can apap sense RERAs?

Rachael · Post by **Rachael** » Sat Jan 13, 2007 10:09 pm

So, after the first few days of APAP my 90% ave. was 9 or something, but since I have started to get used to it it has never been anything other than a 4 (the low end of the range the DME set for the home titration study.) After reading something about 4 leaving most people feeling starving for air, which is how I feel before I fall asleep, I started thinking. I had no apneas and no hypapneas during my study, and I looked at all of those RERAs on the computer with the sleep tech the next morning. They were small subtle things, a bare tweak of the line in the reparatory effort, and a minute dip on the blood ox. They were only really significant because they caused arousals.

So, it doesn't make sense that the APAP can sense those. If it could you would just do a home sleep study... So if my machine can't sense any "action" what in heavens name is the point of a 4 week home titration study? All the machine is ever going to do is sit on 4, unless the machine itself causes me to start having apneas

I am starting to think that a comfort trial would make more sense. Just set my pressure say to a 6, and give that a week trial. If I wake up feeling rested, okay, if not, try 7 for a week, etc. I have not been able to find research that directly addresses cpap for UARS.

Thoughts?

(Oh, and I had no rain-out last night with the polar fleece and pillow set up, so I think I am good there.

Wulfman · Post by **Wulfman** » Sat Jan 13, 2007 10:35 pm

Rachael,

Sounds logical to me. My often-repeated phrase is "It's YOUR therapy!"

Keep tweaking till you get it comfortable and feel good.
(and hopefully the sleep data looks good, too.)

Best wishes,

Den

blarg · Post by **blarg** » Sun Jan 14, 2007 3:58 am

You can set your auto to CPAP (or just raise your min pressure) any time. I couldn't stand 4 either.

Rachael · Post by **Rachael** » Sun Jan 14, 2007 11:58 am

Can someone tell me how to raise the minimum pressure on a respironics M series auto pap? I know there is something to do with pressing two of the buttons at once while plugging it in but I would hate to mess anything up... I promise I won't raise it to more than 6. Actually, my prescription said 5-15, and the RT set it at 4 to be "nice" assuming it would ramp up.

Snoredog · Post by **Snoredog** » Sun Jan 14, 2007 3:48 pm

[quote="Rachael"]Can someone tell me how to raise the minimum pressure on a respironics M series auto pap? I know there is something to do with pressing two of the buttons at once while plugging it in but I would hate to mess anything up... I promise I won't raise it to more than 6. Actually, my prescription said 5-15, and the RT set it at 4 to be "nice" assuming it would ramp up.

Rachael · Post by **Rachael** » Sun Jan 14, 2007 5:32 pm

Thanks guys, you're the best. I slept without the pap last night and I woke up more than I do with it. So, I will reset my pressure to 6 and see how it goes.

Rachael · Post by **Rachael** » Mon Jan 15, 2007 12:21 pm

Wee-hee!

I am here to report amazing success. The difference in how it felt sleeping and how I feel this morning are night and day! (Ahem. Well, you know what I mean...) Thank you so much for your help and the advice for resetting my machine. I still find it hard to breath out, but the greater incoming pressure made falling asleep so much easier, and I feel great this morning. I also like that I can see so much more info on the screen like my AHI. Which I am interested to note is 1.8, which I find very curious indeed since I had 0 apneas or hypapneas during my sleep study.

I did talk to a RT before changing my settings, she was against it and didn't believe that a pressure of 4 would leave me feeling starved for air, "It's greater than the normal breathing pressure" says she, "but normally I don't have a little confining mask over my face holding my CO2 against my nose" says I. But I found a study online that says that patient-comfort based titration is as effective as lab determined titration. So I felt pretty confident in striking forth on my own.

I couldn't get an appointment to see my sleep doc untill 6 weeks for the follow up to my home titration, but I think that is actually for the best. I spent a week getting used to the mask and the very idea. Another week determining that 4 was too low for me. I am going to give 6 a week, than try 7 for a week, if 7 is better than 6 I will try 8, etc. I printed out a variety of copies of the FOSQ and Epworth sleepiness scale and figure if I track how I feel by those measures I should arrive at a good pressure before I see my Doctor. I am assuming a pressure between 6 and 9 will be appropriate since I have UARS. My one concern is avoiding triggering central events with too high a pressure.

Can anyone tell me if the M series plain old cpap has a card system? Does it track the same type of information as the apap? I think an apap isn't really useful for me, but if a cpap doesn't allow me to track data than I would want to stick with an apap. Also, I am wondering if I might need bipap since exhalation pressure actually seems to be causing apnea for me.

Thanks again everyone!
Couldn't have done it without you.

cflame1 · Post by **cflame1** » Mon Jan 15, 2007 5:25 pm

Rachael,
It depends on what model of M series you have... is it the Pro or the Plus??

packer · Post by **packer** » Sun Sep 23, 2007 7:33 am

aflex made a huge difference for me-
I was "fighting" exhale and inhale

to me the aflex has better exhale relief also-

whether it does really have better exhale relief I dont know [ or care really]

if it is the placebo effect-- so be it- I like it

anyhow-- aflex works better-- wish you could try one for a week packer

can apap sense RERAs?

can apap sense RERAs?

Thanks

aflex relief on exhale