Devilbiss Intellipap Question

[justaskin]

Hello everyone. You all have provide such great information I was wondering could someone please give me with some insight regarding what I am doing wrong. I was diagnosed with UARS because my tonger slides back and blocks my airway. I did not recieve a a formal titration though. My Docter prescribed an APAP machine with a standard setting of 4-14. I have been using my APAP for about 2 months now. My AHI averaged around 7.1 for a couple of weeks. I have sinced tried to tweak the settings however my AHI is not improving that much and I continue to wake up feeling tired. My current pressure setting is 11-14, AutoFlex is off, Irounding 1, Erounding 2. One day I woke up and my report stated that my AHI was 2.5! I felt great. However the next day my AHI was 4.5. Everday after that I've had an average AHI of 5.5-6.5. When I attempt to increase the pressure my AHI increases as well. For instance last night I increased the pressure to 13-17 and my AHI was 7.0. It seems like the higher my pressure..the higher my AHI goes as well. I'm just really confused at this point. I'm tired of waking up feeling horrible. Ive tried different pressures. I have also tried to different sleeping positions. I adjusted the irounding and erounding several times. I have even used the APAP in CPAP mode to see if I would get better results. However that didnt change anything either. I dont know what to do any longer.
Does anyone have any know why a higher pressure setting would cause my AHI to increase? I would that that a higher pressure would actually decrease my AHI. Also does the Irounding and Erounding still work if the AutoFlex is turned off? Do you think that and APAP will actualy be able to treat a condition such as UARS?

[HoseCrusher]

If you have the ability to download your data you need to review the pressure settings and their relationship to the various events that are being recorded.

This will also help you zero in on the best pressure to use.

A wild guess would be to reduce your minimum pressure to something like 9 giving you a range of 9 - 14. Without data this is just a guess.

[123.Shawn T.W.]

What mask are you useing? Is it leaking . . . ?

[Slartybartfast]

I agree that it sounds like your pressure might be too high. But without a titration study there's no way to tell other than to use your Intellipap to determine it. I wonder why your doc didn't order one. . .

Forget the upper pressure limit (14). Leave it at the maximum (20); it's not necessary to set it lower than maximum unless you've got some weird breathing irregularities. Your machine isn't going to run away with you. You want to find the minimum pressure that will coincide with the minimum AHI recorded on several successive nights. Were I you, I'd start out with the machine in auto mode and minimum pressure at around 6 for a few nights. In the morning, download the Smart Codes and plug them into the application on the DeVilbiss website. One of the numbers in your report will be your 95% pressure. That number will tell you that the machine was at or below that pressure for 95% of the time during the night. It can be thought of as the highest pressure necessary to allow you to breathe effectively. Once you have a few nights with fairly consistent results, set the minimum pressure of the machine about 2 cm below that number and collect more data and note how your AHI and 95% pressure look over several more days. Keep track of the numbers and you should see the 95% number remaining fairly steady night to night. That's about the best you can do without a titration study.

The Intellipap is a great machine and it provides you with all the data you need to set your pressure and monitor its effectiveness. Try playing around with the I-rounding and E-rounding settings, too. I have them both set to their maximum level (3 each, I think) and it made a big difference in my comfort.

Good luck and pipe up if any problems.

[Julie]

If you are mouth breathing when asleep, turning the pressure higher will make it worse, and you need to investigate if you're losing air that should be going down and not out... possibly with a trial of taping for a few nights, and if you feel better afterward, you might look into a full face mask instead of the nasal one.

[49er]

Hi,

I have had a similar type experience and it was only by using a neck collar that I was able to find a stable pressure with a low AHI. Unfortunately, I am finding the combination of my neck collar and full face mask very uncomfortable which is another post.

It just seems in reading various reviews that there is a very small minority of us folks who have not had a good experience with this machine. By the way, I am not disparaging it as I realize it works well for most people.

Also, I realize that perhaps the machine isn't at fault and once I find the right mask, I can ditch the neck collar and find a stable pressure with a low AHI.

To be continued.

Hello everyone. You all have provide such great information I was wondering could someone please give me with some insight regarding what I am doing wrong. I was diagnosed with UARS because my tonger slides back and blocks my airway. I did not recieve a a formal titration though. My Docter prescribed an APAP machine with a standard setting of 4-14. I have been using my APAP for about 2 months now. My AHI averaged around 7.1 for a couple of weeks. I have sinced tried to tweak the settings however my AHI is not improving that much and I continue to wake up feeling tired. My current pressure setting is 11-14, AutoFlex is off, Irounding 1, Erounding 2. One day I woke up and my report stated that my AHI was 2.5! I felt great. However the next day my AHI was 4.5. Everday after that I've had an average AHI of 5.5-6.5. When I attempt to increase the pressure my AHI increases as well. For instance last night I increased the pressure to 13-17 and my AHI was 7.0. It seems like the higher my pressure..the higher my AHI goes as well. I'm just really confused at this point. I'm tired of waking up feeling horrible. Ive tried different pressures. I have also tried to different sleeping positions. I adjusted the irounding and erounding several times. I have even used the APAP in CPAP mode to see if I would get better results. However that didnt change anything either. I dont know what to do any longer.
Does anyone have any know why a higher pressure setting would cause my AHI to increase? I would that that a higher pressure would actually decrease my AHI. Also does the Irounding and Erounding still work if the AutoFlex is turned off? Do you think that and APAP will actualy be able to treat a condition such as UARS?

[maintenanceman]

Hello everyone. You all have provide such great information I was wondering could someone please give me with some insight regarding what I am doing wrong. I was diagnosed with UARS because my tonger slides back and blocks my airway. I did not recieve a a formal titration though. My Docter prescribed an APAP machine with a standard setting of 4-14. I have been using my APAP for about 2 months now. My AHI averaged around 7.1 for a couple of weeks. I have sinced tried to tweak the settings however my AHI is not improving that much and I continue to wake up feeling tired. My current pressure setting is 11-14, AutoFlex is off, Irounding 1, Erounding 2. One day I woke up and my report stated that my AHI was 2.5! I felt great. However the next day my AHI was 4.5. Everday after that I've had an average AHI of 5.5-6.5. When I attempt to increase the pressure my AHI increases as well. For instance last night I increased the pressure to 13-17 and my AHI was 7.0. It seems like the higher my pressure..the higher my AHI goes as well. I'm just really confused at this point. I'm tired of waking up feeling horrible. Ive tried different pressures. I have also tried to different sleeping positions. I adjusted the irounding and erounding several times. I have even used the APAP in CPAP mode to see if I would get better results. However that didnt change anything either. I dont know what to do any longer.
Does anyone have any know why a higher pressure setting would cause my AHI to increase? I would that that a higher pressure would actually decrease my AHI. Also does the Irounding and Erounding still work if the AutoFlex is turned off? Do you think that and APAP will actualy be able to treat a condition such as UARS?

The Devilbiss Auto does not respond to flow limitations directly! It does respond to Obstructive apneas! What I suggest you do is adjust the Obstructive Apnea Event percentage to
5! This will basically force the machine to react to the Non Obstructive Apnea Event,or that is to say it is reacting to a Flow Limitation/Snore event/Non Obstructive Apnea! I would also leave the SmartFlex Turned off until you get the machine tweaked to a sweeter spot for your needs! Also leave the pressure range at 11 to 14! Your ahi numbers are not bad,but remember if you have UARS then the AHI is not really the best indicator of how your sleeping! I would go more by how you feel when you awaken,and also maybe take your blood pressure right after awakening! I also am assuming you have good mask fit,and no mouth breathing issues! Good Sleep hygiene is also important ("Good Pillow,neck alignment straight,clean sinuses etc...")


Best Regards,Good Sleep To You!
maintenanceman