just got my auto last night

and this morning looked at the little windows of info and it showed
90% pressure
CMH2O
7day avg 14
30 day avg 5.5


My setting are Min of 12 Max 14

so am I right in thinking that I spent most of the night at 14?

This is a brand new machine and last night was the first night using it.

yes you spent a majority of the time at 14cm. But the results can be somewhat skewed because the Minimum pressure is so high at 12cm.

If you can tolerate that high a pressure starting out, that is fine but it will "mask" most of the events seen at lower pressures.

If your auto is the M series it will have AutoRamp, pretty cool feature, you could set it to 6.0cm for example for up to 45 minutes and when the Ramp button is pushed it will drop from 12cm to 6cm then start ramping up from there, a good feature if the pressure keeps you from falling or getting back to sleep.

You might want to wait a few more days your avg. pressure will probably change quite a bit.

What was your PSG titration pressure?

Where there any CA or MA's listed on that report?

What was your PSG titration pressure?

They way they did titration was to send me home with auto for 5 days? And then they set it for 12. Spoke to doctor and told him at first 12 blew me away but lately felt like I couldn't breathe at 12. He said 12 was fine and didn't want to up my pressure. So put me on ambian cr. But he did agree to me getting a auto machine and they set it for min 12 max 14. I slept real nice until pressures hit 14 and blew my lips open. And I admit took mask off but when I woke back up I put it back on. Its amazing with mask on and cpap working good for me I don't have to get up to go pee. But as soon as I take cpap off with in min I have to go pee. I'm hoping that soon we will have the money free so I can also buy the card reader.


OH forgot to say was using the comfort gel nose mask with my new chin strap. Was very comfortable guess I need to look into taping my lips so they dont blow apart in the night.?

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): Titration, CPAP, auto

IBTeri wrote:and this morning looked at the little windows of info and it showed
90% pressure
CMH2O
7day avg 14
30 day avg 5.5


My setting are Min of 12 Max 14

so am I right in thinking that I spent most of the night at 14?

This is a brand new machine and last night was the first night using it.

I may be wrong, but I don't think the 90% pressure means you spent most of the night at 14. As I understand it, "90% pressure" means the machine spent 90% of the TIME using a pressure of 14 AND pressures BELOW 14. Doesn't mean it stayed up at 14 for 90% of the time.

So, you could have spent most of the night using 12 and 13, and very little time actually at 14.

One of the many advantages of having Encore Pro software and a card reader is to see more detail about your individual nights. With the software data, you'd be able to look at the pressure line on a graph and see the ups and downs... get to see how much pressure the machine was actually using throughout the night and when. You'd get that kind of info and much more (leak rate, when apneas/hypopneas sneaked through, etc.) on easy to understand graphs.

One thought...that's a rather narrow range to be using. If it were me (I'm no doctor, though) I think I'd raise the upper pressure more. Perhaps set the machine for 12 - 16. Again, it would be easier to see what's going on with software downloads from the Smart Card. But even without software, I think I'd want to set the top pressure on a figure that the machine never actually used.

It's not a bad idea to have set a very close range to start with, and you might want to keep it like you have it for a week or so. If it keeps averaging 14 as the 90% pressure, I think I'd give it a little more room at the top eventually, to see if more needed to be used.

If I kept hitting the top pressure, though, no matter how much I kept raising it, I'd look very closely at the possibility of acid reflux (whether I had obvious symptoms of it or not) interfering with cpap treatment.

Congrats on getting your autopap, Teri!!!

If I kept hitting the top pressure, though, no matter how much I kept raising it, I'd look very closely at the possibility of acid reflux (whether I had obvious symptoms of it or not) interfering with cpap treatment.

Been told I had that long ago. But it hasn't flared up lately so not sure if its still happening when I'm asleep or not. Most times Ihave it I sit bolt upright and feel sick to tummy. I take zantac when I do have it. Going to new sleep doctor on this coming tuesday. Do the doctors have the card reader or do I have to take it to dme first than have them send info to doctor?

Rested Gal wrote:

I may be wrong, but I don't think the 90% pressure means you spent most of the night at 14. As I understand it, "90% pressure" means the machine spent 90% of the TIME using a pressure of 14 AND pressures BELOW 14. Doesn't mean it stayed up at 14 for 90% of the time.

Directly from the M series User Manual, page 4-6:

90% Therapy Pressure Screen
This screen displays a 7-day and 30-day average of the 90% pressure that you have used. The 90% pressure is the pressure at which you spent 90% of the session time at or below.

is that a 7 day or 30 day session?

I'm sure the machine had some "test" time on the bench included in that avg., but who knows.

IBTeri: You didn't answer my question on the CA's or MA's from your PSG?

I always become suspect of those when I see someone hit the Maximum set pressure with their autopap. If you move it to 15.0cm you may go 15.0cm and so forth. It is important that YOU know if those exist so when someone suggests increasing the Maximum pressure you can do so (or not do so) with with caution.

I did answer you. I said I never had a trations that the way they set my pressure was to send me home with an auto for 5 days and the averge from that was 12. I saw him take the machine out of box. But it did show in the 30 day average 0:24 when I started it at home cause we did have it on for a few min at the DME. The thing is I have seasonal allergys year round its differant types. But this time of year is worse I am highly allergic to xmas trees. I was only told misc trees. But I have found that xmas trees all most kill me. And I mean kill me. I have horrible time breathing and have to avoid any place that had live xmas trees. Or fresh cut. How ever you say it. I am allergic to grass(I have a true Hay allergy which I found out the hard way means grass) And my misc wood allergy which I know xmas tree's are on the top of list. Meds like singular have almost all but got the grass allergy under control now trees is another matter all together. I use a hepa and just plain don't go out much if I can help it when I get real bad. If anyone remembers from chatroom I made my hepa go boom when I cleaned it. LOL have to buy new one. ITs dead. I am not trying to be or play stupid here. I am just trying to understand.

ok I have no clue what CA or MA are. My sleep study is a poor excuse for a sleep study. I am hoping to talk new sleep doctor into another study.

CA=central apneas
MA=mixed apneas

Brenda

oh on sleep study says I only have apenia in rem and had 15.9.
But what tech told me night of sleep study plus the print out he gave me.
Says I only had 15 min of rem and that in that time I had OSA and Hypopneas. During my sleep study my O2 got down to 81 but it also showed me awake when it happened. I didn't know that until DME said I was holding my breath? I wasn't holding breath as far as I knew I was a sleep dont' even remember that happening. when I was in ER the other night with chest pressure the silly machine alarm kept going off cause was saying my O2 was dropping so I would take a deep breath to make it stop. I was also falling asleep when the alarm was going off? My sleep doctor never said much to me. Old DME didn't talk to me either. And after spending almost 3 hrs sitting in new DME office and the guy acting cold and ignoring me until the doctor faxed him stuff I'm not to sure about new DME either. I am tired of people play or acting like there better or GOD. The new DME when I went in at the begining of the week was very friendly but also at this time my husband was with me. yesterday I was by myself and was treated like I wasn't there. Like I said I am new at this and still learning and so far I think it all sucks. Only good thing so far is this forum and I feel more mentally alive. I am still drop dead tired physically. But mentaly I feel great.

Snoredog wrote:Directly from the M series User Manual, page 4-6:

90% Therapy Pressure Screen
This screen displays a 7-day and 30-day average of the 90% pressure that you have used. The 90% pressure is the pressure at which you spent 90% of the session time at or below.

"at or below"

Teri, I just now read another topic at
viewtopic/t15032/argggghhh.html

where you wrote this:

IBTeri wrote:My throat starts to close up when I have allergy attacks mostly around this time of year.

Allergies causing throat swelling, as well as the acid reflux you mentioned in this thread can both interfere greatly with getting effective cpap/autopap/anypap treatment, imho.

You mentioned this, in regard to acid reflux:

IBTeri wrote:Been told I had that long ago. But it hasn't flared up lately so not sure if its still happening when I'm asleep or not. Most times Ihave it I sit bolt upright and feel sick to tummy. I take zantac when I do have it.

There's such a thing as "Silent Gerd" which means you can have acid bathing the esophagus regularly and not have symptoms of heartburn that you'd notice. You could believe it was under control, yet the acid could be seeping up during your sleep (much more likely to happen when we're lying down) irritating the throat tissue and causing swelling. Swollen tissue is more rigid. CPAP is designed to push aside soft tissue. It can't work well to open the throat if the air is hitting swollen, hard tissue in the throat.

I'm not a doctor, but I really, really think you'll need to get the allergies well under control, and get the acid reflux problem that you were told you had "long ago" checked again. Acid reflux might, just might, be doing quite a number on your throat while you sleep, even if you aren't having noticeable flare-ups lately. Silent Gerd.

If your autopap keeps hitting the top pressure no matter where you set the top, it could be a sign of swollen, hard throat tissue during the night preventing xpap from doing its job. Do keep a close eye on either/both possibilities that could do that to throat tissue -- allergies kicking up or acid reflux -- either one can do that to the throat tissue.

Teri, that is how I got tirated. 5 nights at home, with an auto and an oximetry thing on my fingure which measured SpO2 and Pulse rate.

Ask to get the report from that titration. Mine was detailed.

Hopefully you can get another hepa filter soon.

IBTeri wrote:I did answer you. I said I never had a trations that the way they set my pressure was to send me home with an auto for 5 days and the averge from that was 12. I saw him take the machine out of box. But it did show in the 30 day average 0:24 when I started it at home cause we did have it on for a few min at the DME. The thing is I have seasonal allergys year round its differant types. But this time of year is worse I am highly allergic to xmas trees. I was only told misc trees. But I have found that xmas trees all most kill me. And I mean kill me. I have horrible time breathing and have to avoid any place that had live xmas trees. Or fresh cut. How ever you say it. I am allergic to grass(I have a true Hay allergy which I found out the hard way means grass) And my misc wood allergy which I know xmas tree's are on the top of list. Meds like singular have almost all but got the grass allergy under control now trees is another matter all together. I use a hepa and just plain don't go out much if I can help it when I get real bad. If anyone remembers from chatroom I made my hepa go boom when I cleaned it. LOL have to buy new one. ITs dead. I am not trying to be or play stupid here. I am just trying to understand.

My titaration study wasn't too good - I couldn't really sleep enough with the mask on. So I too was sent home with an automatic machine, and they tried to set the pressure based on that.

O.

IBTeri wrote:oh on sleep study says I only have apenia in rem and had 15.9.
But what tech told me night of sleep study plus the print out he gave me.
Says I only had 15 min of rem and that in that time I had OSA and Hypopneas. During my sleep study my O2 got down to 81 but it also showed me awake when it happened.

I didn't know that until DME said I was holding my breath? I wasn't holding breath as far as I knew I was a sleep dont' even remember that happening.

when I was in ER the other night with chest pressure the silly machine alarm kept going off cause was saying my O2 was dropping so I would take a deep breath to make it stop.

I was also falling asleep when the alarm was going off?

My sleep doctor never said much to me. Old DME didn't talk to me either.

And after spending almost 3 hrs sitting in new DME office and the guy acting cold and ignoring me until the doctor faxed him stuff I'm not to sure about new DME either.

I am tired of people play or acting like there better or GOD. The new DME when I went in at the begining of the week was very friendly but also at this time my husband was with me. yesterday I was by myself and was treated like I wasn't there.

Like I said I am new at this and still learning and so far I think it all sucks. Only good thing so far is this forum and I feel more mentally alive. I am still drop dead tired physically. But mentaly I feel great.

I think your mental attitude towards this is great, but I don't think you are getting the straight answers you need from your doctor or DME's.

I put in BOLD some things you indicate, which I see are a bit troubling. From this and other posts I gather:

1. You had a diagnostic PSG in a lab setting with EEG monitoring and yet to see the lab results (request a copy from the sleep lab).
2. For whatever reason that PSG didn't include a pressure titration study, so they sent you home with a 5-day autopap trial to find the pressure?
3. You don't have a copy of your PSG report (only what doctor or DME have told you through conversations)? Again, you NEED a copy of that report, I would call tomorrow for it.
4. After the 5-day autopap trial, they sent you home with a straight cpap machine set to 12cm where it was later swapped out for a Remstar M series Auto?
5. Pressure found from the 5-day trial was 12cm, autopap was then set to 12cm to 14cm?

If the above is correct then I would suggest:

1. Reading the PSG report carefully (it should be 4-6 or more pages), your doctor SHOULD give you a copy of this, if not contact the Sleep Lab and demand a copy of it. You have every legal right to it even if they are slimeballs and want to charge you $1 per page for it. Pay it, get the report.

2. Ideally, a lab pressure titration is preferred over any autopap titration because you get the benefit of seeing what the pressure does to your sleep (i.e. you don't have that info now). In the absence of a lab titration, you need to study your diagnostic PSG report carefully and list out all the information that was seen there. Do NOT rely on your DME to give you this information, they are only a crutch supplier and I wouldn't rely on them for anything.

I highlighted in bold some of the items of concern you mention which could indicate a possible problem with your therapy but without knowing what your PSG report said that can be difficult to ascertain.