CPAPtalk.com

Ok, I'd like to say something about all of this "the Doctor or Technician doesn't want me to be involved in my treatment" talk. I mean no offense to folks, but I want you to know that if you get your pressure too high, you may have central apneas. Also, if you get your pressure too low, and your study showed that you have heart arrythmias (like PVC's and such) that are related to the sleep apnea, then you may not get the benefit of the cpap machine. Another thing to consider is that the machine doesn't measure brainwave activity to see how often or how long you are awake. These are called "arousals" or "micro-arousals". It doesn't check your oxygen saturation, either, which is supposed to be 92% to 100%. You may be having a certain number of events per hour (RDI or AHI), but those events may be causing your oxygen to drop even if the number is low. So what I would like for all of you to do is ask your doctor why exactly he wants you to stay at a certain pressure, rather than think that he has an ego problem or that he doesn't want to listen to you. Sometimes a lower pressure isn't adequate for your sleep apnea problems. Please, work with your doctor on this. I'm a Sleep Technician and I titrate Peoples' cpap pressure during the night. I don't like to increase the pressure unless I'm fairly certain it needs it. I have a cpap machine myself, and I know it's not always easy at higher pressures to get used to it (or even lower pressures for some folks). If you don't trust your doctor, see what you can do about going to another sleep doctor to help you understand what you need to do. Thank you and God bless you in Jesus' name.

Randigoman wrote:Ok, I'd like to say something about all of this "the Doctor or Technician doesn't want me to be involved in my treatment" talk. I mean no offense to folks, but I want you to know that if you get your pressure too high, you may have central apneas. Also, if you get your pressure too low, and your study showed that you have heart arrythmias (like PVC's and such) that are related to the sleep apnea, then you may not get the benefit of the cpap machine.

You are so right, Randi. The wrong pressure can be absolutely destructive to therapy. Especially for those who naively believe the PSG got it right, and keep on struggling with the wrong pressure they were given. Why, some people even stop therapy entirely because they can't tolerate the pressure they got in their PSG. Isn't it terrifying when you realize that?

Another thing to consider is that the machine doesn't measure brainwave activity to see how often or how long you are awake. These are called "arousals" or "micro-arousals". It doesn't check your oxygen saturation, either, which is supposed to be 92% to 100%. You may be having a certain number of events per hour (RDI or AHI), but those events may be causing your oxygen to drop even if the number is low. So what I would like for all of you to do is ask your doctor why exactly he wants you to stay at a certain pressure, rather than think that he has an ego problem or that he doesn't want to listen to you.

Do you mean listen to doctor after he looks at the detailed AHI reports generated by the machine? Or do you mean to listen to him when he doesn't even look at data, because he seems to trust the seat of his pants more than modern technology?

May any God you believe in bless your work in finding the right pressure for the people you treat, and give you comfort and compassion when you find out you have made a mistake. Mistakes are inevitable when we treat human beings - we need to accept them.

I have no doubt than when people track their own data, on a nightly basis, they will ferret out mistakes sooner: whether those are their own mistakes, or the one's in their prescription.

I'd like to add one thing to Ozij's post: many of us don't sleep the same way in the sleep lab as we do at home. In my case, I slept much more lightly than usual. It's my understanding that this alone can impact how a pressure is titrated in the sleep lab. I use the lowest pressure I can and still keep my AHI below 5 and feel rested. And yes, I am one of those folks who get pressure-induced centrals when my pressure is too high so I watch it very carefully.

I don't pretend to know more than the experts about sleep apnea and treatment, but I have found that I know how my body reacts. Imho, the ideal is finding a sleep doc who is not only technically knowledgeable, but also understands the human side of the equation. Sometimes the solution of "find another sleep doc" is not practical due to 1) limitations by location and/or 2) cost & time.

Mindy

I would add one more thing to Ozij's post too.

I mean no offense but faith-based OSA treatment doesn't require all those fancy schmancy gadets like CPAP machines, oximeters, and brainwave thingys ... or even doctors or sleep techs and such.

CHanging your own pressure is illegal

by mindy on Tue Mar 17, 2009 6:49 am
I'd like to add one thing to Ozij's post: many of us don't sleep the same way in the sleep lab as we do at home. In my case, I slept much more lightly than usual. It's my understanding that this alone can impact how a pressure is titrated in the sleep lab. I use the lowest pressure I can and still keep my AHI below 5 and feel rested.

Similarly, I'm one whose sleep study titration set my pressure WAY too low, so after a year of ineffective therapy and not feeling any more rested, I found this forum, learned about data (my machine was data capable, I just didn't know that, and neither my sleep doc nor my RT ever mentioned this feature?!), got the software and card reader, and found that my AHI averaged around 12 during my first year of CPAP! No wonder I felt so tired, no better than before I started CPAP. Next, I got an auto titrating machine that automatically sensed my needed pressure (minimum of 12 rather than 6 as from the sleep study!), been 18 months now with an AHI of 0.4, and, most importantly, I feel great!! Knowledge is power, in this case, the knowledge to particpate or even take control of one's own health and therapy is life changing, perhaps life saving! I shudder to think where I'd be if I had not stumbled upon cpaptalk.com—I'd guess I'd still be "flying blind," not feeling any better, not knowing why . . .

Regarding the Ox saturation, I think everyone should have a recording pulse oximeter to at least spot check this, providing still more useful data regarding the efficacy of one's CPAP therapy.

Guest wrote:CHanging your own pressure is illegal

I never change my own pressures, since that is illegal :<) I just let my auto make the adjustments for me. Hoping the cpap police don't come to arrest my M Series machine!

You're not going to get with blaming your machine so easily, Rip. Those cpap police, they'll tell the judge that every time you breath and stop breathing you are an accessory to pressure change!

O.

Randigoman wrote:Ok, I'd like to say something about all of this "the Doctor or Technician doesn't want me to be involved in my treatment" talk. I mean no offense to folks, but I want you to know that if you get your pressure too high, you may have central apneas. Also, if you get your pressure too low, and your study showed that you have heart arrythmias (like PVC's and such) that are related to the sleep apnea, then you may not get the benefit of the cpap machine. Another thing to consider is that the machine doesn't measure brainwave activity to see how often or how long you are awake. These are called "arousals" or "micro-arousals". It doesn't check your oxygen saturation, either, which is supposed to be 92% to 100%. You may be having a certain number of events per hour (RDI or AHI), but those events may be causing your oxygen to drop even if the number is low. So what I would like for all of you to do is ask your doctor why exactly he wants you to stay at a certain pressure, rather than think that he has an ego problem or that he doesn't want to listen to you. Sometimes a lower pressure isn't adequate for your sleep apnea problems. Please, work with your doctor on this. I'm a Sleep Technician and I titrate Peoples' cpap pressure during the night. I don't like to increase the pressure unless I'm fairly certain it needs it. I have a cpap machine myself, and I know it's not always easy at higher pressures to get used to it (or even lower pressures for some folks). If you don't trust your doctor, see what you can do about going to another sleep doctor to help you understand what you need to do. Thank you and God bless you in Jesus' name.

Guest wrote:CHanging your own pressure is illegal

Why don't you sanctimonious hypocrites advise the person who started this (following) thread how he's supposed to deal with his lying, ignorant DME??? Apparently, neither God or Jesus was there to help him.

viewtopic/t40042/DMEs-misinformation.html

Den

Perhaps you need an auto machine.. some will record their necessary changes the required during the night.
This data is quite valuable and if have one of these machines.. the data log will tell if changes are needed.

by ozij on Tue Mar 17, 2009 11:45 am
You're not going to get with blaming your machine so easily, Rip. Those cpap police, they'll tell the judge that every time you breath and stop breathing you are an accessory to pressure change!

Okay, you got me, I give up, caught red-handed . . . take me away to CPAP jail ;<)

I just completed a sleep study last night. I have been on CPAP for over 10 years. My pressure is now 14 from last nights study. I now have to wait till Monday to see my DR. Can anyone give me some tips on how to change pressure on this unit so I can do it myself. I am really getting some bad side effects...like I am so tired.
Thanks so much!