Lazy Sleep Ctr / DME

I find what I'm about to share amazing...

My GF is a dental hygienist. One of her patients came in and in their talking, he told her he was on CPAP and having a hard time of it. She told him I was on CPAP and that I would be willing to help him if he wanted. She gave him my number, but he never called.

About a year later, he comes back in. She asked him how he's doing with the machine, and same story, just one year later. She gets his phone number and brings it home to me. I call the guy.

So.....I call him. His problem is he keeps taking his mask off in his sleep and he doesn't remember it. I think he said he is using the typical nose mask that most of the DME's hand out. Anyway, we get to talking for a long time. At first he ask a bunch of questions about general CPAP stuff. The longer we talk, the more I get to ask him questions and it ends up I find out that his combination Sleep Center / DME sent him home with a Resmed Auto set on 5 to 20, telling him that his pressure needs would vary during the night and this would take care of that.

This poor guy has been trying to sleep for TWO YEARS with a machine set at 5 / 20! When I figured out that what he had, I just started cussing a blue streak. I told him that they had set him up to fail and that until he set his machine to a single pressure or narrowed it down ALOT he was going to be in the same fix.

He is retired and he told me a couple of times that he tends to be "slow and cautious about making any changes to anything.

I saw the post (I think Dreamstalker posted) about how to change most machines that are on the market right now and I sent him that about two weeks ago. I called him first and told him I was sending it to him.

This morning I get an email from him that he has finally read it and that it was helpful, but that I should remember that he is slow and cautious.

I emailed me back and said that if he didn't change his ways he was going to be slow cautious and dead.


Some peoples kids....


JeffH

_________________

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

Jeff,

Sounds like BOTH parties in that story (sleep center and the CPAP user) contributed to the problem. The sleep center for the pressure setting (and their stupidity) and the user for being "SLOW and CAUTIOUS".

This kind of scenario makes one wonder......if he IS getting over 4 hours of sleep per night (and before taking off his mask), then he's considered "compliant" as far as insurance or other entities go......but the quality of his therapy is NOT good.

It's a very sad situation and probably repeated many, many times every year. Many of us know of some like examples from our encounters with other CPAP users.

And then, some of the "drive-by" Guests/"Snipers" (including some of the other forums) have the nerve to say that people shouldn't take control of their own therapy when it's the medical community that put them in that position to begin with.

Thanks,

Den

AMEN!

Does he use the Internet? Suggest he read the light bulb/our collective wisdom article about pressures, cpaptalk-articles/CPAP-pressure-settings.html

If he needs it, you could talk him through the article. It has lots of slow and cautious advice. It talks about the problems of a wide pressure setting at the start of the article.

Looks like he could also use the article on masks and some more coaching.

Maybe the article on Building Your CPAP Support Team cpaptalk-articles/building-CPAP-support-team.html
would help, too. JeffH, you are in the role of #8, others with OSA.

Hope he starts educating himself and/or gets help.

[quote="Wulfman"]Jeff,

Sounds like BOTH parties in that story (sleep center and the CPAP user) contributed to the problem. The sleep center for the pressure setting (and their stupidity) and the user for being "SLOW and CAUTIOUS".

This kind of scenario makes one wonder......if he IS getting over 4 hours of sleep per night (and before taking off his mask), then he's considered "compliant" as far as insurance or other entities go......but the quality of his therapy is NOT good.

It's a very sad situation and probably repeated many, many times every year. Many of us know of some like examples from our encounters with other CPAP users.

And then, some of the "drive-by" Guests/"Snipers" (including some of the other forums) have the nerve to say that people shouldn't take control of their own therapy when it's the medical community that put them in that position to begin with.

Thanks,

Den

You may not be able to help him, but perhaps you can help me.

I am still trying to understand the mechanics of the pressure settings. Using an auto BiPAP, my max IPAP is set at 20 and my min EPAP is 10. According to what I read on the Collective Wisdom essay, and elsewhere, this may be too great a range (Thanks for the link, Mile High Sleeper) but I am not sure I understand why. I do understand the ill effects of a pressure setting too low or too high, but I don't really get why the broad range would be a problem.

My prescribed BiPAP pressure is 18/20 but according to my Encore Pro results, I don't need that high a level for most of the night. And, when it is that high, leaks increase and cause at least partial arousals.

Is it just a matter of the machine not being able to respond quickly enough to an apnea? (My machine seems able to increase its pressure a lot faster than it decreases it.)

I am one of those people who, when asking for the time, would really like to know how the watch is built.

Susan

Perchancetodream wrote:You may not be able to help him, but perhaps you can help me.

I am still trying to understand the mechanics of the pressure settings. Using an auto BiPAP, my max IPAP is set at 20 and my min EPAP is 10. According to what I read on the Collective Wisdom essay, and elsewhere, this may be too great a range (Thanks for the link, Mile High Sleeper) but I am not sure I understand why. I do understand the ill effects of a pressure setting too low or too high, but I don't really get why the broad range would be a problem.

My prescribed BiPAP pressure is 18/20 but according to my Encore Pro results, I don't need that high a level for most of the night. And, when it is that high, leaks increase and cause at least partial arousals.

Is it just a matter of the machine not being able to respond quickly enough to an apnea? (My machine seems able to increase its pressure a lot faster than it decreases it.)

I am one of those people who, when asking for the time, would really like to know how the watch is built.

Susan

BiPAPs work differently ... you need to read this thread -

viewtopic/t26622/UARS--A-Critical-Link- ... sults.html

Susan,
'Don't confuse an autopap's high and low range with a bi-pap's inhale and exhale. On a bi-level, the inhale can be stable, and the exhale can be stalel at a lower pressure. A wide open range on an auto has the pressure jumping around, and trying to play catch up with apneas that higher pressure would have nipped in the bud.

A bi-pap or bi-level is 2 machines in one, with definite rules how they should work together. And on an auto bi-pap, you have two automatic machines, each with ownhigh and low range, and they still have rules of cooperation - you can't open the as wide as on an APAP..

The problem with the range being too wide (on APAP) is that the constant pressure changes disturb some people. Instead of sleeping, their brain is busy responding to the changed pressure with "oh, this is a new pressure environment, what do I do now?"

O.

Thanks, Den.

When I first read that thread it failed to register that Dr. Krakow's pressures are set very close to mine. Today it is finally registering so I'd better set aside some time to study the other eight pages of the discussion.

Thanks again for an invaluable link.

Susan

Den's a great guy - but so is Dreamstalker.

O.

ozij wrote:Den's a great guy - but so is Dreamstalker.

O.

Oooops! Sorry Dreamstalker

Susan

O, when you mentioned that

"A bi-pap or bi-level is 2 machines in one, with definite rules how they should work together. And on an auto bi-pap, you have two automatic machines, each with ownhigh and low range, and they still have rules of cooperation - you can't open the as wide as on an APAP."

are you referring to the maximum pressure support that limits the difference between the IPAP and the EPAP?

Talking of .... all those missing words ...

Yes, that's what I"m referring too. It keeps you from giving either IPAP or EPAP an unlimited range to roam about.

O.

Perchancetodream wrote:Thanks, Den.

When I first read that thread it failed to register that Dr. Krakow's pressures are set very close to mine. Today it is finally registering so I'd better set aside some time to study the other eight pages of the discussion.

Thanks again for an invaluable link.

Susan

You're very welcome, Susan.

ozij wrote:Den's a great guy - but so is "Whatshisname".

O.

OK.....I just got back and saw this and had to have a little fun.

Susan,

I hope you get your Bi-PAP settings figured out. That's kind of out of my league.

Den (still trying to completely understand how "EPAP" works)