the amount of air you're able to suck in, like squeezing your nose partly shut, you can still get a full breath, it just takes more work...

An apnea is a near complete reduction in the total amount of air you're breathing in... a hypopnea is a partial reduction.

You can have severe flow limitations but still, with increased effort, maintain the same volume of air being breathed in and out.

https://www.youtube.com/watch?v=-gie2dhqP2c

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Re: Why won't cpap raise the pressure?

Post by palerider » Tue Sep 12, 2017 10:47 pm

amess wrote:Your dr controls what the pressure should be. The unit is locked until he or a respitory therapist opens it and changes the pressure. The unit transmits data to the drs office and the insurance company. If you dont use the unit for at least 4 hrs the insurance company will not pay. How do I know all this? I learned it at my drs office and at the respitory therapists office. Big brother knows all.
Your posts are full of fecal matter.

Get back under your bridge, you!

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Re: Why won't cpap raise the pressure?

Post by zoocrewphoto » Tue Sep 12, 2017 11:21 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.

Thanks for this awesome information. Since many of us do not have this machine, we wouldn't know to even suggest this. I know many of us do try to be aware of the differences in machines so that we can generalize advice or tailor it to the right machine.

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Re: Why won't cpap raise the pressure?

Post by palerider » Wed Sep 13, 2017 1:04 am

zoocrewphoto wrote:
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.
Thanks for this awesome information. Since many of us do not have this machine, we wouldn't know to even suggest this. I know many of us do try to be aware of the differences in machines so that we can generalize advice or tailor it to the right machine.
That feature is one of the things that's always mentioned about the 'for her' setting, but I think this is the first time I've actually seen evidence of it kicking in.

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Re: Why won't cpap raise the pressure?

Post by ajack » Wed Sep 13, 2017 2:14 am

The only thing I can think to add is that to remove the bacterial filter, to see if that is obstructing the unit

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

Post by AMK » Wed Sep 13, 2017 9:06 am

I had it in regular APAP mode last night. I can tell that it was different and it might take some time to get used to because I did that "waking up halfway" thing several times. In Sleepyhead the graph is much more spiky than in "for her" mode. The maximum flow limitation is about 1/3 what it typically was in "for her" mode (.94 down to .34) so the flow limitation graph looks calmer to me. I only had two centrals, so the pressure did not need to go above 11.9. I've had nights that good in terms of events before, though, so I can't draw any conclusions about my AHI just from one night. Eventually I would like to try just a straight cpap mode just as an experiment because I wouldn't mind feeling better than I do, but I will give this new setting at least a month. Within that month I will be able to see how the new setting will affect a super bad night.

I watched that link palerider and I guess my question was, why doesn't an OA always appear as a spike in the flow limitation graph? Like here, from the same night we've been discussing:
https://gyazo.com/d2c34ce39991e5e11f788d941a4eb2fa
No flow limitations there. As an aside, I can't figure out how those OA marks are placed. It looks like one long 1min 33 sec OA to me.

Thank you for all the help!

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Re: Why won't cpap raise the pressure?

Post by Pugsy » Wed Sep 13, 2017 11:55 am

AMK wrote:The maximum flow limitation is about 1/3 what it typically was in "for her" mode (.94 down to .34) so the flow limitation graph looks calmer to me.
I have noticed that as well not just with my own report but on a report with someone whose "for her" mode showed really ugly FL graphs and the regular mode wasn't nearly as ugly.
Obviously things are a little different in other areas besides just the response stuff. Reporting FLs is one of those things.

I tend to ignore the FL graph in for Her mode because I have never really had much in the way of FLs show up...confirmed with the Respironics machine which did flag FLs separately. If 2 machines tell me not much is going on and the special mode shows maybe a little more going on...I tend to rely on the results from the other 2 machines.

I don't know what to say about that OA that looks so long...obviously there was some sort of break in there for the machine to score things the way it did. As to what it might be...can't see it.

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Re: Why won't cpap raise the pressure?

Post by AMK » Wed Sep 13, 2017 12:29 pm

Not breathing for over a minute and a half unnerves me. I wonder what the longest AO is that somebody woke up from.

The way I feel today indicates to me that I had a lot of arousals last night due to the new way the machine seems to be jumping on flow limitations. I imagine I'll get used to that.

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Re: Why won't cpap raise the pressure?

Post by Pugsy » Wed Sep 13, 2017 12:34 pm

AMK wrote:The way I feel today indicates to me that I had a lot of arousals last night due to the new way the machine seems to be jumping on flow limitations. I imagine I'll get used to that.
If you can comfortably add just a little more minimum pressure (at least until you get used to the more variations in pressure) it should reduce the need for so many upwards changing.

And yes...the body/brain gets used to the same old way of doing things night after night and when you throw it a curve it will rebel until it realizes this is the new norm.
There is a lot of truth to the old "give it some time" adage.

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Re: Why won't cpap raise the pressure?

Post by AMK » Wed Sep 13, 2017 1:42 pm

xxyzx wrote: but the flags were all for OA

and the max pressure was still stuck at 14
That wasn't from last night; it was a zoom into the original graph I'd posted from last week. I am sure now that if the machine needs to go above 14 it can since I switched off the "for her."