CPAP not working

Hi,

I started using the DeVilbiss IntelliPAP Auto CPAP Machine over a month ago, with a nasal pillow mask.

From my sleep study, I know that I have OSA with an AHI of 20. The study did not show and central apneas.

From the Smart Codes I can review my sleep numbers and I see that my AHI whilst using the machine is consistently between 5 and 10. To be honest, I don't feel much better, even though this is technically an improvement over not using the machine at all. The sleep doctor reviewed the data from the machine and found that the mask fit is good, with little leakage. Therefore I'm confused as to why my AHI is still so high. The pressure settings are supposed to automatically adjust (within a set range). The max pressure is currently set to 11 and the data shows that on an average night, the machine is using a pressure of 8/9.

On the positive side, I have stopped snoring, however, I have noticed no other differences. Does anyone have any thoughts on why the therapy is so ineffective for me?

Thanks a lot in advance,
Slon

I see your max pressure is set at 11 but what is your starting pressure? Auto machines raise the pressure incrementally over time, and if it has to rise very far it can take a while to get to the pressure you need. In the meantime, there may not have been sufficient pressure fast enough to prevent an event. If you raise the lower end of your pressure range a bit, you'll likely see your AHI drop. If it were me, I'd start it at 6 or 7. You might get more knowledgeable advice from someone else, but that's my 2 cents.

Hi kteague,

That's a good idea. I think that my starting pressure is quite low (possibly 3) and you're right, the machine does have a ramp up time, so it may not be providing adequate pressures at the start. Having said that- I think the ramp up time is only 45 mins or so...

Thanks for the response!

slon wrote:Hi kteague,

That's a good idea. I think that my starting pressure is quite low (possibly 3) and you're right, the machine does have a ramp up time, so it may not be providing adequate pressures at the start. Having said that- I think the ramp up time is only 45 mins or so...

Thanks for the response!

Hi slon,

Kteague has given you excellent advice. I would also eliminate the ramp as in many cases, that prevents the machine from getting to the necessary pressure fast enough if you start off having apneas. Try the new settings for 3 days and reevaluate whether you should further adjust the minimum pressure.

49er

Thank you very much- I will turn off the ramp, increase the lower pressure setting and report back with progress!

I am pretty much in the same boat that you are. I have been using mine for about 2 months. Sometimes I wake up feeling good, but most of the time I wake up feeling bad. I have been told that I just need to stick to it and I will eventually get used to it (keeping my fingers crossed).

Hi jsc360, It's early days yet, but I switched off the flex function and it seems to help. It makes it a bit more uncomfortable, but over the past couple of nights my AHI has dropped a bit...

jsc360 wrote:I am pretty much in the same boat that you are. I have been using mine for about 2 months. Sometimes I wake up feeling good, but most of the time I wake up feeling bad. I have been told that I just need to stick to it and I will eventually get used to it (keeping my fingers crossed).

Sticking to it is good advice, but challenging if there are things about the treatment that are not optimized. Yes, it takes some getting used to, but how is your mask fitting and your data looking? Maybe there's something that could be done to help your transition.

From what I have read, I don't think any machine can have a starting pressure of 3. 4 is the most likely starting pressure. However, many people find it difficult to breathe at 4, so if the improvement doesn't continue you might want to look at raising the lower pressure. Of course, if your ramp was set to go from 4 to 10, that will take care of the lower pressure to start with, and a different strategy may be needed.

SleepyToo2 wrote: I don't think any machine can have a starting pressure of 3.

Just for everyone's information...Devilbiss machines have a minimum pressure of 3 available.
Pressure Range 3-20 cm H20 (.5 increments)
https://www.cpap.com/productpage/devilb ... ations-tab

So if we think 4 cm is stifling....imagine what 3 feels like.
Heck even my titration study started off with 5 cm while awake and it wasn't any too breezy.

Pugsy wrote:

SleepyToo2 wrote: I don't think any machine can have a starting pressure of 3.

Just for everyone's information...Devilbiss machines have a minimum pressure of 3 available.
Pressure Range 3-20 cm H20 (.5 increments)
https://www.cpap.com/productpage/devilb ... ations-tab

So if we think 4 cm is stifling....imagine what 3 feels like.
Heck even my titration study started off with 5 cm while awake and it wasn't any too breezy.

Does that fall under the definition of torture?

jsc360 wrote:I am pretty much in the same boat that you are. I have been using mine for about 2 months. Sometimes I wake up feeling good, but most of the time I wake up feeling bad. I have been told that I just need to stick to it and I will eventually get used to it (keeping my fingers crossed).

Has anyone urging you to just stick with it looked at your data? I've seen people here who "stuck with it" for YEARS when it clearly was NOT working. After 2 months if you're not noticing any improvement, it's time to see what's going on. If the professionals aren't helping you, someone here can set you up with software to see for yourself what might be happening.

Hi,

I don't have the SmartLink data module yet, so have just been following progress using the SmartCode. The past 19 days' worth of information are here: http://snk.to/f-cdka69kz

A week ago I increased the base pressure from 3 to 7. I also turned off the flex function. But my AHI is still hovering around or above 5

The data is not really detailed at all- I assume I will need to get the SmartLink in order for anyone to give me further advice/recommendations on what might be wrong with the therapy?

Thanks,
Slon