New here. Do you change your own pressures?

Hello all,
I'm new here. I've heard alot of good things about this forum and I'm glad I found it.
I was curious......I've heard of people getting the software that allows them to make some pressure changes themselves. I'm curious if if these people have used a CPAP for a long time, and just feel they can manage it themselves, and how do their docs feel about it? Has anyone gotten in trouble with their doc for doing it themselves? I've only been using mine since May, but its my understanding that they've programmed it so I can't make changes. Fortunately, I can check out the data every morning, as to how I've done. Thanks!
P.S. I have a ResMed S8 Auto Vantage with humifier and use a Swift nasal pillow.

Yes I do change mine... there are directions around here... or somebody will pm you with them.

I have made some careful adjustments to my pressure, with the knowledge of my sleep doc. Originally, he gave me a specific pressure, then when it didn't work real well, indicated that a couple of cmH20 higher would be OK, but if that didn't handle it, he'd want another sleep study.

I changed from CPAP to APAP, set a range based on his upper limit, and watched the data for a while. Gradually I narrowed the range until I'm nearly back to where he started me.

Part of my problem was trying to breath through a nose that has a slightly deviated septum. Going to nasal prongs really helped that out.

In general, I feel like it's MY treatment. If the doctor has a rational argument against something I'm doing, I'm fine with that. If it's just his ego talking, my ego will be ignoring it!!

Country4ever wrote:Hello all,
I'm new here. I've heard alot of good things about this forum and I'm glad I found it.
I was curious......I've heard of people getting the software that allows them to make some pressure changes themselves. I'm curious if if these people have used a CPAP for a long time, and just feel they can manage it themselves, and how do their docs feel about it? Has anyone gotten in trouble with their doc for doing it themselves? I've only been using mine since May, but its my understanding that they've programmed it so I can't make changes. Fortunately, I can check out the data every morning, as to how I've done. Thanks!
P.S. I have a ResMed S8 Auto Vantage with humifier and use a Swift nasal pillow.

The software allows us to monitor our therapy. The software isn't necessary to make changes in machine settings......that can be done by getting into the "setup" configuration......which is very easy to do.
There is absolutely nothing illegal or forbidden about changing one's own therapy settings......however, I wouldn't really advise anyone doing it without having a machine that records the nightly statistics and the software to interpret it.

You have to ask yourself....."Whose therapy is it?"
Is it your doctor's? Is it your insurance company's? Is it your DME's?
Nooooo......it's YOURS.
With the failure rate of this therapy at around 50%, that doesn't speak very highly of the medical professionals and those who are supposed to be helping with making it successful.
Many of us who have found these forums (and this one in particular), wish to make the best of our therapy.......by acquiring data-collecting PAP machines and the software with which to enterpret that data.

I didn't use a local DME. I purchased all of my equipment from CPAP.COM and my insurance provider reimbursed me for most of the cost.
I didn't believe that my sleep doctor had selected the proper pressure for my therapy.....which was 18 cm. Within an hour of attempting to tolerate that pressure, I decided on my own to change my pressure to something I felt would be more "reasonable" and decided on 10 cm. SInce I had the software from the very beginning, I was prepared to adjust my pressure as the reports dictated. Oddly enough, I did very well at the pressure I had chosen......and left it there for almost a year. I finally experimented with pressures of 11 and 12 and finally ended up at the latter. My AHI numbers were the same for all three settings, but at 12, my snoring was pretty well eliminated. Basically, I figured all of this out on my own.

I only had a very few meetings (maybe 3) with my sleep doctor and none were what I would call "warm and fuzzy".
I have absolutely no regrets about how I went about getting on with my therapy.

Hope that answers some of your questions.

Den

You have a good machine ... and there is an experienced and knowledgeable group of folks here willing and able to help those with less than helpful or knowledgeable healthcare professionals.

Around here we don't get in trouble with the docs ... the docs get in trouble with us. In other words, it's our health and if the docs can't or won't cooperate with our being involved in the mamangement of our treatment then we fire the docs.

Anyway, welcome to the group.

I hear an echo in this thread

Thanks everyone,
Dreamstalker, I liked your comment about "we don't get in trouble with our docs. They get in trouble with us."
I haven't really given my doc enough chances yet. What I mean is, I haven't known enough to get aggressive with him....but that doesn't mean I won't. Plus, I didn't want to alienate him until I "owned" the machine!
I can recall my nightly/monthly stats on my machine, but I believe the DME disabled my ability to make any changes.
I like her alot, for the most part, but when she got all flustered when I mentioned talking to some people on the internet.....I knew it wasn't a good sign. I was pretty insulted that she was taking the power of my being involved in my treatment away from me. She should have given me credit for having half a brain. Perhaps she just works with mostly people who don't??? I just don't know....but I didn't like it.
Are any of you aware if I CAN adjust my own pressures, if she said it was disabled??
I thought my numbers were good, (AHI less than 5), but in talking with people, I'm thinking I could so some small adjusting and maybe get it even lower.
Like I said earlier, my doc let me have this treatment without another sleep study. He could have gotten real obnoxious about it, but felt, considering my anxiety, that we could monitor things well, just by looking at the data.
Anyhow.......thanks for your input. And please tell me if you think its possible that they did disable the machine program for adjusting the pressures.
P.S. If I ever do get alienated from my sleep doc.....I worry about not being able to get insurance coverage for supplies, etc. What do you think?

As far as i know they can't fix it so that you can't get in to change your settings, they just remove the manual that tells you how. I think this is what you need.

Jerry


To get into the provider setup mode in a ResMed S8 CPAP machine - such as the S8 Compact, S8 Elite or S8 AutoSet Vantage - follow these steps:

press the right and down arrows simultaneously for about 3 seconds until the "Clinical Menu" appears on the screen
Use the up and down arrows to cycle through the settings and use the left "soft key" to select "Change" or use the right "soft key" to "Exit" from the Clinical Menu. Below is a list of settings you can cycle through on an S8 AutoSet Vantage automatic CPAP machine. There are four groups of settings which have adjustments and data within them.
Settings
CPAP Mode
Minimum CPAP Pressure
Maximum CPAP Pressure
Maximum Settling / Ramp
Mask Type
Tube Length
Humidifier
Smart Start
Leak Alert
Results
Efficacy Data
Usage Data
Options
Smart Data
Reminders
Factory Defaults
Erase Data
Date
Time
Menu Type
Language
Servicing
Run Hours
Serial Number
PCV Number
SW Number
BR Number

I would STRONGLY suggest that before you go thru that Clinician's Menu you get a long piece of paper and a pencil and you write down EACH menu option BEFORE you push the next button. This will allow you to KNOW exactly how your doctor ORDERED your therapy to be set up.

You, or any other new CPAP user, would do well to get some time on your CPAP under your belt before you jump in and start making any changes.

AND, when you do make a change, make just ONE change at a time (even if it is just the mask you are using), AND STAY w/that ONE change for a week, then collect that AVERAGES for that week before opting to make the next change.

One nice thing about adjusting your own therapy, you have no one but yourself to blame if it doesn't work out.

Once you have some time under your belt w/CPAP therapy more than likely with the advice and suggestions from the experienced PAPpers in the forum you will be able to "tweak" your therapy even better than your doctor.

I've been using my CPAP for a year and a half. My sleep study indicated that I needed a constant pressure of 6. Several months ago, I decided to do a little research, found out that I could acquire the therapy report software, and realized from those reports that my numbers (AHI) were very high, I just wasn't really getting any therapy from my machine. So, I purchased a new APAP machine that automatically adjusts the pressure to my needs night by night. Now I get the therapy I need, and I feel SO much better!

Ted

I do adjust mine. My sleep doc actually told me to "play with it" within certain parameters until I got the pressure that made me feel best ("it's good to have the software, but what's most important is how you feel, not what the numbers say").

Welcome to the board, Country4ever!

"I believe the DME disabled my ability to make any changes."
She can't "disable" the ability to make changes. You just have to know how to access the clinical menu.
What Jerry (6PtStar) said.

"Are any of you aware if I CAN adjust my own pressures, if she said it was disabled??"
You sure can. Again, if you know how to get into the clinical menu.
What Jerry said.

"please tell me if you think its possible that they did disable the machine program for adjusting the pressures. "
Nope. Pushing and holding down the correct pair of buttons on a resmed machine lets you go into the clinical menu where you can make changes, including changing the pressure, if you want to.
What Jerry said.

What Slinky said.... is very important. If you do decide to go into the clinical menu, don't make ANY changes you're first time through. Write down every menu item's setting. You may want that record of how it was originally set up if you make a change later, don't like it, and want to go back to your original settings.

Country4ever wrote: Dreamstalker, I liked your comment about "we don't get in trouble with our docs. They get in trouble with us."

Ditto!
That's the way to look at it if you want to be proactive about your own treatment.
What Dreamstalker said.

Panhandler wrote:In general, I feel like it's MY treatment. If the doctor has a rational argument against something I'm doing, I'm fine with that. If it's just his ego talking, my ego will be ignoring it!!

Another ditto!

wulfman wrote:You have to ask yourself....."Whose therapy is it?"
Is it your doctor's? Is it your insurance company's? Is it your DME's?
Nooooo......it's YOURS.

Exactly!

Thanks everyone! What great info you've given me! I wish I'd known about this place sooner!
And the suggestion to write the present settings down before making any changes is a really good one I probably wouldn't have thought of.
I'm not sure I'll make any changes for awhile........but its good to know that when I have more experience, I'll be able to if I want. Thanks again!

I'm gonna 'fess up. That advice to write EVERYTHING down your first time thru the Clinician's Menu is NOT my brainstorm. That advice was passed to me by RestedGal and it was WONDERFUL advice that should be made clear each time directions are given on how to access that menu. Thank you yet again, RG!!!

Heed RestedGal's advice... she is very knowledgeable and accurate!

Also, Slinky's point about making one change at a time is a wise course to follow. For example, if you decide to change your ramp time, change that ONLY and give it a week to see how things go. How do you feel? What do your numbers show? Then make another change if needed. Same with pressures. Change by one point, wait a week and monitor, then consider another change if needed.

Also, remember that our pressure needs vary from night to night, and from position to position. You need more pressure when sleeping on your back as a rule than when side-sleeping. Aches and pains, colds, emotional stress; all can and do change our pressure needs.

Good luck!

Thanks Bookbear.
Question about Ramp......that's just how the pressure starts out low and increases over a set amount of time, so we don't feel so much pressure at the beginning, right? I think its called "settling" on my machine? Why would people not want that? Thanks!