CPAPtalk.com

Also remember that your brain is not used to any of this and while trying to make sense of what you are feeling it may goof and tell you one thing is happening when it is really something else. Jus saying. I did this a lot, I had my humidity set too high and I kept thinking I was congested. I tried all the standard things for congestion with no relief, then I turned down the humidity by one and bingo no more "congestion"

palerider wrote:

raven1962 wrote:I was hitting some sort of limit in the machine. It was like hitting the limit of a respirator, before they adjusted the flow. I don't know how better to describe it. Just a normal breath and there wasn't enough air. A sort of bump, like popping a valve. I hit it with almost every breath.

you may need a machine that provides separate inhale and exhale pressures, ie, a bi-level machine, if you breath really slow and deep, you'll need a resmed VPAP machine, because they offer adjustments on how long the machine stays at inhale pressure.

as to your 3 liter lung capacity, the resmed vpap auto can maintain 25cm/h2o pressure while delivering 161 liters PER MINUTE of air, using a standard size hose. so as long as you're not breathing more than 53 times per minute, full capacity, it can keep up with you.

Probably what I was up against. I breathe slow enough to continually set of the alarms, whenever I've been on the monitors. If I'm on supplemental O2, in the ER, my sat usually stays between 97% and 100%, but the respiration rate, especially when I am focusing on being relaxed, forcing myself to relax for sleep, or doing self-hypnosis, like prior to a procedure, drops significantly below normal respiration rates, and I do tend to breathe deeply every few breaths.

There was a definite pause in the airflow and on deeper breaths, there was even a second pause in the airflow.

As for mask fit, Thinking a bit on it, I have dental implants and as part of the procedures, they smoothed out that bump, at the front of my jaw, to remove an undercut that was preventing my dentures from fitting well. Try running your finger up, from your chin, toward your lips. There's a dip, then a bump, then it drops back, to your teeth. I don't have that bump, unless I'm wearing my dentures.

raven1962 wrote:There was a definite pause in the airflow and on deeper breaths, there was even a second pause in the airflow.

hospital ventilators are entirely different beasts, especially the ones with two tubes, don't try and cram cpap into that mold.

Over-thinking is a bad habit that can mess up your perception and cause unnecessary stress.
Please get some help in that area!

chunkyfrog wrote:Over-thinking is a bad habit that can mess up your perception and cause unnecessary stress.
Please get some help in that area!

Easier said than done if it's a lifelong pattern.

But I do think the OP needs to reserve judgment on the CPAP until he has tried it. Express your concerns to the doctor who writes the script.

To the OP:
Most likely what you were feeling was pressure that was too low as they were finding the ideal pressure AND the EPR. The EPR "paces" your breathing and that takes some time to get used to. When you don't breathe in or out as quickly as the machine thinks you should, it sends out a pulse to see if the airway is open or not.

Remember when you felt this you were AWAKE. Our brains can learn to sync up with the machine, but I had the hardest time at first fighting the pacing of the machine when we are awake and aware of it. The trick is to relax and let it work, but that's very hard at first.

You may have an easier time without exhalation pressure relief, but that may take some time getting used to exhaling against pressure.

When you get your machine it will almost certainly be set up with a ramp feature. The idea is to keep the pressure low until you fall asleep, since many people are disturbed by the "wind" blowing in their face at first. But for you, it will be important to learn how to turn the ramp OFF, as it will drive you crazy.

You will need to really work on getting used to the machine. Plan on spending some awake time doing something quiet and relaxing (reading, listening to music or watching tv) with the machine on, just to get used to it.

This is going to be challenging for you, especially to relax and not tweak until you have more data to go on.

Wearing a mask, in and of itself is not going to be a problem. I've had military training as well as civilian use of supplied air, in super-clean industrial environments. The limit I ran into, on inhalation was a physical limit. The supply bottomed out and had to rebuild, before allowing more to flow. Like breathing through your mouth and shutting it, while continuing to try to inhale, then opening your mouth again. Mostly, I hit it once on every breath, but sometimes twice. Like popping a valve to override and allow more air into the system.

Brief update:
Managed to find out: NO, there is no permit requirement for me to order the Vygon/Boussignac C-PAP mask, commonly stocked in EMS vehicles. Ordered one.

Found a suitable capacity, professional-quality air pump. Ordered one.

Found an HME (Heat and Moisture Exchanger) that should fit, inside the mask, with minor modifications to the mask. Ordered one.

Spoke with a person that did his Doctoral Thesis on the Boussignac C-PAP and he is providing me with a copy, as well as an interest in learning my results, especially in light of the complicated setup to run a humidifier for the Boussignac C-PAP mask.

Next step is to add a decent condensation-trap/filter/regulator. Most common filter is down to 5 microns, which should be more than adequate. If it becomes evident, as needed, I can add a dessication canister, since I live in a high-humidity environment.

The air pump is roughly 30% larger than rated maximum airflow capacity/requirement for the mask, based on mask rated at 30 lpm air/O2 flow max. It may take several months, given that I have to utilize the VA for my medical needs, to obtain a typical C-PAP set up. Mine should be up-and-running within 2 weeks, net cost less than $200. If I had been willing to spend more, I could have had it all within a few days.

Using the Boussignac virtual valve eliminates, as I see it, the need for unnecessarily complex machinery. It works on a rather simple process. Mask is pressurized by line-supply, which also boosts flow of incoming air, during inhalation. Exhalation only has to overcome the pressure in the mask.

No mechanical valves/solenoids, etc., to limit airflow in either direction.

Add that, just like using some types of O2 cannula, a thin airline provides the supply, through the space between the wall, mattress and head, rather than trying to lift some honking-huge hose out of the way, or keep from rolling over on it.

The Boussignac is designed to work with normal breathing, not adjusted to approximate it. It you aren't breathing, it's not doing anything but pressurizing the mask. With central apnea, I breathe, just not as often, or as deeply as most, which causes O2 deprivation. By increasing the volume of air inhaled, I can overcome that limitation, but without fighting the valves and solenoids of a regular machine.

Worst-case scenario: I wasted ~$50-$75 and some effort, but have a nice pump/filter/regulator for other projects.
Next best: It works, but not as well as hoped, so I use it until I get a regular machine, then start making further modifications.
Better: Works great, no problem.
Best: Works great and I now have a patentable product.

One more thing to consider is how you are going to monitor your progress...

HoseCrusher wrote:One more thing to consider is how you are going to monitor your progress...

Depends on the data necessary. O2 sat can be monitored just as easily as they do at the hospital, the testing clinic and the EMS, with an LED and photo-detector, same as NASA developed in the original space program. How fancy a gadget all depends on other factors. I'm sure there's a simple hookup for an iPhone, by now, as well. Otherwise, the first indication is either I will sleep well and be rested, or not. If I suddenly start feeling well enough to mow the yard, or a million other 'honey-do's, I'm sure the whole household will be relieved. There is a port capable of being used to sample and monitor O2 and CO2, if the doc needs something fancier than a simple finger-tip type Blood-O2 Sat level, but, at that point, the VA is going to want me hooked up to far more monitoring that that.

A week for monitoring on my setup and a week for monitoring on theirs should suffice, if absolutely necessary.

Anyone heard of "AirStrip" apps for iPhone...

http://www.imedicalapps.com/2010/03/air ... onitoring/

Are you pregnant...?





Ok, bad joke.

Overall it looks good. I don't know how much it would cost but if you could hook up for a month you would probably have enough information to dial in your therapy.

HoseCrusher wrote:Are you pregnant...?





Ok, bad joke.

Overall it looks good. I don't know how much it would cost but if you could hook up for a month you would probably have enough information to dial in your therapy.

Wow. I can so no more. I'm outta here.

OK, so, despite all the negative nellies, I bought the mask (next time I'll order the largest one), an air pump (not a compressor), a copper-mesh based heat and moisture exchanger, had to add a second air source (nebulizer pump we had from a bout of pneumonia) and hooked up numerous configurations. I have the Boussignac factory O2/Air line to the low pressure/high-volume air pump, with the Nebulizer pump on the additional port. It works, and I've avoided the monster hose off the front, instead having 2 small lines up one side. Yes, it's subjective, rather than hard-science, but it's helping ME for just a tad over $100. Could have been done cheaper, but I was unsure of the hme and bought, then destroyed one for a ski-mask, to be absolutely certain.

Essentially, the Boussignac virtual valve seems to give a measured resistance, for the higher pressure air to push off of, into the mask (that's my theory, not lab-data).

I have no idea how long I have been keeping the mask on, but the copper hme has more than tripled that, and I don't wake with total dry-mouth,dried/swollen sinuses, or bad thirst, while the better oxygenation has allowed me the energy to get a few hours of stuff done, w/o sudden bouts of sleep from O2 deprivation.

The Nebulizer pump makes too much noise, but, until I can make a better air inducing 'jet' (Bernoulli's principle), I'm stuck with this setup, while I wait for the VA to kick the Rx for their crud, through the system and spit-out whatever the government will allow.

Next step will be to see if I can create a higher-flow air induction valve, so I can ditch the noisy nebulizer pump and associated extra air line.

DID finally get an official set of lab results. I don't know how to read them, but the breakdown is:
Apnea Indes-4.6
Resp. Effort Related Arousals (RERA)-21
Resp. Disturbance Index (RDI)-27/hr