Titration Results

I am new to this board, but have been lurking for many months, and
have gotten lots of info here...Thanks....
My concern is: I got my titration results Tuesday, I was all
fired up to go to the appointment knowing exactly what I wanted in
equipment....Remstar Auto with C-flex, HH and a Swift mask. Then
the doctor threw a wrench into it by telling me I need a pressure of
19, a full face mask, and agreed to the auto pap....I am not a mouth
breather, I do not have problems with allergies, stuffy nose or any
other nose problems....

My question is...With a pressure of 19 will a
swift mask be okay, and will the auto pap work it's wonders with a
pressure of 19?? I so had my heart set on a Swift...Would like to hear
from those who have a high pressure and what mask and machine you
are using....I still can't believe I need a pressure of 19...I've misplaced
my first sleep study, waiting on another plus my titrations results to
come in the mail, I will post the results when I get them...
I do know I had an AHI of 128 an hour plus 344 RLS/PLM within the
4 1/2 hours I slept...and all my doctor could say was "it is bad" duh!!
Would really appreciate any help...

I have waited 9 months and really can't wait to get treatment started...
Thank you all again...

Mar

Mar,
I know you asked about the Swift. But I though you might want to know:

The Breeze, according to its manual can take up to 35, (thirty five) and I've read of people using it happily at 18.

With a pressure of 19 you might be better served by a bi pap (or vi pap) - don't buy before you've checked.

As for why the good doctor decided of a full face mask - maybe he thinks your mouth is bound to open when the pressure is so high? Maybe he's not aware of the developments in masks, straps, and mouthguards?

O.

Thanks O for your reply. Discussed the Bi pap with the doc, said I would
need a titration with a bi pap...I will stick with the auto and see how
that does for me....I will ask the DME about the breeze and the activa
as well....the doc said a pressure of 19 would be very hard for me to
take just going in the nose, that's the reason for the full face....
Thanks again....

Mar

the doc said a pressure of 19 would be very hard for me to take just going in the nose

I think he's wrong about that. I'd worry more about the chance of aerophagia at that kind of pressure regardless of what mask a person used, rather than be concerned about airflow into the nose.

My autopap usually doesn't have to go above 11 or 12 briefly. But experimentally, I've set it for several straight high pressures, including 20, just to see how it felt, and to test how some of my nasal pillows masks would hold up to stratosphere pressure. Breeze sealed fine up there. So did the Aura.

But on the point of what your doctor said, I had no difficulty at all inhaling through my nose at 20 cm H2O. It was a bit of a shock, that first breath, but after a breath or two, it was no problem inhaling and caused no discomfort inside my nose. I had a heated humidifier and the Aussie heated hose was on.

What I did have a big problem with was exhaling. A bi-level machine could make that much, much easier. With heated humidification, the nasal passages should be fine using a nasal pillows interface.

Granted, I used that high pressure for only 15 minutes or so. C-Flex didn't make a dent in it for me, exhaling. If I were prescribed such a pressure, I'd definitely at least try an autopap first, set probably at 10 - 20, just to see if I really did need to spend most of the night up at a very high pressure. If so, I'd get a bi-level machine.

I don't think you have to worry about a nasal pillows interface like Breeze, Aura, or Swift being able to seal against high pressure. You might have to add a homemade extra strap down low around the nasal pillows area to steady any one of them perfectly... or they might "stay put" just fine for you. But nasal pillows definitely can work great with high pressure...probably better than most traditional nasal (covers the nose) or FF (full face) masks.

mar:

Rested gal's advice above is right on in my opinion. also have used the SWIFT since January with a PB420 at a fixed pressure of 18cm H2O with no problem with the SWIFT handling the pressure. since last month i have used the remstar auto also with the swift at a range of 15 to 20 no problem. but it is easier to exhale against the pressure with the c-flex feature for me! for me this combo of auto and swift is perfect and even better now with the hose placement idea from tridens (see his posts)

best of luck to you,

steve
ufo13

Thanks to all of you...what a relief to read your reply...
When I go to the DME to get the equipment I will ask about
the breeze and the swift. As far as the Aerophagia goes, I am
very worried, I told the tech that I have severe Irritable Bowel and
don't even dare chew gum or drink anything carbonated or a hospital
visit is a definite. That is my biggest concern, hopefully I won't need
that pressure all the time even better would be never. I have asked
for the Remstar Auto C-Flex, with the HH, hopefully that will help.
But I am allwilling to do what I have to do to get better. Thanks for all the words of encouragement...just gotta love this group....Will let you know how
it goes...

Mar