Question for you??

karessamom · Post by **karessamom** » Mon Dec 07, 2009 5:06 pm

JohnBFisher wrote:
karessamom wrote:
rested gal wrote:
karessamom wrote:He did NOT have a titration study because the dr. he went thru did not believe in them.
The more I think about what you said the doctor said, the more bizarre that doctor's notion seems to me.

... The more info the better, imho, and even if I'd personally want to use autopap at least for awhile to get more info before or after a PSG titration, I'd DEFINITELY want to have a full night PSG titration if at all possible. A LOT more info can be revealed in a PSG titration than through any amount of info from an autopap machine at home. ...
I think the dr. was looking at it from a money savings thing. ... His reasoning was that the autopap should take care of the pressure settings automatically ... as a side note--why would the machine just stop in the middle of the night?? out of the blue??? apparently last night it just shut itself off
This is exactly why board certified sleep specialists worry about self titration.

IF your husband's ENT knew enough about your husbands physical status, it might have been OK to go without a sleep study. HOWEVER, if there was some underlying health issue where the increased pressure adversely impacted your husband, you would not have known it until you struggled through it ... or worse. No, I am not being an alarmist. I've done a LOT of research that clearly shows that the pulmonary and cardiovascular systems are closely linked. Tinkering with one can adversely interfere with the other.

The sleep study reveals SO much more than the pressure required. It is important to have that as a baseline.

And, karessamom, with your "Oh, By The Way..." you just proved my point. I knew I was having SERIOUS problems when my BiPAP would start to turn itself off during the night. In my case, it was an indication of serious central apneas during sleep.

I do not know if your system has an Auto Off feature (it will turn off after one minute or so, if you no longer have the mask on). If it does it could indicate you had an apnea that lasted a minute or so. Reviewing the manual for your unit, I did not see a feature like that. But you might want to call the supplier of the unit to see if it does have such a feature ... Or just turn it on without wearing the mask and see what happens after a minute or so. If there is no Auto Off, then you may have just briefly lost power to your power outlet last night.

No other problems with his health, no heart problems or lung problems except asthma that's allergy induced and way under control to the point it doesn't even bother him anymore! no probelms with the machine last night so not sure what happened maybe it was power but mine should have gone off too because same circut and it didn't?? who knows maybe the power strip?? I've increased the pressure up to about 6 and 16 that may still be too low but i don't want to screw anything up either and make it harder for him to sleep because he really is doing really good. I might go a little higher--I also activated the epr to make it accessable which it was not. that may only be for CPAP mode though?? thanks for all the suggestions! We don't use the auto start feature so it's diabled

rested gal · Post by **rested gal** » Tue Dec 08, 2009 12:45 am

karessamom wrote:I also activated the epr to make it accessable which it was not. that may only be for CPAP mode though??

In the Autoset II machine, EPR can be used in either mode -- auto or cpap modes.

I would mention this, however ... if EPR is used in auto mode with a minimum setting of 6, EPR is going to drop that minimum pressure down an exact number of cms, according to whether you set EPR at 1, 2, or 3 -- "3" giving a 3 cm drop in the minimum pressure which would take it down to just 4 cms during exhalation. That might not be enough to hold the airway open, especially during any pause at the end of exhaling, before the next inhalation is started. And if the airway closes with an apnea during that pause, it's unlikely a new inhalation can even get started. The machine will remain down at that possibly sub-therapeutic pressure until a safety measure designed into EPR times out, and the regular pressure of 6 is allowed back in.

If it were me, and I wanted to use EPR, I'd raise the minimum pressure however many cms I wanted to allow EPR to drop it. But that's just what I'd do, and I'm not a doctor.

More about my thoughts on using the EPR feature:

Nov 2008
viewtopic.php?p=310021#p310021

karessamom · Post by **karessamom** » Tue Dec 08, 2009 10:33 am

Last night seemed to go ok. I did set the EPR feature back to non-accessable as my husband was a little upset that i'd tinkered with it in the first place--so it's back to the way it was originally set. as far as the pressures--he says it seems to be ok. numbers look good same as before. he did mention that sometimes with the lower pressure setting it was hard for him to breathe so the upped pressure should help with that. He also says he can check his machine before he turns it off to get (what he says) was the highest pressure setting for the night. I'm not sure if that's actually what it is or if it was the highest pressure for that point in time?? since we don't have data capability it's hard to know--i might have to download his card and take it to the DME and get a reading. right now he just gets mad when I start tinkering with things. so i'm backing off.

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