Using a family member's apap

I'm worried at the moment. My husband is using his dads apap machine. Dad got it and won't use it- even though he's been encouraged a lot from me and other family members. So when my husband went to the dentist and had a sedation procedure done, the dentist told him his SpO2 went down in the 70's... And that he has horrible sleep apnea- my husband went and got his dads a pap machine since he wasn't using it. I know that the settings are very particular for every person. But my husband wants to try it for the night and see if he can even tolerate it before going through all the trouble of getting a sleep study. (however, I only agreed to this if he'd make the appointment for the referral visit before he could "try" it. And he did.)
I know that they are programmed per patient and you have to have an Rx for the settings and yadda yadda.
My question is- is there a real reason to worry about him trying it out for the night? My husband and father in law are both big men, and are roughly the same size, and we know his dad's sleep apnea is from "being too fat" (not trying to offend anyone with that remark- I just can't think of another way to put it right now.) my husband's sleep apnea is the same. He's never has it before and has gained a lot of weight (like 80 plus pounds) in just over a year- so all those things add up to sound like it's from obstruction rather than a nerve issue. Neither man has any history of lung disease or pneumothoraxies or anything like that. Do I need to worry about him possibly popping a lung or anything else as he sleeps here tonight with it?
Thank you in advance for answering.

i've been around the block a couple times and done alot of risky things, but what you suggest would not be one of them. not knowing anybodies history or anything about the machine nobody in the world would say to use it. let me put it this way: if his apnea is as bad as the dentist says he has no choice about tolerating it. he will have one and use it for the rest of his life. while weight plays into the equation, it's not that much and not going to make a difference about him being on cpap. if his apnea is as bad as the dentist says and his o2 is dropping that low, he needs a sleep study sooner than asap. he needs to call his doctor and get a home overnight o2 test set up and probably get on an o2 generator until his sleep study. you're playing with fire here. call the doctor. o2 is a serious thing. serious enough that insurance pays for the generator if it drops below 89 for a few minutes and you're talking 70. he may need o2 and a cpap. you don't know til he has the study.

his sleep apnea is not new, he's just been made aware of it. thank God he was made aware of it.

As a do it yourself er I am not as afraid of going it alone as greatunclebill but and I MEAN a BIG BUT, you have to know more about what your doing first.
Does he know how to clean the gear?
Does he know if the pap machine is a straight pressure unit like a Cpap or an Apap?
Does he know how to set the unit to a Diagnostic setting of 4cmH20 - 20cmH20 if it is an Apap?
Does he have a machine that can collect data?
Does he have the software?
Does he know how to properly wear the gear?
Can he read a report and understand the terms used in a Sleep Report?
If no to any of these I would say no don't try it solo.

He should do a sleep study and skip the solo route if you have options and I DID it the solo way with a cpap, so I know what he is going to try. You will need to have the sleep study sooner or later regardless. That O2 level of 70 is bad mine got as low as 57% in my first study. HE has to go in and have a study.

Any therapy is better than no therapy.
If he was under anesthesia it's a safe bet that increased his apneas.
If it's an auto machine, it can be set to a range to detect his pressure needs.
Make sure he gets in for a sleep study ASAP.
If you register and list the equipment in the user signature, we can give you more information.

That said, His dad needs to be using his machine so you are looking at double duty here!

Let's not jump onto the 02 concentrator too soon...
My sleep study showed a minimum 02 of 41% ... My sleep doctor still decided to only put me on APAP first before trying anything else. He asked for an overnight oximetry test a week after starting APAP. Minimum 02 during the night was 94%. So no O2 concentrator for me (and life is much more easier that way with only a small xPAP machine in the room and to travel).
So if apneas are correctly treated with a xPAP, sometimes 02 levels, although very low without the machine, can be normalized just with the xPAP. I do not say this is always (or often) the case, but it is worth a shot.

But to self titrate with an APAP, you will have to be able to understand the data given by the machine. An initial range of 4-20 will probably not be optimum (I would even set it at 6-20 as 4 is very low and he could feel as if he is not getting enough air... bad feeling and not conducive to continuing the treatment!) and will have to be adjusted according to the results of the first few nights.

Bluecat wrote: An initial range of 4-20 will probably not be optimum (I would even set it at 6-20 as 4 is very low and he could feel as if he is not getting enough air... bad feeling and not conducive to continuing the treatment!) and will have to be adjusted according to the results of the first few nights.

The only reason i brought up 4-20 was to demonstrate the range the unit had. Also with NO idea at all what a base pressure might even be, the first night a 4-20 set should be ok, unless you want to walk him through what too low a pressure feels like. Once you have at LEAST a first nights data with no huge leaks getting in the way by all means up the pressure to that past nights Average Pressure and give it a go for a week. So say you find it hits 12cmH20 during the first night go 10cmH20 - 14 or 16cmH20 if you see your data ranging that high. I would say start there seeing we are without any Sleep study at all to ether give a base pressure or confirm the need. The O2 issue could be many things other then OSA or CAs as well that pap treatment wont really do much for.

Even when I self titrated with a cpap by feel with no data, I at least had a partial sleep study to work off of it had no titration but did show how bad my OSA was.

Guestygal wrote:I'm worried at the moment. My husband is using his dads apap machine. Dad got it and won't use it- even though he's been encouraged a lot from me and other family members. So when my husband went to the dentist and had a sedation procedure done, the dentist told him his SpO2 went down in the 70's... And that he has horrible sleep apnea- my husband went and got his dads a pap machine since he wasn't using it. I know that the settings are very particular for every person. But my husband wants to try it for the night and see if he can even tolerate it before going through all the trouble of getting a sleep study. (however, I only agreed to this if he'd make the appointment for the referral visit before he could "try" it. And he did.)
I know that they are programmed per patient and you have to have an Rx for the settings and yadda yadda.
My question is- is there a real reason to worry about him trying it out for the night? My husband and father in law are both big men, and are roughly the same size, and we know his dad's sleep apnea is from "being too fat" (not trying to offend anyone with that remark- I just can't think of another way to put it right now.) my husband's sleep apnea is the same. He's never has it before and has gained a lot of weight (like 80 plus pounds) in just over a year- so all those things add up to sound like it's from obstruction rather than a nerve issue. Neither man has any history of lung disease or pneumothoraxies or anything like that. Do I need to worry about him possibly popping a lung or anything else as he sleeps here tonight with it?
Thank you in advance for answering.

Personally, I think testing out someone else's machine to see if you can tolerate it is like wearing someone else's dentures to see if you would like them! They are so customized for each individual's needs - using someone else's is almost guaranteed to not be a good fit and make your husband convinced he won't tolerate a xPAP even if he could have had a much better experience had he been set up properly at a sleep lab.

And - you don't ever really know things like "it's from obstruction rather than a nerve issue" just because he gained weight. He could have gained weight FROM the apnea instead of the other way around. There are plenty of really skinny people with obstructive apnea, and fat people with central apnea. Diagnosing yourself or someone else is misguided at best, treating oneself based on self-diagnosis is dangerous.

Gaining 80 lbs in a year could be a sign of some other serious condition and he needs to be checked out by a real doctor.

Guestygal wrote:... My husband is using his dads apap machine. ...

Unless his dad has a death wish, he really should be using his machine every time he sleeps. No, you can't make him wear it, but he needs to be made aware of what decision he's making. Get an oximeter to show him what's happening at night so he understands why he has to wear the mask.

Likewise, regardless of whether your husband thinks he'll 'like' it or not, he needs to get sleep tested. It's obviously hereditary if both men have it. 70% 02 is serious. The dentist is not a fool.

There are some ethical quandaries about using someone else's machine when they're still alive and have no backup machine.

You have a choice (to educate yourself and then them, or not). They have a choice (to keep oxygenated and stay healthy longer, or not). This is a tough one. We certainly can't make the decision for you, or them. Education and testing are key.

I'd suggest your husband should stop pinching pennies. Get tested.

Well, I guess I am one swimming against the tide. "They" are starting people out on APAPs w/o a sleep study if an evaluation indicataes the likelihood of the person having OSA. Find the Epworth Sleepiness Scale online and combine that w/his symptoms according to that dentist. If OSA is indicated then I see no reason NOT to try out his dad's APAP.

Take a good look at the APAP to get the brand and model. Then check in the forum here for a link to download the Clinicians Manual for it. Hopefully and most likely the APAP is a Resmed or a Respironics. There is a link in the forum here to download the SleepyHead software which will work for either brand.

The Clinicians Manual will have instructions on how to set the therapy settings for the APAP. (Be sure to go thru the menus first and write down ALL of the info on each screen so that it can be PROPERLY re-set for his father). Download his dad's data to SleepyHead and share his data w/him if he has used the APAP at all. Then set the pressure range for your husband. Personally I would select 5 cms and 15 cms to start.

The mask is going to be the "kicker" as it always is. Large leaks produce higher pressures w/an APAP, higher than what is actually needed if you have a proper mask fit and low leak rate. You really can't trust the data if the Leak rate is too high. He should practice w/the mask on and APAP turned on just sitting around the house not trying to sleep but rather watching TV or something to occupy his mind and get "comfortable" w/the mask and air blowing in his face/nostrils.

This can all put him one step ahead when he finally gets his sleep approintment, sleep study and titration study. Certainly if he is acclimated to the APAP and mask now they will get a MUCH better and more accurate titration study for him at the sleep lab.

GASP! I can't believe that I am actually advising this!!! Me, who used to shrink and cringe when I would see others on the forum giving instructions on how to change pressure, how to access the Clinicians Menu on their PAP and where to get their PAP's Clinicians Manual!!!! My, my how the worm has turned!

Ditto what Slinky said...........I totally agree, there are lots of folks out there that have been titrated by using the 4 to 20 scenario. That is what they did with me, sent me home for 2 weeks with a machine wide open from 4-20, then by reading the data set my pressure at 11.

I am tempted to set my hubby up with my old auto and see what he does, I KNOW he has sleep apena, but he is HARD HEADED, and will NOT go for a sleep study until I PROVE to him he NEEDS one. Right now I keep nagging him to get the study, but I'm worn out with all the MOTHERING. So if he refuses to may an appointment this week, he will be MASKING UP on my old tank.

nanwilson wrote:Ditto what Slinky said...........I totally agree, there are lots of folks out there that have been titrated by using the 4 to 20 scenario. That is what they did with me, sent me home for 2 weeks with a machine wide open from 4-20, then by reading the data set my pressure at 11.

I was sent home with a 6-18 setting (with a 15 minute ramp from 4). I hated the ramp as I felt I was suffocating at a pressure of 4, so I stopped using it after a few days. 6 felt ok.

portiemom wrote:I am tempted to set my hubby up with my old auto and see what he does, I KNOW he has sleep apena, but he is HARD HEADED, and will NOT go for a sleep study until I PROVE to him he NEEDS one.

Tell him he can go for the sleep study OR get another life insurance policy. His choice. Hopefully, he'll realize how important it is...and how serious you are about it.

hades161 wrote:As a do it yourself er I am not as afraid of going it alone as greatunclebill but and I MEAN a BIG BUT, you have to know more about what your doing first.
Does he know how to clean the gear?
Does he know if the pap machine is a straight pressure unit like a Cpap or an Apap?
Does he know how to set the unit to a Diagnostic setting of 4cmH20 - 20cmH20 if it is an Apap?
Does he have a machine that can collect data?
Does he have the software?
Does he know how to properly wear the gear?
Can he read a report and understand the terms used in a Sleep Report?
If no to any of these I would say no don't try it solo.

He should do a sleep study and skip the solo route if you have options and I DID it the solo way with a cpap, so I know what he is going to try. You will need to have the sleep study sooner or later regardless. That O2 level of 70 is bad mine got as low as 57% in my first study. HE has to go in and have a study.

The OP said it was an APAP that he wanted to try for one night to see if he could tolerate it.

A one night self test may be an inconclusive toleration test, and he may come to the wrong conclusion, but the other points listed here are overblown.

An APAP is going to self adjust the pressure.
I doubt that most users collect data, have the software to look at it, or have any interest in looking at it (us forum members are special ).
If he's honestly just trying it for one night, cleaning won't be an issue.

At any rate, he's not going to blow out a lung.

I just love it when somebody drops in, asks a question, and gets 13 helpful responses, and never says another word.