Setting CPAP pressure youself?

[roster]

......... What would be everyones choice for a nasal mask. This is my problem as well as the waiting game. I actually go ton here to find the CPAP they were recommending and ask around about different masks as they tried two nasal masks on me and want a long term commitment. What has everybody found doesn't work and does work for them? This would help this picky impatient newcomer out a great deal.

Standard advice for newbies:

Things To Ask About Your Polysomnogram (PSG) and Titration Study

1. Did I have any central apneas? How many?

2. Were there any comorbidities? What were they?

3. Did I breathe or leak through my mouth? How often? What do you recommend to prevent it?

3. Did I exhibit Positional Sleep Apnea (PSA)? Was my apnea more severe in one sleeping position as compared to others? Is my pressure requirement higher in one position as compared to others? (Often sleep apnea is more severe when sleeping on the back.)

4. Is there anything else unusual about the results?

5. How will I know my therapy is preventing apneas?

6. I am determined to own a data-capable machine and software to monitor apneas, hypopneas and mask leak. This will allow me to call your office with specific questions if I have problems with the therapy. Will you help me with the appropriate prescription?

In addition to the questions:

1. Get a copy of your PSG. It is your legal right to have one.

2. Get a copy of your CPAP prescription.

3. Make sure the prescription calls for an integrated humidifier with the machine.

Also, become a member and fill out your equipment profile (text not images).

[Pugsy]

So which 2 nasal masks did you try?

I can offer an opinion on the Optilife nasal pillow, Swift LT nasal pillow, Nasal Air II prong, and the Opus 360 nasal pillow. I have zero experience with the nasal (cover you nose) mask except for a brief trial during the titration study which lasted all of about 45 minutes.

Did you find the information you needed about setting the machine that you do have? Which machine is it if you did not find what you were needing?

Of the 4 nasal pillow masks I have tried I like the Optilife the least but that was more because the head gear wouldn't adjust down to fit my tiny head. The chin strap portion of it was what gave me the most trouble.
Any of the other 3 does very well and I like them all. I just started trying the Opus. It shows great promise.

[Muse-Inc]

...they tried two nasal masks on me and want a long term commitment...

I loved the Respironics OptiLife pillow mask, it's a minimalist mask, pillow support frame, a pillow (or cushion), and just enough headgear so it doesn't slide off your face. Worked great until I lost enough wt that my airways changed shape and I started losing air thru my lips. Wearing the RespCare Hybrid mask now: nasal pillows and mouth cushion...no more leaks.

[marcuss]

Uhm, just an "up-date" for you all on my reducing my own CPAP pressure.

Seems that I'm getting a lot better sleep now with my pressure reduced. It is helping in all areas.

Yeah, including "down there" (where Mr. Big lives) At least my wife says so, after last night, she was like, "Oh my!": . hardy-har-har.

I didn't think I would get such a "big" benefit to adjusting my own pressure. Been years since it was like this, Almost forgot what "normal" felt like.

If you havn't done it recently, I strongly suggest you mess around (with your CPAP pressure adjustment).

[twokatmew]

Uhm, just an "up-date" for you all on my reducing my own CPAP pressure.

Seems that I'm getting a lot better sleep now with my pressure reduced. It is helping in all areas.

Yeah, including "down there" (where Mr. Big lives) At least my wife says so, after last night, she was like, "Oh my!": . hardy-har-har.

I didn't think I would get such a "big" benefit to adjusting my own pressure. Been years since it was like this, Almost forgot what "normal" felt like.

If you havn't done it recently, I strongly suggest you mess around (with your CPAP pressure adjustment).

See there? You thought you'd go to jail for changing your own CPAP pressure, and what happens? You get to give up those "male enhancement" products! Wait ... listen ... I hear the sirens now. Hurry Marcuss, hide ... the cpap police are on their way!

Actually, congrats on feeling better and taking charge of your therapy! And it only took eight days for us to recruit you to the dark side!

[fishhead]

marcuss,

what's next? cutting the tags off your seat cushions?

i hope we don't see you on CNN.

but seriously, my sleep doc prescribed CPAP at 10 cm. My S8 Autoset came set at APAP 4-20cm. I thought to myself: "Huh. I thought the R/T was supposed to adjust that to 10cm." That made me think that there must be some wiggle room here to fine tune. Later as i watched the numbers night after night, i noticed that rarely did i need 10cm. And the APAP was keeping me from sleeping straight through. I backed it down to 8cm and put it in CPAP. Since then, I've sleeping better and better each night. My AHI is next to nothing, and with the lower pressure I'm managing leaks and aerophagia much better.

so, i say good for you!

[GaryG]

Rooster, thanks for the list. I've been on the CPAP machine now or a month, and I have my first appt with sleep doc later this week. So still a newbie.

Regarding adjusting pressure, isn't that what autoset does - doesn't it mean that the machine adjusts to the pressure you need to minimize the apneas by itself?

My range is 8-15 and based on what I see from my machine the average is 10.8 for the week and month. Still getting adjusted to the machine, and its been up and down, but I think I hit another milestone today. When I felt I needed a nap, I actually went to hook up the CPAP. Seemed wierd, but I guess I'm still getting used to it. My weekly AHI is 6.00 but my monthly is 8.8, so I'm getting it in the right direction.

I haven't ordered the software from Australia yet, want to talk to doc to get him to order for me. Want to convince him why I want it, and want him on board with having me actively involved with my treatment.

Really not too concerned with my numbers yet. Just trying to get comfortable with my mask, and sleeping with it.

[twokatmew]

but seriously, my sleep doc prescribed CPAP at 10 cm. My S8 Autoset came set at APAP 4-20cm. I thought to myself: "Huh. I thought the R/T was supposed to adjust that to 10cm." That made me think that there must be some wiggle room here to fine tune. Later as i watched the numbers night after night, i noticed that rarely did i need 10cm. And the APAP was keeping me from sleeping straight through. I backed it down to 8cm and put it in CPAP. Since then, I've sleeping better and better each night. My AHI is next to nothing, and with the lower pressure I'm managing leaks and aerophagia much better.

fishhead, my doc prescribed 7cm, and I felt rotten, had a high AHI. I've been gradually raising it and got to 10cm but still had AHI too high. I finally got my hands on an AutoSet II, and I see it goes to almost 13cm, 95% pressure is 12.2cm. Leaks are well under control, so I must finally consider that I may have positional apnea. I go to sleep and wake up on either my right or left side, so I don't know that I sleep on my back. But perhaps I do and don't know it! I have no tennis ball to tape to my back, so tonight I'll look around and find something to tape to my back, perhaps an eyeglass case. I'm also going to set the APAP 8-15cm and see what happens. Fingers crossed that I find a lower pressure, as I wake up when it goes over 12.8cm.

I'm glad you found the right pressure so quickly, fishhead!

[roster]

Rooster, thanks for the list. I've been on the CPAP machine now or a month, and I have my first appt with sleep doc later this week. So still a newbie.

Regarding adjusting pressure, isn't that what autoset does - doesn't it mean that the machine adjusts to the pressure you need to minimize the apneas by itself?

........

Most people "do better" with a pressure range of no more than 2 to 3 cm. With the software you can find the sweet spot that gives an excellent therapy.

[GaryG]

Rooster, thanks for the list. I've been on the CPAP machine now or a month, and I have my first appt with sleep doc later this week. So still a newbie.

Regarding adjusting pressure, isn't that what autoset does - doesn't it mean that the machine adjusts to the pressure you need to minimize the apneas by itself?

........

Most people "do better" with a pressure range of no more than 2 to 3 cm. With the software you can find the sweet spot that gives an excellent therapy.

But wait, when I check my stats, my daily averages are quite constant, and I've never "seen" my machine go anything above 11.8, so I suspect I'm not going much higher than 12, so in that case, would an adjustment from 8-12 or 9-12 be that different from 8-15?

[roster]

........Most people "do better" with a pressure range of no more than 2 to 3 cm. With the software you can find the sweet spot that gives an excellent therapy.

But wait, when I check my stats, my daily averages are quite constant, and I've never "seen" my machine go anything above 11.8, so I suspect I'm not going much higher than 12, so in that case, would an adjustment from 8-12 or 9-12 be that different from 8-15?[/quote]

I agree if your pressure line is fairly stable.

The hypocrite that I am, I don't follow the 2 to 3 cm rule myself. I have my machine set 10 to 20. But it is stable and rarely goes above 10.5 so a narrower range is not necessary for me. (There is another reason I want 20 max but that is a subject for another thread.)

You say your AHI is 6. Personally I like to see 1.0 and lower. But get the software and you will have much better indications of what needs to be done to lower that AHI.

Regards,

[gardener22]

The thing I have learned about doctors is that most of them are very well intentioned but completely over-worked and over-exhausted to be able to give each patient the time and attention we deserve. So, being able to change the pressure settings on our own and being able to analyze the results on our own is critical to our health. In an ideal world, doctors would be able to spend hours going over our numbers with us, and fine tuning our care. In an ideal world, we would each be able to take days off from work to go and spend hours with our doctor so that she or he could come up with just the right treatment for us.

But that's not how it is. I learned a long time ago that I might not always be right, but that I am the person who knows my body best. Doctors can provide information, but ultimately I have to decide what works and what doesn't. As I said to one doctor once, I've been living in this body for 40 years, I think by now I know what does and doesn't feel right.

Trust your thinking. It doesn't mean you won't make mistakes, but be informed and learn all you can about your apnea. I think in the end an uninformed patient is a greater danger to himself or herself than a CPAP pressure that might be set too high or too low.

[DreamDiver]

Marcuss - Congratulations on considering changing your pressure.

However, as Rooster and others have pointed out, you'll get much better results from you therapy if you do this with the software and card reader installed. Anything else really is just a stab in the dark. If you haven't already gotten the Encore Viewer and the card reader, please consider it soon. Fine tuning will go much more smoothly when you can see numerically exactly where your results sit.

[marcuss]

Marcuss - Congratulations on considering changing your pressure.

However, as Rooster and others have pointed out, you'll get much better results from you therapy if you do this with the software and card reader installed. Anything else really is just a stab in the dark. If you haven't already gotten the Encore Viewer and the card reader, please consider it soon. Fine tuning will go much more smoothly when you can see numerically exactly where your results sit.

I have the Remstar Pro (standard CPAP), I was under the impression that the software won't do me any good, since it only records compliance data, is that wrong?

[jdm2857]

Does your machine say "M Series" on it?