What should I start off with on the first night?

mindy · Post by **mindy** » Wed Aug 22, 2007 5:59 am

crazybimmer wrote:Yea I wasnt smart enough to even get a sleep study done.

I have a high deductible insurance so i took the matter in my own hands. Better than ignoring it...

Crazybimmer, that's not a matter of "smarts". I am *not* a doctor but do work in medical research. I did a very brief search of the medical literature and found that there has been at least 1 study (possibly more) of using an auto CPAP in order to titrate a patient's pressures.

The paper I found is "Titration Efficacy of Two Auto-Adjustable Continuous Positive Airway Pressure Devices Using Different Flow Limitation-Based Algorithms.", written by Hertegonne KB, Rombaut B, Houtmeyers P, Van Maele G, Pevernagie DA. (from Belgium) and published in the medical journal "Respiration" in January 2007. Their conclusion: "...this face-to-face comparison of Auto-adjustable continuous positive airway pressure devices seems useful for the assessment of titration efficacy."

I do agree with other posts that suggested leaving pressure at 4-20 to first see what you get with that, then gradually adjust one small step at a time.

It's a reality that sleep labs are expensive and the auto cpap is a potential. *Warning*, however: if you have central sleep apnea instead of obstructive sleep apnea, the machine won't do you any good!!! Sleep labs do exist for a reason. Some researchers seem to be doing this kind of work to look for options for those who can't afford sleep labs. I've found that my sleep lab is so overloaded that they are not looking for business!

Mindy

_________________

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

darthlucy · Post by **darthlucy** » Wed Aug 22, 2007 7:14 am

crazybimmer wrote:
darthlucy wrote:
crazybimmer wrote:Yea I wasnt smart enough to even get a sleep study done.

I have a high deductible insurance so i took the matter in my own hands. Better than ignoring it...
May I ask, then, how do you know for certain you have sleep apnea?

Well had many who slept in the same room as me that i "choke" in my sleep. Also have...

* Loud snoring
* Periods of not breathing
* Awakening not rested in the morning
* Abnormal daytime sleepiness, including falling asleep at inappropriate times
* Recent weight gain
* Limited attention
* Memory loss
* Poor judgment
* Personality changes

I know some people here will not approve of this and im ok with that. But from all the reading that i have done, i dont see how this could be harmful for me if i monitor everything.

Will I harm myself?

oceanpearl · Post by **oceanpearl** » Wed Aug 22, 2007 7:48 am

[quote="mikester"]oceanpearl - Geez, no need to be so hard on the new guy. Not everyone can afford to pay for a study, and there's really nothing wrong with self-titrating using an APAP, as long as you know what you are doing.

http://www.foocus.com/pdfs/Articles/Mar ... rtelle.pdf

So, are we going to be jerks and drive away a new user, or are we going to help someone who needs it become compliant.

oceanpearl · Post by **oceanpearl** » Wed Aug 22, 2007 7:52 am

My question is, what if this person has CSA as opposed to OSA??
When we start recocomending that someone try a CPAP machine without consulting a doctor we are getting on dangerous ground and it wouldn't suprise me if our host shut the site down due to liability questions.

mindy · Post by **mindy** » Wed Aug 22, 2007 8:41 am

[quote="oceanpearl"]My question is, what if this person has CSA as opposed to OSA??
When we start recocomending that someone try a CPAP machine without consulting a doctor we are getting on dangerous ground and it wouldn't suprise me if our host shut the site down due to liability questions.

Guest · Post by **Guest** » Wed Aug 22, 2007 9:51 am

The things that I sometimes see thrown around on here seem to make Apnea seem like a "not so dangerous disease" and we can run down to the drug store and get something off the shelf to make it better. We know more than any sleep doctor out there.

Bad mouyhing DME's and sleep doctors is getting to be a passtime here.
My sleep doctor is a caring and open minded person, listens to me and works with me in getting the treatment that I need. He specifies what machine and mask that I get and I have never asked for anything that I didn't get. The whole secret is being reasonable. We are not always going to get the latest and greatest unless we are willing to pay out of our own pocket. I can just see myself walking into my cardioligist and telling him that I need him to put in a pacemaker and by the way, while you are in there go aheah and put in a couple of stents.

DME companies are running a business and basically going to stick peanut butter up you nose instead of a machine if it makes the bottom line look better. I would never go to a sleep doctor who dispenses CPAP equiptment anymore than I would go to an eye doctor who sells glasses.
My understand is that your family doctor can prescribe a CPAP.

Snoredog · Post by **Snoredog** » Wed Aug 22, 2007 10:09 am

I would set the machine from 6.5 cm to 20 cm for the first night. That Minimum pressure would be high enough so you are not starving for air to breathe and yet low enough for the machine to get a good read. The 6.5 cm is also high enough so the mask work efficiently to flush out your exhaled CO2.

Then I would observe the AHI information, if it remains high you can start increasing the Minimum pressure up by 1 cm. When AHI gets close to 5, then increase by .5 cm.

darthlucy · Post by **darthlucy** » Wed Aug 22, 2007 11:23 am

mindy wrote:
oceanpearl wrote:My question is, what if this person has CSA as opposed to OSA??
When we start recocomending that someone try a CPAP machine without consulting a doctor we are getting on dangerous ground and it wouldn't suprise me if our host shut the site down due to liability questions.
Oceanpearl,

I agree that one should be reasonably certain about the diagnosis (other things ruled out). If I were in the spot of having no or high-deductible insurance, I would probably ask my doc if this were a reasonable thing to try rather than just going out and doing it.

Mindy

Absolutely agree 100% with both of you, and with oceanpearl's other comments in this thread. In this thread, treatment advice is being given to someone who appears to have entirely self-diagnosed. Scary stuff in my view, and I would even go so far as to say this is why xpaps require prescriptions.

mindy · Post by **mindy** » Wed Aug 22, 2007 11:42 am

Darthlucy,

I agree.

It would, IMHO, also be more likely that someone would discontinue therapy if problems occur after self-diagnosis and treatment than when properly diagnosed.

Auto paps could, perhaps, be useful for titration of pressures *after* a sleep study to diagnose OSA. I don't think I'd want to skip that first step, however.

Perhaps we need to stick to what this forum does best ... trading info on products and experiences and leave the diagnosis to the docs who are trained to do so. [Picture me ducking as the rotten tomatoes and eggs come flying!]

Mindy

oceanpearl · Post by **oceanpearl** » Wed Aug 22, 2007 12:25 pm

Mindy
No need to duck. Someone should have brought this forth a long time ago. We are fortunate that our host doesn't censor the board, but people are taking advantage of that.
I ran into a situation a few years ago on a Cigar forum and the host had to shut it down because of liability issues.

mindy · Post by **mindy** » Wed Aug 22, 2007 12:41 pm

oceanpearl wrote:We are fortunate that our host doesn't censor the board, but people are taking advantage of that.
I ran into a situation a few years ago on a Cigar forum and the host had to shut it down because of liability issues.

Oceanpearl,

That would be an incredible waste! I have read many very helpful posts on this forum that saved me a good deal of misery.

Mindy

Guest · Post by **Guest** » Wed Aug 22, 2007 1:04 pm

OK fine, you can give advice now.

I went to a sleep study and they diagnosed me with OSA.

Now we can move on from the liability garbage.

Wulfman... · Post by **Wulfman...** » Wed Aug 22, 2007 1:13 pm

For those of you of the "Chicken Little" crowd that's afraid of MEDICAL ADVICE being dispensed here, there's the disclaimer at the bottom of every page for anybody to read. Ultimately, it's YOUR therapy.....take any advice obtained here with a grain of salt....I DO!!!. It's the quack doctors and greedy DMEs that you really need to watch out for. Yes, there ARE some good ones out there (and here), but they're few and far between.

Den

The information provided on this site is not intended nor recommended as a substitute for professional medical advice.

mikester · Post by **mikester** » Wed Aug 22, 2007 1:17 pm

This board is more likely to get shut down from all the talk about pirating software, or even worse, people SELLING illegal copies of software to other members. Right oceanpearl?

Guest · Post by **Guest** » Wed Aug 22, 2007 1:21 pm

Im just not going to post anymore if this is the type of advice i will be given.

There was two options i had. I can assume that i have OSA and do treatment on my own which wouldnt harm me. Or pay $2k (my deductible) to pay for a sleep study.

If the CRAP machine doesnt work for me... then I will think its something more serious. In which case I will go seek help from a sleep doctor right away.

Guess I am on my own. Thanks guys for the support.

oceanpearl, you keep bringing up stuff thats not even mentioned here. No advice was given to me on what machine to use. So take your liability crap and shove it up your righteous ass.

Mask

Mask