What can you do anyway?
-
Sleeping With The Enemy
- Posts: 454
- Joined: Tue Jan 25, 2005 11:54 pm
- Location: Minnesota
So what kind of auto
Needing c-flex because I feel like I'm dying when exhaling, I guess there is only one choice when it comes to apap, right?
Re: So what kind of auto
I should let the APAP experts answer this, but the impression I'm getting from them is that the benefit of APAP is that you don't really NEED CFLEX, because your pressure is not at maximum except when you need it.hhunt wrote:Needing c-flex because I feel like I'm dying when exhaling, I guess there is only one choice when it comes to apap, right?
But I'll let the experts correct me if I'm wrong, because I am...
Liam, aka Fallible Boy.
_________________
| Machine | Mask | |
 |  |
-
rested gal
- Posts: 12881
- Joined: Thu Sep 09, 2004 10:14 pm
- Location: Tennessee
True, Liam, the autopap will keep the pressure down until you actually need more to prevent events, or to stop an event that sneaked by. Autopap simply makes leaf-blower treatment more comfortable for most people.
However....(you knew there'd be a "however", didn't you? heheh) .... adding C-Flex to an autopap sure can make treatment even more comfortable for many people, whether they absolutely need relief on exhalation or not.
Case in point:
I can breathe out fine against any pressure up to about 14. From 14 on, it does feel like "work". My autopap, however, rarely touches 13. Most of my nights are spent rocking along nicely at 10 or 11. I've used both the 420E auto and a REMstar auto (with no C-Flex). I was getting good treatment from both those autos and was exhaling against the pressure fine. You could say, "She doesn't need C-Flex."
However, when I got a REMstar auto WITH C-Flex.....wow! I loved the extra comfort of feeling like I was exhaling into an empty hose. It felt much more like a "natural" way to relax into sleep, breathing out sooooo easily.
Did I need that feature? No.
Do I like my treatment better with it? Yes.
Does it make my treatment better? I don't know.
It sure hasn't hurt the treatment any for me. My results still show low AHI every night, as usual, and I feel the same (good) every morning. Where I feel better is when I put the mask on, flip on the humidifier and start the machine going. It's wonderful to exhale so easily with C-flex dropping the pressure some every time I breathe out.
Which would I give up first, if I had to make a choice? I'd let C-Flex go and stick with autopap...simply because I want a machine that will vary the treatment pressure for me, and let me avoid having to get a sleep study. With autopap I don't ever have to worry, "Is the pressure right for me?"
Of course, since the Respironics REMstar auto now comes with C-Flex, I can have the best of both worlds. I get excellent treatment as well as two kinds of comfort all at once:
1. The comfort of sleeping most of the night at lower pressures. (autopap)
2. The comfort of breathing out more easily. (C-Flex)
If I'm going to try to sleep with a mask and a machine, I want as much comfort as possible.
Need vs Comfort is always interesting. We might "need" only a wooden stool with 3 legs, to be able to sit in front of our computers. I don't think that's what any of us are sitting on right now, though.
However....(you knew there'd be a "however", didn't you? heheh) .... adding C-Flex to an autopap sure can make treatment even more comfortable for many people, whether they absolutely need relief on exhalation or not.
Case in point:
I can breathe out fine against any pressure up to about 14. From 14 on, it does feel like "work". My autopap, however, rarely touches 13. Most of my nights are spent rocking along nicely at 10 or 11. I've used both the 420E auto and a REMstar auto (with no C-Flex). I was getting good treatment from both those autos and was exhaling against the pressure fine. You could say, "She doesn't need C-Flex."
However, when I got a REMstar auto WITH C-Flex.....wow! I loved the extra comfort of feeling like I was exhaling into an empty hose. It felt much more like a "natural" way to relax into sleep, breathing out sooooo easily.
Did I need that feature? No.
Do I like my treatment better with it? Yes.
Does it make my treatment better? I don't know.
It sure hasn't hurt the treatment any for me. My results still show low AHI every night, as usual, and I feel the same (good) every morning. Where I feel better is when I put the mask on, flip on the humidifier and start the machine going. It's wonderful to exhale so easily with C-flex dropping the pressure some every time I breathe out.
Which would I give up first, if I had to make a choice? I'd let C-Flex go and stick with autopap...simply because I want a machine that will vary the treatment pressure for me, and let me avoid having to get a sleep study. With autopap I don't ever have to worry, "Is the pressure right for me?"
Of course, since the Respironics REMstar auto now comes with C-Flex, I can have the best of both worlds. I get excellent treatment as well as two kinds of comfort all at once:
1. The comfort of sleeping most of the night at lower pressures. (autopap)
2. The comfort of breathing out more easily. (C-Flex)
If I'm going to try to sleep with a mask and a machine, I want as much comfort as possible.
Need vs Comfort is always interesting. We might "need" only a wooden stool with 3 legs, to be able to sit in front of our computers. I don't think that's what any of us are sitting on right now, though.
-
Guest
Need vs Comfort
Sometimes "comfort" even becomes "need" where xPAP therapy is concerned. Comfort is so often the compliance breaker.
Hhunt, your Spirit data shows that you fared okay on AutoPAP. If you were sticking with the Spirit for the long-laul, then pressure-range adjustment would have been the best course toward lowering your AHI on the Spirit.
I am surprised that cpap.com said that AutoPAPs can only respond to events (versus prevent apneas). I'm one-hundred-percent sure there was a communication "disconnect" somewhere in that conversation. If AutoPAPs could only respond to each event, then it simply would not be a technically feasible treatment for the vast majority of patients.
My guess is that because exhalation is an issue for you, and because you demonstrated reasonable efficacy on the Spirit, that the Remstar Auto with C-Flex just might be your best bet. If anything about that particular AutoPAP didn't suit you, you could always revert it to your current fixed-pressure treatment with C-Flex---all the while collecting valuable over-night sleep data if you so wish. That is only an opinion, or blind guess really, on my part. You would really have to try any given AutoPAP to see how you fare on it. Most patients seem to fare quite well on them in if I were forced to wager a guess regarding overall AutoPAP efficacy.
I personally fare better on an AutoPAP than I do on fixed pressure.
Hhunt, your Spirit data shows that you fared okay on AutoPAP. If you were sticking with the Spirit for the long-laul, then pressure-range adjustment would have been the best course toward lowering your AHI on the Spirit.
I am surprised that cpap.com said that AutoPAPs can only respond to events (versus prevent apneas). I'm one-hundred-percent sure there was a communication "disconnect" somewhere in that conversation. If AutoPAPs could only respond to each event, then it simply would not be a technically feasible treatment for the vast majority of patients.
My guess is that because exhalation is an issue for you, and because you demonstrated reasonable efficacy on the Spirit, that the Remstar Auto with C-Flex just might be your best bet. If anything about that particular AutoPAP didn't suit you, you could always revert it to your current fixed-pressure treatment with C-Flex---all the while collecting valuable over-night sleep data if you so wish. That is only an opinion, or blind guess really, on my part. You would really have to try any given AutoPAP to see how you fare on it. Most patients seem to fare quite well on them in if I were forced to wager a guess regarding overall AutoPAP efficacy.
I personally fare better on an AutoPAP than I do on fixed pressure.
Hi. I hope you don't mind me adding my own 2 cents here...I believe in "the simpler is better" theory. Thanks to this site and you great people, I know more about this stuff than I could ever imagine. However, while I had 2 sleep studies done, and they did give me all the episode/event numbers...I only know two: my cpap ramps starting at 4.0 and stops (and stays) at 9.0. I don't use a heated humidifier (I do use the cool water pass-over), and I never knew auto-pap machines existed until I found this site. Given that, I would recommend that all individuals start out simple and then go from there.
In other words, if you find that you experience annoying dryness or cold issues...then check out heated humidifiers. If the hose then builds up excessive moisture...check out an aussie-hose (and I don't mean the guy that played Crocodile Dundee!) If you find that your mask leaks, then check out other types of masks or pillows that might work for you. If you find you have intolerable pressure, then explore an auto-pap.
It's all different for everybody...cpap'ing is probably like a fingerprint...no two situations/solutions are exactly the same. Some things work for some, others work for others. However, everyone needs a starting base. And remember, like the new car you might buy...the more you add on, could also mean the more things that can go wrong.
In other words, if you find that you experience annoying dryness or cold issues...then check out heated humidifiers. If the hose then builds up excessive moisture...check out an aussie-hose (and I don't mean the guy that played Crocodile Dundee!) If you find that your mask leaks, then check out other types of masks or pillows that might work for you. If you find you have intolerable pressure, then explore an auto-pap.
It's all different for everybody...cpap'ing is probably like a fingerprint...no two situations/solutions are exactly the same. Some things work for some, others work for others. However, everyone needs a starting base. And remember, like the new car you might buy...the more you add on, could also mean the more things that can go wrong.
Starters...
I think that's fair advice, Bozeman.
I'm also an advocate of patients initially starting out with treatment exactly as their doctors prescribe. Then suggest changes from there if things don't work out.
-SWS
I'm also an advocate of patients initially starting out with treatment exactly as their doctors prescribe. Then suggest changes from there if things don't work out.
-SWS
My wife disagrees, and gives a very good example.bozmon wrote:I believe in "the simpler is better" theory.
I have a tempurpedic bed. Have since before we got together. She's sleeping FAR better on it than she did on her old mattress. The old one was a good mattress, and she "slept fine" on it.
Had you asked her back then, she would have not have recommended spending the money on the tempurpedic.
Now, having experienced the difference, she would absolutely say it's worth it. Starting simple can cheat you out of something much better, she thinks.
Liam, who is just a mouthpiece for the old ball-n-chain.
(Who is apt to stop rubbing his shoulders if he keeps saying things like that.)
_________________
| Machine | Mask | |
| |
-
wading thru the muck!
- Posts: 2799
- Joined: Tue Oct 19, 2004 11:42 am
-
rested gal
- Posts: 12881
- Joined: Thu Sep 09, 2004 10:14 pm
- Location: Tennessee
I would agree that following exactly what the doctor says to do at the beginning is what an OSA patient should do....
That is....if the basic "start out" equipment prescribed by the doctor consisted of:
Autopap with C-Flex (could always be set back on straight cpap if that was better for the patient.)
Heated humidifier (could always be turned off.)
Heated hose (doesn't have to be plugged in.)
Four masks (Activa, Breeze, Swift, Mirage Ultra FF)
Looks like a lot of money to spend on each OSA patient for what I would call "the basics", doesn't it? Looks more like what the people who luckily have internet and enough computer savvy to find their way to apnea message boards might eventually buy, doesn't it? It takes less than 30 seconds to scribble those specific items on an Rx.
Yeah, I know - insurance isn't going to pay for those things. It should. Maybe someday the bean counters will learn what sleep apnea does to every organ of the body. Organs like the heart and brain. Medical care for those parts is much more expensive than medical care to keep the throat open.
Consider the drop out rate - I've read estimates that 40% who are prescribed "cpap" give up using it. I'd bet that's an underestimation by the time two years are up. I'd also bet that the four biggest factors in the drop out are: masks that hurt, leak, cause open sores, treatment air leaking out the mouth, cold air blowing at them or water dripping on them, and a single straight pressure that may be too much most of the time, not enough some of the time, and for some - tough to breathe against all the time.
How much are the 40% going to cost in health care later?
Weigh a $50,000 stay in intensive care after a stroke, heart attack, or automobile accident against spending perhaps $1,000 more per "cpap" patient to give them the kind of comfortable equipment and support that could keep them actually using it.
With truly comfortable "basic" equipment and real follow-up support during the crucial beginning days and weeks, perhaps more people would actually be treated. Instead of becoming statistics now - and in the future.
That is....if the basic "start out" equipment prescribed by the doctor consisted of:
Autopap with C-Flex (could always be set back on straight cpap if that was better for the patient.)
Heated humidifier (could always be turned off.)
Heated hose (doesn't have to be plugged in.)
Four masks (Activa, Breeze, Swift, Mirage Ultra FF)
Looks like a lot of money to spend on each OSA patient for what I would call "the basics", doesn't it? Looks more like what the people who luckily have internet and enough computer savvy to find their way to apnea message boards might eventually buy, doesn't it? It takes less than 30 seconds to scribble those specific items on an Rx.
Yeah, I know - insurance isn't going to pay for those things. It should. Maybe someday the bean counters will learn what sleep apnea does to every organ of the body. Organs like the heart and brain. Medical care for those parts is much more expensive than medical care to keep the throat open.
Consider the drop out rate - I've read estimates that 40% who are prescribed "cpap" give up using it. I'd bet that's an underestimation by the time two years are up. I'd also bet that the four biggest factors in the drop out are: masks that hurt, leak, cause open sores, treatment air leaking out the mouth, cold air blowing at them or water dripping on them, and a single straight pressure that may be too much most of the time, not enough some of the time, and for some - tough to breathe against all the time.
How much are the 40% going to cost in health care later?
Weigh a $50,000 stay in intensive care after a stroke, heart attack, or automobile accident against spending perhaps $1,000 more per "cpap" patient to give them the kind of comfortable equipment and support that could keep them actually using it.
With truly comfortable "basic" equipment and real follow-up support during the crucial beginning days and weeks, perhaps more people would actually be treated. Instead of becoming statistics now - and in the future.
Compliance
Gotta wonder what compliance rates would be if that were standard issue, Rested Gal. Certainly much higher than they are now. The "system" is broken---without question. Sadly a broken medical/DME system translates to many broken patients in the end...rested gal wrote:That is....if the basic "start out" equipment prescribed by the doctor consisted of:
Autopap with C-Flex (could always be set back on straight cpap if that was better for the patient.)
Heated humidifier (could always be turned off.)
Heated hose (doesn't have to be plugged in.)
Four masks (Activa, Breeze, Swift, Mirage Ultra FF)
How on earth does a process that massively broken get fixed? A few lucky Internet patients stumbling onto the on-line-DME way of life is not the large-scale solution. What is the solution????
-
Sleeping With The Enemy
- Posts: 454
- Joined: Tue Jan 25, 2005 11:54 pm
- Location: Minnesota
I Think.......
I think there are a couple of you, and you know who you are, that should actually pursue careers in this field because you are obviously in tune, caring and knowledgable. Not to mention having first hand experience. We are very lucky to have found this forum and to have you people on here, specifically Wading in the Muck and Rested Gal. We appreciate you!!!!!!!!!