Post
by riverdreamer » Wed May 13, 2009 1:22 pm
1. You can change the ramp settings. You would have to get into the Clinical Menu, or ask your RT to do it for you. You might want to set your initial ramp pressure to 7, 8, or even 10, if you can tolerate it. That would put you closer to your treatment pressure, and make the jump less severe. It would also relieve the feeling of not enough pressure in the beginning. If you would like the Clinician's Guide, which tells you how to access this info, send me a PM with your email.
2. When you get into the Clinical Menu, you can also set the ramp period for a longer time. You might want to try making one change at a time, if you are doing them yourself. If you need your RT to do so, then you might want to do both. The settings set the maximum time for ramp. You still have an option whether or not to use it, and for how long. This would just give you more options.
3. You may already have access to exhalation pressure relief (EPR). If you choose the menu option when you see the ramp LCD on your machine, it will allow you to access the EPR option, if your doctor ordered it to be set with access. EPR lowers the pressure while you exhale. You can set it to 1,2, or 3 levels of relief. This makes the pressure easier to exhale against, and can make your breathing more natural. It is the closest a CPAP can get to Bi-level, which several people mentioned as an option with higher pressures. You may need a Bi-level, but in the meantime, EPR may help you tolerate the machine better. It may even help with the air in the stomach. I don't know for sure, but just having the pressure lower should help.
To access the Clinical Menu, you hold down the right and down buttons for 3 seconds. The Clinical Menu should flash on your LCD screen, and then you will see options. As you go through the menu, you might want to write down all the current settings, in case you need to change anything back. You want to go into the settings menu, and choose ramp, then pressure, or ramp, then max time for the ramp settings, and choose EPR to change the EPR settings. To choose menu, or options, or to change something, hit the left arrow. To scroll, hit the up or down arrows. To save a change, or to exit a menu, hit the right button. To get out of the Clinical Menu, hit the right button repeatedly, till you are back to your initial screen.
4. To stop air from exiting your mouth, you want to rest your tongue at the top of your mouth, on the palate and gums just behind your top front teeth. Press gently upward. It shouldn't be a big effort, it should just be a matter of making it a habit. Your tongue is supposed to create a seal, so that air is only going through your nose, not your mouth. You can still swallow while this blockade is in place, so you don't have to worry about choking on saliva. As I said, I don't have problems with air going into my stomach, but this may help, and it will at least help some of the chipmunk cheeks from air filling your mouth.
5. I suggest you try spending some time getting used to your machine, while you are awake. Set it up while you are watching TV, or some other distracting activity, and get your mask comfortable, and try running all the settings, ramp, treatment pressure, EPR, no EPR. See if you can figure out what bothers you, and then see if you can troubleshoot it. It is much easier to do than when you are desperate for sleep. When it seems to work OK, just run it to let your body get adjusted. That way, when you go to bed, you will know what you need to help yourself get to sleep.
6. It is possible that you will need a Bi-level machine, and you should certainly let your doctor know if treatment continues to be miserable. The time you spend trying to adjust will not be wasted, because even with a Bi-level, you need to adjust to the machine, the mask, and treatment. It will just make certain aspects easier.
Good luck! There is lots of info here, but it takes time to learn, meanwhile you are trying to sleep, and work. It IS possible to resolve most of these issues, so keep giving it a shot. Instead of starting a new thread each day, you might want to keep reposting in your old one (this one). That way, all the suggestions are in one place, and people won't keep telling you things that have already been suggested. Plus you will have all the info in one place, to look over at your leisure.
