New settings for auto cpap

[palerider]

Thanks for all the info I really appreciate it! To be clear I had a sleep study at a clinic with all the wires and hoses, then they called me and said they had sent my prescription to a local medical equipment supply, the prescription was from a doc I’ve never met, not the one I saw first. I don’t want to deal with the local local supply store racquet, so asked for a copy of my prescription and they emailed it to me, I’m going to buy the machine online and just want to set it up the way a therapist would to the prescription and get started. I will be using a full mask and live at 4500 feet

Out of curiosity, was the sleep study done at the same elevation where you live? That might affect the settings that the machine needs to be set too.

No. All data-capable machines have automatic altitude compensation (and have for quite a few years)

However, there have been more than a few people who reported that their apnea was *different* at different altitudes.

[Wulfman...]

Thanks for all the info I really appreciate it! To be clear I had a sleep study at a clinic with all the wires and hoses, then they called me and said they had sent my prescription to a local medical equipment supply, the prescription was from a doc I’ve never met, not the one I saw first. I don’t want to deal with the local local supply store racquet, so asked for a copy of my prescription and they emailed it to me, I’m going to buy the machine online and just want to set it up the way a therapist would to the prescription and get started. I will be using a full mask and live at 4500 feet

Out of curiosity, was the sleep study done at the same elevation where you live? That might affect the settings that the machine needs to be set too.

No. All data-capable machines have automatic altitude compensation (and have for quite a few years)

However, there have been more than a few people who reported that their apnea was *different* at different altitudes.

Yeah, I know, I've read them, too.
Doesn't necessarily have anything to do with "altitude". Different beds, pillows, eating different foods can make a huge difference when you're away from home or in different surroundings.
We were back in eastern Nebraska for about two weeks last month (to celebrate my father's 100th birthday) and even taking my water-based pillow with me, I had some (mostly) lousy nights of therapy. That was at an altitude of almost 5500 feet lower, too. Mostly it was the bed we slept in. Couldn't wait to get back home to my own.


Den

.

[palerider]

Thanks for all the info I really appreciate it! To be clear I had a sleep study at a clinic with all the wires and hoses, then they called me and said they had sent my prescription to a local medical equipment supply, the prescription was from a doc I’ve never met, not the one I saw first. I don’t want to deal with the local local supply store racquet, so asked for a copy of my prescription and they emailed it to me, I’m going to buy the machine online and just want to set it up the way a therapist would to the prescription and get started. I will be using a full mask and live at 4500 feet

Out of curiosity, was the sleep study done at the same elevation where you live? That might affect the settings that the machine needs to be set too.

No. All data-capable machines have automatic altitude compensation (and have for quite a few years)

However, there have been more than a few people who reported that their apnea was *different* at different altitudes.

Yeah, I know, I've read them, too.
Doesn't necessarily have anything to do with "altitude". Different beds, pillows, eating different foods can make a huge difference when you're away from home or in different surroundings.
We were back in eastern Nebraska for about two weeks last month (to celebrate my father's 100th birthday) and even taking my water-based pillow with me, I had some (mostly) lousy nights of therapy. That was at an altitude of almost 5500 feet lower, too. Mostly it was the bed we slept in. Couldn't wait to get back home to my own.


Den

.

The *point* is that peoples apnea can be different, and the machine, if it's not auto adjusting may need different settings to continue effective treatment. Not because the machine itself won't deliver the correct pressure because it delivers it's pressure in relation to prevailing ambient conditions, which you alluded to, but because the patients needs may be different

[Wulfman...]

Out of curiosity, was the sleep study done at the same elevation where you live? That might affect the settings that the machine needs to be set too.

No. All data-capable machines have automatic altitude compensation (and have for quite a few years)

However, there have been more than a few people who reported that their apnea was *different* at different altitudes.

Yeah, I know, I've read them, too.
Doesn't necessarily have anything to do with "altitude". Different beds, pillows, eating different foods can make a huge difference when you're away from home or in different surroundings.
We were back in eastern Nebraska for about two weeks last month (to celebrate my father's 100th birthday) and even taking my water-based pillow with me, I had some (mostly) lousy nights of therapy. That was at an altitude of almost 5500 feet lower, too. Mostly it was the bed we slept in. Couldn't wait to get back home to my own.


Den

.

The *point* is that peoples apnea can be different, and the machine, if it's not auto adjusting may need different settings to continue effective treatment. Not because the machine itself won't deliver the correct pressure because it delivers it's pressure in relation to prevailing ambient conditions, which you alluded to, but because the patients needs may be different

Just having an APAP/Auto doesn't guarantee better/effective treatment. I occasionally use some of my APAPs with ranges of pressure......and I've had some of my worst therapy with them......even with having the top pressure open to 20. I don't have enough or the precursor events to drive up the pressures and the hypopneas and apneas happen regardless. I will frequently end up with AHIs of over 5.0 and even over 10.0........I think 14 and 22 were my highest numbers.

At least if I have a "constant" (fixed pressure) in my therapy, I know what other factors to look for.


Den

.

[palerider]

Just having an APAP/Auto doesn't guarantee better/effective treatment. I occasionally use some of my APAPs with ranges of pressure......and I've had some of my worst therapy with them......even with having the top pressure open to 20. I don't have enough or the precursor events to drive up the pressures and the hypopneas and apneas happen regardless. I will frequently end up with AHIs of over 5.0 and even over 10.0........I think 14 and 22 were my highest numbers.

At least if I have a "constant" (fixed pressure) in my therapy, I know what other factors to look for.

It doesn't surprise me at all that your apaps are not set up properly


But, that's not the issue.

[Muse-Inc]

...minimum and maximum, I’m not sure where they should be set with a prescription of 13

Welcome aboard!
If I were you, I would set 10 to 17, then review my numbers over the next several days. Get OSCAR installed and post graphs to get help tweaking settings.

My 2007 sleep study said 11 was ideal for me and I used a data-less brick for almost 18 months, then developed rib pains and got educated here. Doc loaned me an APAP and recording oximeter over a holiday weekend and wow, the difference in how I felt was huge ! We fought to get me an APAP on my insurance and lost, so I ended up buying an APAP and with his help set the range to 8 to 16 with exhale relief of 2. Help/suggestions here got me into the RespCare Hybrid FFM (I was now a mouth breather) and tweaked range to 9.8 to 16 yielding annual AHI of 0.1 for at least 8 years. My average overnight pressure ranges between 12 and 14 depending on pollen I have lost 55#s (got lots more to go), and find my average pressure is higher now, so thinking I will increase the maximum.

[bajeiceman]

[/quote]
No. All data-capable machines have automatic altitude compensation (and have for quite a few years).
[/quote]

I wasn't aware. Will do some checking.

[babydinosnoreless]

Thanks for all the info I really appreciate it! To be clear I had a sleep study at a clinic with all the wires and hoses, then they called me and said they had sent my prescription to a local medical equipment supply, the prescription was from a doc I’ve never met, not the one I saw first. I don’t want to deal with the local local supply store racquet, so asked for a copy of my prescription and they emailed it to me, I’m going to buy the machine online and just want to set it up the way a therapist would to the prescription and get started. I will be using a full mask and live at 4500 feet

Out of curiosity, was the sleep study done at the same elevation where you live? That might affect the settings that the machine needs to be set too.

No. All data-capable machines have automatic altitude compensation (and have for quite a few years).


Den

.

I had my sleep study at 5000+ feet. I got my machine where I now live at 1200 feet. It most definitely makes a difference. My prescription was for 18/23 that pressure almost made me quit. 2 weeks later and daily calls from me, the DME tech finally switched it to 8-24 and I was still all over the place. Thats when I found this forum. Pugsy and Palerider and many others were able to help me get it dialed in correctly. Now 10.6 min I have a nice low ahi of under 1 a night.

So my point is, in theory the machine does compensate for elevation but it compensates if you are using your machine and you take it up and down in elevation, not if you are having a sleep study done one night in one place with one machine and then actually living with it another night another place and a different machine.

I would also like to mention, I've had two visits with my doctor since I got the machine and started to do my own adjusting on pressures. He gets a summary of my compliance and ahi,
he had no idea IMO that I had changed my own pressures or if he knew he didn't care. He said your 100% compliant good job see you next year.

There are no cpap police that come and get you. If you don't use insurance, no-one is monitoring you. It is just like if you get a prescription for pills. They can tell you how much and how often they want you to take it but if you throw away their advice and half the bottle of pills thats on you not them. Any doctor that had a problem with me adjusting my own machine would soon find themselves fired. I don't deal well with stupid people and I am not afraid to fire my doctor.

[zoocrewphoto]

Ihad a split night study, so only 5.5 hours with the cpap machine. They found that 11 did pretty well, but I barely had any REM sleep during that time, so they recommended a range of 11-17 to cover the REM. I started with that, and in my case, the recomendations worked well for me. I tend to have a few short spikes above 13. Most nights, it doesn't go higher than 15. The highest I have ever seen is a 16.9. I think I had less than 5 nights with an ahi in the 3-6 range. Over 2 is rare. And most nights are 1.2 or less.


The idea is to have a fairly boring graph with your pressure with most events prevented by the minumum pressure. Otherwise, events sneakby as the machine works to prevent them. If you have short needs for higher pressure such as REM and/or sleeping on your back; then you want a range that will allow the pressure to handle those times.

[Wulfman...]

Thanks for all the info I really appreciate it! To be clear I had a sleep study at a clinic with all the wires and hoses, then they called me and said they had sent my prescription to a local medical equipment supply, the prescription was from a doc I’ve never met, not the one I saw first. I don’t want to deal with the local local supply store racquet, so asked for a copy of my prescription and they emailed it to me, I’m going to buy the machine online and just want to set it up the way a therapist would to the prescription and get started. I will be using a full mask and live at 4500 feet

Out of curiosity, was the sleep study done at the same elevation where you live? That might affect the settings that the machine needs to be set too.

No. All data-capable machines have automatic altitude compensation (and have for quite a few years).


Den

.

I had my sleep study at 5000+ feet. I got my machine where I now live at 1200 feet. It most definitely makes a difference. My prescription was for 18/23 that pressure almost made me quit. 2 weeks later and daily calls from me, the DME tech finally switched it to 8-24 and I was still all over the place. Thats when I found this forum. Pugsy and Palerider and many others were able to help me get it dialed in correctly. Now 10.6 min I have a nice low ahi of under 1 a night.

So my point is, in theory the machine does compensate for elevation but it compensates if you are using your machine and you take it up and down in elevation, not if you are having a sleep study done one night in one place with one machine and then actually living with it another night another place and a different machine.

I would also like to mention, I've had two visits with my doctor since I got the machine and started to do my own adjusting on pressures. He gets a summary of my compliance and ahi,
he had no idea IMO that I had changed my own pressures or if he knew he didn't care. He said your 100% compliant good job see you next year.

There are no cpap police that come and get you. If you don't use insurance, no-one is monitoring you. It is just like if you get a prescription for pills. They can tell you how much and how often they want you to take it but if you throw away their advice and half the bottle of pills thats on you not them. Any doctor that had a problem with me adjusting my own machine would soon find themselves fired. I don't deal well with stupid people and I am not afraid to fire my doctor.

The thing to remember about ANY in-lab sleep study is that it's a short period of one night in typically unfamiliar surroundings and conditions. Altitude may or may not be a factor. The important thing is for the user to have a fully data-capable machine and use software to monitor and tweak their therapy settings for optimal results. Straight-pressure settings may not work for everyone and neither may ranges of settings. Each user needs to figure out for themselves what does work. Likewise, advice from members of forums may or may not help you figure it out.......so, sort through the advice and see what works for YOU.
As I said in a post on page 1, I TRIED my prescribed settings for about an hour and promptly changed them to something better (tolerable) for me. I was upfront with my doctor and told him of my changes and made it clear in no uncertain terms that I was taking control of my own therapy. I also did not rely on insurance or a brick & mortar DME either. My insurance did reimburse me 80% for my initial equipment purchase (from CPAP.COM) , but I was prepared to pay it all out-of-pocket if necessary........I didn't want to experience the same problems others I had read about on this forum had experienced.


Den

.

[palerider]

So my point is, in theory the machine does compensate for elevation but it compensates if you are using your machine and you take it up and down in elevation,

So, here's the deal. back in 'ye olde days', machines were pretty much just blowers that had to be manually adjusted to a pressure, they didn't have any of the computerization and pressure sensors that the modern ones do.

You actually had to hook a manometer up to them and adjust the pressure by hand. so basically, they were just running at a set speed, and when you change altitude, because the air density changes, the fan in the cpap has to spin at a different speed to generate the same pressure, and since those machines were manual, they had to be manually adjusted if you moved.

Modern machines have computers and pressure sensors in them, they adjust the fan speed over 100 times per second to get exact pressure delivery, and since the pressure sensor is comparing the pressure against the ambient pressure, they maintain proper pressure whether you're at sea level or somewhere in the mountains of Colorado

That's what wolfman was talking about.

However as noted, *PEOPLE* often require different pressures at different altitudes, and thus their machine *does* need to be adjusted... it just doesn't need to be adjusted to compensate for the altitude change.

If that doesn't all make sense, please ask questions

[babydinosnoreless]

So my point is, in theory the machine does compensate for elevation but it compensates if you are using your machine and you take it up and down in elevation,

So, here's the deal. back in 'ye olde days', machines were pretty much just blowers that had to be manually adjusted to a pressure, they didn't have any of the computerization and pressure sensors that the modern ones do.

You actually had to hook a manometer up to them and adjust the pressure by hand. so basically, they were just running at a set speed, and when you change altitude, because the air density changes, the fan in the cpap has to spin at a different speed to generate the same pressure, and since those machines were manual, they had to be manually adjusted if you moved.

Modern machines have computers and pressure sensors in them, they adjust the fan speed over 100 times per second to get exact pressure delivery, and since the pressure sensor is comparing the pressure against the ambient pressure, they maintain proper pressure whether you're at sea level or somewhere in the mountains of Colorado

That's what wolfman was talking about.

However as noted, *PEOPLE* often require different pressures at different altitudes, and thus their machine *does* need to be adjusted... it just doesn't need to be adjusted to compensate for the altitude change.

If that doesn't all make sense, please ask questions

That makes sense. I am one of the people that must need a different pressure at higher altitude. Even after 15 years there I never did adjust, I would be frequently short of breath with very little exertion while here I can walk a lot longer without that issue.

Thanks for the explanation.

[palerider]

So my point is, in theory the machine does compensate for elevation but it compensates if you are using your machine and you take it up and down in elevation,

So, here's the deal. back in 'ye olde days', machines were pretty much just blowers that had to be manually adjusted to a pressure, they didn't have any of the computerization and pressure sensors that the modern ones do.

You actually had to hook a manometer up to them and adjust the pressure by hand. so basically, they were just running at a set speed, and when you change altitude, because the air density changes, the fan in the cpap has to spin at a different speed to generate the same pressure, and since those machines were manual, they had to be manually adjusted if you moved.

Modern machines have computers and pressure sensors in them, they adjust the fan speed over 100 times per second to get exact pressure delivery, and since the pressure sensor is comparing the pressure against the ambient pressure, they maintain proper pressure whether you're at sea level or somewhere in the mountains of Colorado

That's what wolfman was talking about.

However as noted, *PEOPLE* often require different pressures at different altitudes, and thus their machine *does* need to be adjusted... it just doesn't need to be adjusted to compensate for the altitude change.

If that doesn't all make sense, please ask questions

That makes sense. I am one of the people that must need a different pressure at higher altitude. Even after 15 years there I never did adjust, I would be frequently short of breath with very little exertion while here I can walk a lot longer without that issue.

Thanks for the explanation.

Well, air is thinner at higher altitudes, with less oxygen, of course.