Kenny's CPAP Thread

[rested gal]

I think RG was referring to raising the minimum since your pressure is dropping about 3cm on EPR, but if I'm wrong she or someone else will correct me I'm sure.

You weren't wrong, Dori, since you were probably looking at the name of the machine Kenny's profile shows, which is an autopap.

However, I think Kenny is using the autopap in CPAP mode, per his doctor's prescription. The DME set it for CPAP mode at a single pressure of 10. If Kenny were using the machine in autotitrating mode, yes, you'd be right about what I'd suggest (raising the minimum pressure.) In Kenny's case, I was talking about just "the" pressure, not a minimum pressure in a range.

Right now they want to keep it on straight CPAP but will write my DME rep. a new prescription for "auto" down the road if I request it.

This is a long thread -- I get lost, too.

By the way, you and your husband have done a great job getting his treatment going right, Dori!

[tattooyu]

2/17/2009 Stats

Usage: 7 hr, 11 min
AI: 0.8
HI: 11.4 (ResMed/2 = 5.7)
AHI: 12.0 (adjusted = 6.3)
Leakage: 0.04 (is that acceptable?)

Man do I feel run down today. I must not have had that restful a night. Still, it's better than before the CPAP. I'm going to go back to the EPR of 3 tonight.

[rested gal]

Leakage: 0.04 (is that acceptable?)

That's better than "acceptable", imho. Looks plumb good to me.

Man do I feel run down today. I must not have had that restful a night. Still, it's better than before the CPAP.

There can be lots of other reasons to feel run down even if CPAP treatment is doing its part of the job like a champ, which I think yours is.

You've been running on a like-a-happy-kid-at Christmas high for several days now, haven't you? And rightly so! We all have some not so good days even when CPAP is working fine for us. I wouldn't give it a second thought unless the run down feeling persists for a week. Maybe you're getting ready to come down with a cold, or something temporary is affecting how you feel today -- something that may not have anything at all to do with how effective your CPAP treatment is.

[tattooyu]

There can be lots of other reasons to feel run down even if CPAP treatment is doing its part of the job like a champ, which I think yours is.

You've been running on a like-a-happy-kid-at Christmas high for several days now, haven't you? And rightly so! We all have some not so good days even when CPAP is working fine for us. I wouldn't give it a second thought unless the run down feeling persists for a week. Maybe you're getting ready to come down with a cold, or something temporary is affecting how you feel today -- something that may not have anything at all to do with how effective your CPAP treatment is.

I feel like I want to sneak out in the living room early in the morning for presents! The last two days I have felt better than I have in years, even though my batteries are just beginning to recharge. Life is life. There will be good days and bad; I am not looking for perfection. Just wanted to make sure I'm on the right track. I just talked to my DME rep., and in a week or so, we'll check the data and if necessary, he'll call the doctor to see if we can enable the Auto mode with a controlled range of 8-13cm or so.

I'm sure what I'll get from CPAP therapy will be far better than my life has been lately. Last night, I had my therapy appointment (only my third ever) and we just started getting into the CBT (cognitive behavioral therapy) stuff. As he says, "I'm getting all my ducks in a row to start healing."

[rested gal]

There will be good days and bad; I am not looking for perfection. Just wanted to make sure I'm on the right track.

Good attitude, Kenny. And I think you are on the right track.

I just talked to my DME rep., and in a week or so, we'll check the data and if necessary, he'll call the doctor to see if we can enable the Auto mode with a controlled range of 8-13cm or so.

Good idea, but...ummmm.... I'd make that range be 10 - 20 (or 10 - 15, or 10 - 13...whatever, but with 10 as the minimum pressure, if it were me.

[tattooyu]

Good idea, but...ummmm.... I'd make that range be 10 - 20 (or 10 - 15, or 10 - 13...whatever, but with 10 as the minimum pressure, if it were me.

So you would have the minimum pressure be the titrated pressure? I guess that makes sense. I just don't want it to go too high really. Auto mode has a "settling" feature kind of like the ramp right?

[rested gal]

So you would have the minimum pressure be the titrated pressure?

I would. Yes. Others have other opinions about that, and there can be perfectly valid reasons for different ways to set autopaps for different people.

Here are some discussions where I posted my thoughts about why I like the minimum to be at, or nearly up at, "prescribed" CPAP pressure, when I personally use an autopap set for a range:

November 2008 Just got an APAP (topic started by turbosnore)
viewtopic.php?p=319619#p319619

October 2008 Turning off Aflex and Cflex (topic started by DoriC)
viewtopic.php?p=307265#p307265

September 2008 New Guy - Need Help w/Settings (topic started by alanhj13)
viewtopic.php?p=294319#p294319

Doesn't mean I'm correct. There can be medical reasons, or even just comfort (aerophagia, for example) reasons for setting the minimum lower than for what prevents most events most of the time, right from the get-go.

[tattooyu]

Wow, thanks.

I guess there's no point in having your minimum go below what is useful for treatment.

You don't really have all those links memorized, right?

[nomoore]

Wow, thanks.

I guess there's no point in having your minimum go below what is useful for treatment.

You don't really have all those links memorized, right?

If you look at the bottom of a thread you are looking at there is a "Bookmark Topic" button. You can later got to your "User Control Panel" on this site, click on "Manage Bookmarks", and browse all the threads that you have bookmarked. Good stuff.

[rested gal]

Nice tip, nomoore!

I do it the old fashioned way. I just copy the URL of topics I want to keep into a notepad file.

[SharkBait]

Good idea, but...ummmm.... I'd make that range be 10 - 20 (or 10 - 15, or 10 - 13...whatever, but with 10 as the minimum pressure, if it were me.

So you would have the minimum pressure be the titrated pressure? I guess that makes sense. I just don't want it to go too high really. Auto mode has a "settling" feature kind of like the ramp right?

When I was first trying the APAP mode, I was trying to "pull one off" by going with a lower pressure than my titrated pressure. Couple of reasons... Was my titration correct? I slept with therapy for a couple of hours and wasn't really comfortable with being titrated in such a short amount of time. Turns out it was correct. Also, I was thinking logically I would need less pressure when sleeping on my side than on my back. Now I've come along to the conclusion of "so what?". Of course, now I'm a seasoned old vet coming up on 2 weeks of CPAP use and the pressure of 10 seems like nothing to me.

Strangely, the pressure was so easy for me to handle that I changed my C-Flex setting from 2 to 1. I didn't like that at all; made a big difference...

[DoriC]

Sharkbait, just curious, so are you back to straight pressure of 10 now or still on auto? If on auto, what are your settings and what settings did you experiment with? Thanks, Dori

[tattooyu]

If you look at the bottom of a thread you are looking at there is a "Bookmark Topic" button. You can later got to your "User Control Panel" on this site, click on "Manage Bookmarks", and browse all the threads that you have bookmarked. Good stuff.

Thanks... duhhhh. I'm a techie, I swear!

Results for 2/18/2009 (switching back to EPR 3)

Leakage: 0.18
AHI: 9.1 (ResMed adjusted = 5.4)
AI: 1.7
HI: 7.4 (ResMed/2 = 3.7)

I noticed that my AI number is higher with EPR 3 but I sleep much more soundly. In a week or so I'll go in and have my rep. get approval to either: 1) Set my CPAP to 11.0cm, or 2) Set it to APAP with a range of 10.0-15.0cm.

[rested gal]

I noticed that my AI number is higher with EPR 3 but I sleep much more soundly.

A few decimal points or even a whole cm or two are meaningless differences in the data, imho. There are going to be variations from night to night no matter what. What we think may have made a difference in the data might have absolutely nothing to do with it.

What matters is how well we sleep and how good we feel. Even that is going to vary occasionally, without being attributable to the something about the CPAP treatment at all.

The data can be helpful in making overall treatment decisions, but not so much so in trying to figure out why "this night"'s data looks slightly different from "that night's" data, especially when it's minor differences in the reports. A major difference to me would be three or more whole cms in the apnea index...seen during at least 4 or 5 nights of data gathering at one setting.

[SharkBait]

Sharkbait, just curious, so are you back to straight pressure of 10 now or still on auto? If on auto, what are your settings and what settings did you experiment with? Thanks, Dori

At first I went with 8-12, but now I'm on straight 10. At a later date, I might play with Auto again but as RG has suggested I will definitely use a minimum pressure of 10.