C-PAP Prescribed Pressure Not Actual Pressure on C-PAP

[lbrown]

Hello, C-PAP community:

I am new here, though I have been reading the posts voraciously for some time. I was diagnosed with mild-to-moderate sleep apnea (AHI=11, Lowest O2 Desat. 87%) in 2007 and like a lot of people here I had some initial trouble adjusting to it, so much so that it worsened my sleep (i.e. the brain fog, my main symptom, was worse and longer lasting than before). Even after I finally slept through the night with the machine, I awakened feeling the same. Needless to say, I was extremely frustrated. I informed my sleep doctor on several occasions that I had received no relief, but she dismissed me, suggesting that I was, perhaps, depressed.

I passed several years in frustration, but I stumbled upon this site several days. I was amazed to discover that many of you tinkered/worked with your machines' pressure settings. I was not aware that doing so was possible. Given that several of you seemed to achieve some success with altering your pressures, I decided I would give it a try. I have nothing to lose. Using a tip I picked up from a post here, I took a look at my machines pressure setting, but was left thoroughly confused.

My C-PAP titration determined that I should receive a pressure of 12cm, but my machine was set at 6cm.

Has anyone noticed a discrepancy between the pressure prescribed by the sleep physician and the pressure setting on your machine?

By the way, I have a REMSTAR PRO M SERIES C-FLEX. Any responses would be much appreciated. Thanks.

[miketech]

Yikes! Yes, there have been some people who have reported that the right pressure was not correctly set on their machine. But 6?, man, that is very low. Most people that have written in with a 6, have said that they feel like the machine is suffocating them. I used to have my machine start at 6 when I use the ramp up feature, but I raised the start (ramp) pressure to 8, and later to 10. (my final pressure is 12.5)

[pap4life]

Thats quite a disparity. No wonder you didn;t feel good with your machine. Sounds like some checking with the DME or sleep study that originally set the pressure on your machine. They might have set the ramp and thought they had set the final setting. Who knows, but I'd even discuss this situation with your sleep doc. Tampering/tinkering with the pressures yourself should be done with quite a bit of caution. Yes, it is done by many people. But do so in small increments, such as .5 CM at a time for a few days each new setting.

[lbrown]

I keep thinking that I must have looked at the screen improperly. But I looked at it again and also looked at the ramp feature. The ultimate pressure is set at 6 and the ramp feature is set at 4. I suppose it's possible that I am mistaken about the pressure my doctor prescribed, but my sleep study titration report concludes that 12cm was the most effective pressure and states that I had less than 3 hypopneas/apneas at that pressure.

If I do increase the pressure, I will do so cautiously.

[Wulfman...]

I keep thinking that I must have looked at the screen improperly. But I looked at it again and also looked at the ramp feature. The ultimate pressure is set at 6 and the ramp feature is set at 4. I suppose it's possible that I am mistaken about the pressure my doctor prescribed, but my sleep study titration report concludes that 12cm was the most effective pressure and states that I had less than 3 hypopneas/apneas at that pressure.

If I do increase the pressure, I will do so cautiously.

Why be so cautious? You obviously NEED more pressure. I'd set it all the way up to 12 cm. That's not all that bad.......but, if it is, try 10 cm. for a few nights and then move it up. If you have a follow-up appointment with your doctor, take the opportunity to point out that the dummies at the DME shop set the machine up wrong.


Den

[Slinky]

Wicked witch that I am I wouldn't wait - I'd be "talking" to my DME provider AND my doctor about the misery I've been going thru the last 3 years. I would be sooooo sweet as I rubbed my sleep doctor's nose in the dirt w/the fact that I had asked him/her repeatedly for help and my problems were ignored. I'd also let my DME provider know how much I had suffered the last 3 years due to their setting my CPAP pressure wrong. I would soooo rub their noses in their mistakes and the misery it has caused me for better than THREE years!!! I would lay such a freaking guilt trip on them ..... did I mention I can be one spiteful ole broad???

[lbrown]

Hey, Wulfman:

I was thinking that I should exercise caution because I saw some web material urging people increasing their pressure to do so deliberately.

In any case, I will have a word with my doctor and will have no further dealings with the DME.

[lbrown]

Slinky:

I might just take your suggestion!

[Wulfman...]

Hey, Wulfman:

I was thinking that I should exercise caution because I saw some web material urging people increasing their pressure to do so deliberately.

In any case, I will have a word with my doctor and will have no further dealings with the DME.

If you were self-titrating, then "yes", you would be wise to proceed with caution. You apparently had a sleep study and had the DME gotten your machine set up properly, you would probably be dealing with a full 12 cm. of pressure.

I would also suggest getting the Encore Viewer software so you can SEE what's going on while you're sleeping.


Den

[rested gal]

I keep thinking that I must have looked at the screen improperly. But I looked at it again and also looked at the ramp feature. The ultimate pressure is set at 6 and the ramp feature is set at 4. I suppose it's possible that I am mistaken about the pressure my doctor prescribed, but my sleep study titration report concludes that 12cm was the most effective pressure and states that I had less than 3 hypopneas/apneas at that pressure.

If I do increase the pressure, I will do so cautiously.

Why be so cautious? You obviously NEED more pressure. I'd set it all the way up to 12 cm. That's not all that bad.......but, if it is, try 10 cm. for a few nights and then move it up. If you have a follow-up appointment with your doctor, take the opportunity to point out that the dummies at the DME shop set the machine up wrong.

Den

I agree with Den. I'd go straight for pressure of 12. Set a ramp starting pressure of 8 or 9 or 10 if you need less for awhile to get to sleep. I just wouldn't spend one more night at 6. Nor 7, nor 8. I wouldn't waste one more minute of my time and my health than what the DME and the sleep doctor have already wasted for you. grrrrrrrrrrrrrrrrrrrr

If the doctor's prescription said to set the machine at 12 cm H20, and the DME set it for 6 cm H2O, that is an absolutely terrible mistake for a DME to make.

Wicked witch that I am I wouldn't wait - I'd be "talking" to my DME provider AND my doctor about the misery I've been going thru the last 3 years. I would be sooooo sweet as I rubbed my sleep doctor's nose in the dirt w/the fact that I had asked him/her repeatedly for help and my problems were ignored. I'd also let my DME provider know how much I had suffered the last 3 years due to their setting my CPAP pressure wrong. I would soooo rub their noses in their mistakes and the misery it has caused me for better than THREE years!!! I would lay such a freaking guilt trip on them ..... did I mention I can be one spiteful ole broad???

I'd love to be a fly on the wall if Slinky ever had a chance to "discuss" a situation like this with the involved sleep doctor and DME.

[Goofproof]

That is why you need to take control of your own treatment (with the software), there are way too many fools in control of our lives to remain unschooled with our treatment. Jim

[Big S]

The first time I returned to my sleep doc to assess progress, I asked the tech how they knew the pressure was correct. Like most newbies, I thought my machine was putting out too little pressure in the middle of the night and I wanted to check it to reassure myself. The tech said they dialed in the number and it is correct. After some debating, the tech pulled out a water column manometer and hooked it up and guess what? It wasn't the same as the setting. It turns out the manometer wasn't zeroed correctly (I showed them how to do it) and the correct pressure wasn't in the machine. In looking back at this comedy of error, I think this really was a positive way to start my cpap journey.

[BigNortherner]

Dan S, your message isn’t clear.

I think of two pressure values – what the machine is set to produce – readily visible on the display - and what it actually is producing.

A significant difference means the machine is not functioning correctly. I infer that you got it fixed.

(Sounds like your tech was being glib, as in the common scam of “Oh, it couldn’t be wrong.”, wasting effort denying instead of just checking.)

[Big S]

BigNortherner, thanks for your comments, I wanted to be clear and you have helped. The thing that wasn't working was the simple manometer. It required a "re-zeroing" to make sure the max reading was correct. She did not know how to do this and was grateful when I showed her how. She wasn't a grizzled veteran but a pretty young woman who was there to help assess my progress. I appreciated her time but I think her advice had to be taken with a grain of salt. Thanks again for taking the time to comment.