Can't use fixed pressure CPAP??

Hi there,

You'll have to bare with me as I am new to this whole CPAP thing. I recently was diagnosed with severe sleep apnea and was given a one month trial on a Philips Respironics Remstar System One (a mouthfull) All's I know is that it was an auto-cpap with a humidifier, one of the newer ones on the market. I used this for a month with good compliance and fairly good results. I had some mouth leak issues but was then given a chin strap to help resolve the issue.

After this trial was up I was given another CPAP to try, a cheaper one, to see if I could adjust to to save myself a lot of money. It's a Fisher & Paykel Sleepstyle 600? or 604? I can't recall exactly. It's a fixed pressure (my pressure is 12) and has a good humidifier. I used it for a month and didn't have good success with it, I wasn't very compliant at all and it was just an all around headache. The mask ALWAYS came off in my sleep obviously because the pressrue bothered me, so even when I did use it, the mask came off way too much, almost every night. It was too hard to fall asleep/stay asleep with.

To make this short, I ended up buying the Fisher & Paykel (stupid, right?) simply because of finances and having no insurance. I contacted my sleep therapist last week and told him this machine just will not work, I have not adjusted and I don't foresee myself adjusting anytime soon. So tomorrow I get a direct exchange to the auto cpap that I had from the start, I am very excited as that machine was so nice to use. When I had the Remstar my pressure went to a maximum of 11 and never 12. So having a constant 12 all the time is really bothering me. It only ever reached 11 at one time in a 30 day period as well.

So my question is, is adjusting to a fixed pressure a difficult task? Are there other health benefits to using a fixed over an auto? And does anyone think that the fixed pressure was causing me to remove my mask all the time? This only happened once with my Remstar compared to a nightly thing with the Fisher. I am so tired and frustrated, I just want the right machine now to get the proper treatment without hassles. Sorry for the long post .

I like to backup a step. The most important thing you can do with the new machine is to review the data and see how well the therapy is working. Check what your AHI is and the leak level.

As far as adjusting to pressure, that is a very individual thing. Some start out with a very high pressure and have no problems.

Other have problems with a low pressure.

The good thing is you are going to have a machine which will report on the effectiveness, or lack thereof, of the therapy. It would also be good to have the software to go with that machine.

NewToCPAP wrote:Hi there,

You'll have to bare with me as I am new to this whole CPAP thing. I recently was diagnosed with severe sleep apnea and was given a one month trial on a Philips Respironics Remstar System One (a mouthfull) All's I know is that it was an auto-cpap with a humidifier, one of the newer ones on the market. I used this for a month with good compliance and fairly good results. I had some mouth leak issues but was then given a chin strap to help resolve the issue.

After this trial was up I was given another CPAP to try, a cheaper one, to see if I could adjust to to save myself a lot of money. It's a Fisher & Paykel Sleepstyle 600? or 604? I can't recall exactly. It's a fixed pressure (my pressure is 12) and has a good humidifier. I used it for a month and didn't have good success with it, I wasn't very compliant at all and it was just an all around headache. The mask ALWAYS came off in my sleep obviously because the pressrue bothered me, so even when I did use it, the mask came off way too much, almost every night. It was too hard to fall asleep/stay asleep with.

To make this short, I ended up buying the Fisher & Paykel (stupid, right?) simply because of finances and having no insurance. I contacted my sleep therapist last week and told him this machine just will not work, I have not adjusted and I don't foresee myself adjusting anytime soon. So tomorrow I get a direct exchange to the auto cpap that I had from the start, I am very excited as that machine was so nice to use. When I had the Remstar my pressure went to a maximum of 11 and never 12. So having a constant 12 all the time is really bothering me. It only ever reached 11 at one time in a 30 day period as well.

So my question is, is adjusting to a fixed pressure a difficult task? Are there other health benefits to using a fixed over an auto? And does anyone think that the fixed pressure was causing me to remove my mask all the time? This only happened once with my Remstar compared to a nightly thing with the Fisher. I am so tired and frustrated, I just want the right machine now to get the proper treatment without hassles. Sorry for the long post .

First of all, welcome to the forum. Please consider joining......with a user name and list your equipment in your profile.

I'm glad to hear you got them to exchange your machine. You now have a data-capable one with which to monitor your therapy.

There are varying opinions, but for many of us, a fixed pressure is less disturbing to our sleep. If an Auto-CPAP is not set up properly (minimum pressure set too low), you can have too many "events" (apneas, hypopneas, etc.) before the pressure can increase to where it needs to be. And, if the maximum pressure is set too high, there can also be "runaway" pressure increases which can take your pressure up beyond what is actually needed and comfortable.
Therefore, I am an advocate for new users to use a single pressure when starting out to get accustomed to the machine and this new way of sleeping......and because it minimizes the number of problems they can have.

With regard to the mask removal......almost EVERY user goes through that when they start out. It may happen right away or a couple of months into therapy.......but it's one of those (almost) universal experiences. It could be that the humidifier setting was too high. Just train yourself not to do it.


Den

I don't understand why you didn't just reduce the pressure on the Fisher & Paykel. Why was it set at 12 to begin with if your
Auto pressures were under 11? The F & P does not give data but it is a very quiet machine that eliminates rain-out.

I will set myself up with a profile this evening as I am most definitely going to have more questions. This is all sounding quite confusing!!

Unfortunately I do not have access to my data, my sleep therapist checks the data with each follow-up visit. Last time I was in with the Fisher & Paykel my AHI was 8. He wasn't overly joyed with that number and said they like it to be below 5 and would keep an eye on it with the follow-ups.

I am also glad to be switching back to the Philips, it just seems like a better unit in general. I had much better success and compliance with that machine so it makes sense to use it. The difference in price is huge for me but this is something I need to use every single night and need to be happy with it.

I'm hoping my sleep therapist will properly setup and adjust the Philips one for me so all is well, shouldn't have to worry about the pressure settings (hopefullyl?) This will be about my third month on CPAP so I still feel so new to all of this.

The problem with taking the mask off is that I do it in my sleep and have no recollection of taking it off. I wake up and its blowing air into my face. Is this normal??? It freaks me out somewhat to know I just remove it without knowing in my sleep, and it happens all too often. I am hoping with the Philips this won't occur as it only happened one time when using that machine.

Thanks for your quick replies!

LSAT wrote:I don't understand why you didn't just reduce the pressure on the Fisher & Paykel. Why was it set at 12 to begin with if your
Auto pressures were under 11? The F & P does not give data but it is a very quiet machine that eliminates rain-out.

I didn't reduce the pressure because my prescribed pressure is 12. This is what was prescribed to me after my sleep study. Auto pressure was under 11 for a one month period but obviously my sleep therapist set it to 12 given the results from my sleep study.

Like I said, I am new to this. I am still learning loads here, and even moreso now that I have posted here. You'll have to bare with me.

NewToCPAP wrote:I will set myself up with a profile this evening as I am most definitely going to have more questions. This is all sounding quite confusing!!

Unfortunately I do not have access to my data, my sleep therapist checks the data with each follow-up visit. Last time I was in with the Fisher & Paykel my AHI was 8. He wasn't overly joyed with that number and said they like it to be below 5 and would keep an eye on it with the follow-ups.

I am also glad to be switching back to the Philips, it just seems like a better unit in general. I had much better success and compliance with that machine so it makes sense to use it. The difference in price is huge for me but this is something I need to use every single night and need to be happy with it.

I'm hoping my sleep therapist will properly setup and adjust the Philips one for me so all is well, shouldn't have to worry about the pressure settings (hopefullyl?) This will be about my third month on CPAP so I still feel so new to all of this.

The problem with taking the mask off is that I do it in my sleep and have no recollection of taking it off. I wake up and its blowing air into my face. Is this normal??? It freaks me out somewhat to know I just remove it without knowing in my sleep, and it happens all too often. I am hoping with the Philips this won't occur as it only happened one time when using that machine.

Thanks for your quick replies!

You can actually see some summary (average) numbers in the LCD screen. If you would log in with your user name, we could send you a link on how to download the provider manual for your machine.
Don't count on your sleep therapist always being there to help you diagnose what happened weeks ago. With the software, you can find out the next day while things are still fresh in your mind.

https://www.cpap.com/productpage/respir ... eader.html

If you already have an SD card reader, you can get the software by itself......which will make it cheaper. If you have to pay for an office call to see your sleep therapist, having the software will save you MEGA-$$$.


Den

NewToCPAP wrote: .... I'm hoping my sleep therapist will properly setup and adjust the Philips one for me so all is well, ....

I guess most of us started out that way. But then after some self-education studying this forum, we no longer cared how the machine was set up by the professionals. 'Cuz before we would ever use a machine, we would check out all the settings and adjust them properly ourselves.

Yes, it is very confusing starting out. But you can get up to speed fairly quickly.

Here is a short list of questions you should know the answers to.

Questions to ask about your PSG and Titration Study
by CPAPtalk member rooster

1. Did I have any central apneas? How many?

2. Were there any comorbidities? What were they?

3. Did I breathe or leak through my mouth? How often? What do you recommend to prevent it?

3. Did I exhibit Positional Sleep Apnea (PSA)? Was my apnea more severe in one sleeping position as compared to others? Is my pressure requirement higher in one position as compared to others? (Often sleep apnea is more severe when sleeping on the back.)

4. Is there anything else unusual about the results?

5. How will I know my therapy is preventing apneas?

6. I am determined to own a data-capable machine and software to monitor apneas, hypopneas and mask leak. This will allow me to call your office with specific questions if I have problems with the therapy. Will you help me with the appropriate prescription?

In addition to the questions:

1. Get a copy of your PSG. It is your legal right to have one.

2. Get a copy of your CPAP prescription.

3. Make sure the prescription calls for a humidifier with the machine.

Luckily for me with this private sleep clinic I go to I do not have to pay for office visits. Anytime I need to be seen it's just a call away. There is a catch however. The Philips Respironics machine costs me $2500 with the mask. It's a big hit on me considering I have no insurance and I am only 23 years old.

Posting here has further confirmed how lost and confused I really am. I have an appointment with my therapist tomorrow so I will be writing down a list of those questions. I would like to view my data if possible, hopefully he can help me in obtaining the sofware. I understand what you guys are saying about not relying on them completely and that makes sense. It's something I have the option to know and should know.

I'll create a profile shortly, I just don't want several threads with a different username and what not. I am tied up at work and want to take the time to fill out the info.

NewToCpap, honey, that's a HUGE amount of money for your machine and mask. While it's lovely that your sleep clinic will see you any time, you have certainly paid a lot for that service. And it appears the folks at the clinic don't know as much as they should, they supplied you with a less advanced model and a pressure different from what the data showed you needed. This is why checking data YOURSELF is so important. If you don't review your data daily you will forever be at their mercy.

Yeah, that's the big "catch" in being able to be seen at any time. I realize it's crazy, it's too much money, etc, etc. I just want it to be done with. If I buy a machine from cpap dot com or the like, I will have to pay $70 a visit at the sleep clinic. The machine will also be void of warranty they say after it's shipped from the US to Canada.

I would have preferred to order from cpap dot com but oh well. The most unfortunate part is that I have to finance this over 24 months and I will be in school starting in September. I don't know how I'll make it work but I will find a way.

In other news I am now focused on being able to access the data from my machine.. hopefully he can help me out. It might have to wait a bit as that's another expense for a micro sd reader.

NewToCPAP wrote: ....

The most unfortunate part is that I have to finance this over 24 months and I will be in school starting in September. I don't know how I'll make it work but I will find a way.

....

Holy s***! Slow down. Some Canadians on the forum can surely tell you how to get that machine without paying that much!


Void the warranty? For $2500 you can buy four of those machines, NIB, on the internet and have enough money left over to visit your sleep doc every quarter for the next two years!

Yeah, I know it's crazy. It obviously comes with a great warranty and such but it's still expensive. My appointment is tomorrow and I cannot cancel. I am unfortunately going to have to take the hit and go with this machine. I have been without now for too many nights and just want to get back on with the therapy.

In reality I should have come here sooner! I wasn't really aware there could be a cheaper alternative, I just keep going off of what the sleep clinic tells me.

NewToCpap, well, now you know! We can't turn back time and restore your finances, but we CAN help you from this day onward. The Remstar machine is perfectly adequate for most users' needs, so you'll be fine there. Learn to change the settings yourself, it isn't hard and people here can help you. Check your data every day so you can spot trends and adjust accordingly. I don't have that machine so I don't know, does it have data on the screen? That would simplify things.

I will definitely be signing up and sticking around for help. I might not have access to my data for some time as I need to balance out my finances and get back on track before purchasing the software and SD reader.

When I used the machine for the first month it did give little bits of information. Once I pick it up tomorrow I will snoop around and get familiar with the machine and settings. You guys are a great help here and I will definitely be signing up once I get home or either tomorrow after my appointment.

My username will change however, most likely to OCDP. So watch out for that username as that'll be me.

I have heard good things about this CPAP machine, it seems to be used by lots of people here so that's a plus.