Having obstruction on exhalation..

[napagirl]

Hi,

I have been using CPAP for about 3yrs now. Insurance denied my claim initially, so I ended up with one study and no help from DME. I ordered all the stuff myself. Was doing pretty good, but just bought a new machine.. intellipap (see my equip below). My initial rx was for a pressure of 9. I could never tolerate a 9 on my old machine, so had it at 7.5, and that seemed ok.

Now with the auto pap machine I have now, I initially set it to a range of 4-11. I assume it was going pretty high, cause it would wake me up practically blowing the FF mask off my face. I also had major nasal irritation regardless of how high I set the humidity. So I ended up lowering the pressure to a high of 7.5. Now, I am not getting restful sleep (not waking, but tired all day). My husband just informed me this morning that during the night, I was on my back with mask on. I was inhaling quietly- no problems. But evidently, my exhaling was noisy and sounded obstructive. This is a new one for me! Not sure what to do next... I am thinking up the pressure again, but then will fight the pressure and irritation again. Again, I do not have insurance that will cover this malady and am working on this alone.

Thanks in advance!

Napagirl

[Julie]

Hi, well to begin with, 4 is not a good place to set your lower pressure at - it is the default low setting for most machines, but no one can really get any air there. Normally, if your pressure should be e.g. 10, you'd set your machine to 8 and 12, or if the script is for 8, then 6 and 10, though again 6 is a bare minimum. I think your having changed to 7.5 was maybe a mistake - it's low for someone who was prescribed a higher pressure to start with. Sleeping on your back is also asking for trouble and there are 'fixes' you can use to prevent it from happening (some people even attach a tennis ball to the back of their pj's)! I think you should reset your pressures starting with a higher low number to begin with, and a high number just a few beyond the scripted one, and try to arrange pillows or whatever to keep you off your back. Now, there are machines which address problems with exhaling, the feature is called c-flex (or a-flex) and is built-in (as something you can turn on or off) to Respironics M Series machines (check into them at Cpap.com for more information) if that problem still bothers you.

[elader]

Don't sleep on your back. You know, the APAP always did that to me too. Woke up in a windstorm. Maybe try 8-12 and see where it spends most of its time? I eventually gave up using Auto and moved the pressure manually and found what worked for me.

[napagirl]

Thanks for the advice! I did up the range for pressure. I will try this for awhile and see how it goes. So far, seems to be helping, as I am not in that "semi-awake" state all nite long and feel more rested.

I never knew that OSA could occur on exhalation. I thought it was only when one inhaled.

My machine has the capability to go into CPAP mode vs. APAP mode. If I have further issues, I will experiment with using the CPAP mode.

Right now, my Rx is for 9, so I have it set from 7 to 11.

Thanks,
Napagirl

[araminta]

Don't sleep on your back. You know, the APAP always did that to me too. Woke up in a windstorm. Maybe try 8-12 and see where it spends most of its time? I eventually gave up using Auto and moved the pressure manually and found what worked for me.

when I sleep on my side, my mask goes kattywompus and leaks like crazy.
But if i sleep on my back (my preference) i stay still during the nite and less leakage...
it's a conundrum.

[nate fry]

Sure the cpap is like blowing up a baloon, if you let the pressure off to much it collapes. I turn my c=fles up a bit myself to prevent this. It is not a serious problen you just have to adjust the bottom number till it quits. I had a tounge advancement which help also keep your tounge from choking you.

[napagirl]

Sure the cpap is like blowing up a baloon, if you let the pressure off to much it collapes. I turn my c=fles up a bit myself to prevent this. It is not a serious problen you just have to adjust the bottom number till it quits. I had a tounge advancement which help also keep your tounge from choking you.

Nate,

What is a tongue advancement?

[gerrymoorerrtdotcom]

I am not firmiliar with this cpap system, but is there a ramp setting that is causing the initial pressure to be high? If you set a 4 cm as your baseline that is what it should stay at until you are asleep. Gerry

[SleeplessInNyack]

I am not firmiliar with this cpap system, but is there a ramp setting that is causing the initial pressure to be high? If you set a 4 cm as your baseline that is what it should stay at until you are asleep. Gerry

The IntelliPap only has a ramp setting in CPAP mode. In APAP mode there is only the upper and lower range, and a delay setting where the machine will remain at the lower pressure for a set number of delay minutes.

[carbonman]

I was on my back with mask on. I was inhaling quietly- no problems. But evidently, my exhaling was noisy and sounded obstructive. Napagirl

Maybe this could help.

http://www.sleepapneashirt.us/index.html