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momexp5,

I hope you are going to get some relief from what is going on. I know I couldn't handle the CFlex part and don't use it anymore. That was one of the main reasons, too, I went for the Remstar Auto as opposed to the 420e.

And don't you think that guest deserved a ???

Sleepless on LI wrote: PEEP is CPAP, PEEP standing for positive end expiratory pressure and CPAP standing for continuous positive airway pressure. <snip>

When you are titrated at your sleep study, they are only setting an ePAP for your CPAP machine. Your iPAP is irrelevant. They set the end expiratory pressure that you should never go below.

That seems kind of odd. So, if I'm titrated during a CPAP study to 8cm - then that's the ePAP???? As in, my doctor is incorrect setting iPAP=8 and ePAP=4?

The CPAP titrated value, isn't that what keeps us from snoring, from being blocked on the inhale? Isn't that iPAP?

I'm skeptical here - sorry, Lori, no offense meant and certainly I hope you won't take offense! lol - still digging - I do *not* mean to say that I think you would take offense, I totally think you wouldn't, sweetie (may I call you sweetie? <g>)

Yes, feel free to call me "sweetie." That is just fine.

The problem is, you're talking about BiPAP, which according to my son is totally more involved than CPAP. CPAP is only setting an end pressure upon exhalation. Please look at the link I provided at the bottom of the post. Your doctor was not incorrect. But he was regulating your breath so that it won't go over a certain amount on inhalation and a lesser amount in exhalation due to him feeling you need more of a ventilation type therapy than CPAP/PEEP, if I'm remembering now, a couple of hours later, what my son explained.


The two terms PEEP and CPAP are used interchangeably, and lead to inappropriate confusion: they are the same thing, although CPAP is a more technically correct term. The concept of PEEP is that a pressure is applied at the end of expiration to maintain alveolar recruitment (click here). Airway pressure is kept positive, and is never allowed to return to atmospheric (click here). When inspiration commences, it is on top of this the pressure that remains in the airway at the end of expiration – this is the baseline airway pressure (below which it cannot go) and lasts for the duration of the respiratory cycle (regardless of the inspiratory mode of ventilation). Therefore, all patients who have a resistance applied to expiration (to prevent derecruitment) are on CPAP. Nevertheless, it is conventional to describe this mode as PEEP, and this is what you will read in books and journals. The current thinking on CPAP is that the level set should be above the lower inflection point of the pressure volume curve (labeled Pflex in figure below), although this is controversial (click here). An easier strategy is to base PEEP on Oxygen requirements (click here).

When people have further problems other than just OSA, they are put onto BiPAP so both iPAP and ePAP get regulated specifically. It is for pulmonary problems, according to what my son says, or people who have trouble with breathing, not just OSA.

I sent your remarks to his email address; however, since he worked a 12 1/2 hour shift last night, he is sleeping today until about 5 PM. He's going in again tonight. I will try to get his reply to your question before he goes. I'm sure he'll have one. But in the meantime, please look at the link I put at the bottom of my last post which shows that PEEP is synonymous with CPAP. They are both settings for ePAP only. And that's what CPAP is if it's synonymous with PEEP. You can inhale as much as your lungs can tolerate on CPAP because, if you think about it, pushing air into your nose is not going to stop you from inhaling, is it? But it's the exhale that causes the problem, so they will titrate you at the least amount of pressure possible upon exhalation to stop the airways from closing up.

I don't know. It makes sense to me. But I will talk to him later and see his specific explanation and get back to you.

Sleepless on LI wrote:momexp5,

I hope you are going to get some relief from what is going on.

Oh, I'm sure I will, Lori - I seem to be just great once the machine straightens itself out - I might try a different mask soon, though - have to call insurance Monday and see whether they do 3-month replacements.

And don't you think that guest deserved a ???

lol, that or a spanking - got a smiley for that? <g>

momexp5 wrote:

WillSucceed wrote:Guest wrote:

I know how to fix it but I am too lazy to type it out

Sheesh! What was the point of that post? 'I know how to help you but can't be bothered.' Very nice! I'm sure that many posters on this forum don't always have the time or energy to type out a big long answer but, if we can help one-another, why not do it?

lol, thanks, Will - but perhaps guest has a cold or is depressed or something and saying he/she was lazy was a wry self-deprecating device.

I don't feel right even posting this, but couldn't help myself. No offense to Will or Lori intended (you are terrific posters), but reading these, I kinda wished that guest's post had simply been ignored rather than commented on. (But here I am doing it, huh?) I guess I wanted to agree with momexp5 for her wish to give the guest the benefit of the doubt. I'm feeling a little bit depressed today myself, and even this may be an inappropriate post, one I might not post if I didn't feel this way. This is internet, these are discussion boards, it's hard to really know what a person is thinking when they post something a little confusing, something that might be construed as insulting. Maybe the guest is feeling ill or depressed. There might be another time they'd like to post something substantial, some question which might get answered and help them. I would want them to feel comfortable to do so. ...... Sheesh, I shouldn't have written this. ..... My apologies. Blame it on my blue Sunday.

Linda

momexp5 wrote:

Sleepless on LI wrote:momexp5,

I hope you are going to get some relief from what is going on.

Oh, I'm sure I will, Lori - I seem to be just great once the machine straightens itself out - I might try a different mask soon, though - have to call insurance Monday and see whether they do 3-month replacements.

And don't you think that guest deserved a ???

lol, that or a spanking - got a smiley for that? <g>

LOL-I think a spanking may be inappropriate, don't you? I'll just call it a "tsk, tsk" smiley. Sound good???

Linda,

You are very sweet to take that approach. You have every right, as you mentioned, to post your take on something. You are much more generous than I would be. I think the kindest thing to do if someone doesn't have the time to impart their solution to a problem, though, would be to just not write, "OH, I know how to help you but I don't have the time." Silence was a better choice, IMHO. But don't ever apologize for stating your opinion. That is what this forum is for. You are never wrong by doing so and none of us should take offense to it. Keep posting and feel better...

Sleepless on LI wrote: When people have further problems other than just OSA, they are put onto BiPAP so both iPAP and ePAP get regulated specifically. It is for pulmonary problems, according to what my son says, or people who have trouble with breathing, not just OSA.

Yeah, I think I'm just sort of fragile - tons of allergies - small person - inhaled smoke from age 0 (dad smoked in the house) to age 40 (quit over a year ago - I've even been off pharmaceutical nicotine for a long time now - yea!)

But in the meantime, please look at the link I put at the bottom of my last post which shows that PEEP is synonymous with CPAP. They are both settings for ePAP only. And that's what CPAP is if it's synonymous with PEEP. You can inhale as much as your lungs can tolerate on CPAP because, if you think about it, pushing air into your nose is not going to stop you from inhaling, is it? But it's the exhale that causes the problem, so they will titrate you at the least amount of pressure possible upon exhalation to stop the airways from closing up.

I am still considering this - iPAP has to be sufficient, though, to keep one's (my) extra-long upper palate from flapping around, and keep all the throat and tongue tissue from sucking in on itself. Exhale, and you're pushing all those tissues outward. My brain needs time to process this, I think, none of it's at all intuitive.

LDuyer wrote: My apologies. Blame it on my blue Sunday.

{{{{{{{{{hug for Linda}}}}}}}}}}} Go for a walk or something!

I think what you're confusing is CPAP and BiPAP, which are more than different names for types of machines. CPAP is given to those who just need help with keeping the airways open due to them closing on exhalation. When you have a certain set of problems, which they can tell from your study, then you are put on BiPAP where they are able to adjust both your inspiration and exhalation. If I'm remembering this right, with CPAP, you inhale as far as your lungs can take an inhalation. But on BiPAP, you are restricted to what the machine is set for on iPAP.

It does getting confusing, but to listen to my son explain it is amazing. He really did pay attention when they taught these things and he is doing an incredible job at work; and that's not just a mom talking. He has been recognized for his knowledge by the staff at this hopt. and has really given a lot in the short time that he's been there.

Like I said, I will definitely ask for further clarification. In the meanwhile, where is DeltaDave when you need him? Should we send up the DD signal into the sky for him??? He would probably explain everything in very easy to understand language...

Sleepless on LI wrote:Linda,

You are very sweet to take that approach. You have every right, as you mentioned, to post your take on something. You are much more generous than I would be. I think the kindest thing to do if someone doesn't have the time to impart their solution to a problem, though, would be to just not write, "OH, I know how to help you but I don't have the time." Silence was a better choice, IMHO. But don't ever apologize for stating your opinion. That is what this forum is for. You are never wrong by doing so and none of us should take offense to it. Keep posting and feel better...

Thanks for indulging me, Lori. Yes, silence would have been better. But there's another reason you might consider in just ignoring a guest's short post. I as a member have written stuff I regret or feel plum embarrassed about. But as a member I can go back and edit or even delete what I wrote, if I want. A guest can't do that. Once it's said and typed, it's there, whether you want it there or not. I once posted as a guest on purpose, many months ago, to demonstrate my side of the argument of whether to allow guests to post (I was for it). That's when I remembered I had to be careful what I said and typed, because as a guest, I couldn't edit it or delete it.

Silly notion, I'm sure. But I feel someone's post shouldn't be poo-pood unless they are obviously hurting or slandering someone. I guess what I'm saying is, I defend a person's right to be stupid. I've been stupid often. Like maybe now. lol


Respectfully (and embarrassingly),
Linda

(blame it on my peeps )

momexp5 wrote:

LDuyer wrote: My apologies. Blame it on my blue Sunday.

{{{{{{{{{hug for Linda}}}}}}}}}}} Go for a walk or something!

What? With my bad ankles??
How about a nice long tub soak, with bubbles (and a glass of wine). Much better.

Thanks!


Linda

LDuyer wrote:

momexp5 wrote:

LDuyer wrote: My apologies. Blame it on my blue Sunday.

{{{{{{{{{hug for Linda}}}}}}}}}}} Go for a walk or something!

What? With my bad ankles??
How about a nice long tub soak, with bubbles (and a glass of wine). Much better.

Thanks!


Linda

Now, either one to me is a treat...Linda, don't give it a second thought. You are right about guests not being able to delete a post. You are obviously a thoughtful and generous person and that is nothing to apologize for. Don't be ridiculous.

I, on the other hand, as I age, find I have a lower and lower tolerance for rudeness and inappropriate behavior, although I'm sure I'm guilty of that at times, but not deliberately. So maybe it's me that should apologize for being fast to judge? Nah...

Lori sent me a great PM outlining the info that she got from her son. As I go back and read my post, it's clear that I did leave out the word "auto" in front of "peep." I did mention that CPAP and autoPAP are delivering pressure all the time -the error that I have made is that PEEP and AutoPEEP are two different things. Thanks so much for catching this Lori. (I'm blaming my stupidity on having a rotten cold, did not sleep last night, got out of bed around 5 and spent some time online posting when I clearly had not had enough sleep.) Or, perhaps I was just hit with the 'stupid' stick!

I am well aware of bi-pap being a very different creature than CPAP. There has been discussion on this forum about 'is C-FLEX like bi-pap?' which is why I made the comment about bi-level. I guess I just was not clear.

Given the error that I have made, I've opted to edit out the post -I'd hate to give erroneous/misleading info. My hat is off to Lori for being so quick to catch, and correct my error!

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CPAPopedia Keywords Contained In This Post (Click For Definition): C-FLEX, CPAP

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CPAPopedia Keywords Contained In This Post (Click For Definition): C-FLEX, CPAP

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CPAPopedia Keywords Contained In This Post (Click For Definition): C-FLEX, CPAP