"please keep me updated about oximeters "
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Broken CPAP
Last Friday I had the appointment with my sleep doc and told him I was still feeling tired. He ordered a pressure increase by two points. Today an Apria tech came out and adjusted my pressures but before leaving she made sure that they were right. She hooked up her machine and got a confused look on her face. She told me that at an 8 setting it was reading at 5. It all makes sense now why I've been sleeping so crappy. My machine is broken :(. Thank god it was figured out when it was so I can start sleeping better. She left the new pressures on the machine and she's going to call ResMed about getting me another unit in a couple of days. I still have the old one to use until then. I really thought that there was something wrong with me. I kept thinking "Why do I still feel like crap?" I thought I had some other medical issues besides the apnea and being overweight. Now I know that that's probably not the case. If I would've changed the pressures on my own like my sleep doc told me to do I would have never known the machine was broken. When I first got the machine I would wake up rested and ready to go. I wonder if it broke just recently? Hm guess there's no way to tell....
Views: 1390
Replies to This Discussion
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Permalink Reply by mollete on
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Charles McDermott said:
Anna,
Do I understand this correctly? If my pressure should be set at 10 and the EPR is 3, the effective pressure could be 7 .
I suppose the answer would lie in one's definition of "effective".Using a somewhat more sensitive software package to analyze the ResMed waveforms, in this example of breathing at CPAP 7.0 cmH2O with EPR 3.0 cmH2O it can be seen that the sub-therapeutic EPR-influenced pressure of 4.0 cmH2O carries into the inspiratory effort following the long central apnea:
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Permalink Reply by Charles McDermott on
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Well, I am just a layman and the reply contains too many technical terms that could be reduce to laymans language so I am not impressed with the answer. Could you answer it by saying "the cpap was set at 7 ccmh2o and during an apnea event it was reduced to 4"? By the way , you mentioned central apnea which is NOT the majority of apnea events are.
mollete said:Charles McDermott said:
Anna,
Do I understand this correctly? If my pressure should be set at 10 and the EPR is 3, the effective pressure could be 7 .
I suppose the answer would lie in one's definition of "effective".Using a somewhat more sensitive software package to analyze the ResMed waveforms, in this example of breathing at CPAP 7.0 cmH2O with EPR 3.0 cmH2O it can be seen that the sub-therapeutic EPR-influenced pressure of 4.0 cmH2O carries into the inspiratory effort following the long central apnea:
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Charles McDermott said:
By the way , you mentioned central apnea which is NOT the majority of apnea events are.
Correct. This event was selected to demonstrate the difference between the principles of the ResMed technology (pressure relief not only throughout expiratory phase but possibly extending into inspiratory phase as well) vs. Philips Respironics technology ("Flex Family")(which occurs only during active exhalation):
While EPR methodology may not be an issue during true central events, it would certainly seem that airway is in a less than ideal state during the ensuing inspiratory effort if there is a tendency to obstruct.That being said, EPR essentially results in a bilevel approach to respiratory event management, but in the absence of frank obstructive apnea, may not be an issue from a practical standpoint, especially if one is in an APAP mode, where residual events will be addressed.
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Actually, I disagree that the EPR is just a comfort setting. In my case, lowering the EPR to 1, seem to prevent any long apneas (i.e.40 seconds) as the pressure remained around 6, as opposed to dropping down so far that my airway seem to collapse. Granted, I run low pressures (5-10), so a low EPR was necessary. Others with much higher pressures, a higher EPR allows breathing out comfortably without so much resistance.
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Thanks K.S, at least someone is aware of what EPR does. Aapparently mollete seems to be so caught up in trying to impress me with graphs and fancy constructed sentences using technical terms than trying to answer a simple question. AND, as far as comparing what happens in a C-Flex and Bi-flex is of no concern to me.
My point in responding to mollete to your post that when you get too technical an answer is 1. I get to thinking someone is trying to impress me with knowledge they think they only have and 2. they don't really know how to answer my question. Your simple answer was great!
K. S. said:Actually, I disagree that the EPR is just a comfort setting. In my case, lowering the EPR to 1, seem to prevent any long apneas (i.e.40 seconds) as the pressure remained around 6, as opposed to dropping down so far that my airway seem to collapse. Granted, I run low pressures (5-10), so a low EPR was necessary. Others with much higher pressures, a higher EPR allows breathing out comfortably without so much resistance.
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Go screw yourself.
Is that simple enough for you?
Asshole.
Charles McDermott said:Thanks K.S, at least someone is aware of what EPR does. Aapparently mollete seems to be so caught up in trying to impress me with graphs and fancy constructed sentences using technical terms than trying to answer a simple question. AND, as far as comparing what happens in a C-Flex and Bi-flex is of no concern to me.
My point in responding to mollete to your post that when you get too technical an answer is 1. I get to thinking someone is trying to impress me with knowledge they think they only have and 2. they don't really know how to answer my question. Your simple answer was great!
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Permalink Reply by Mary Z on
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Mollete did point out that the EPR effect could prolong into the beginning of inspiration and thus could certainly have a negative effect for some of us. I have flex (respironics) and don't use it because I don't need a lower exhalation pressure on ASV.
Please lets stop this infighting. I think many of us got off to the wrong foot with Mollete, but her points, however expressed (and I was very distressed in the beginning) were on point. Her posts lately have been helpful and knowledgeable. She is willing to help and may be somewhat technical for this forum which tends more toward laymans terms and explanations. If you need something explained more simply please just ask her. This forum is very important to me. I am a homemaker and this is a social network for me so I have an interest in keeping things informative and thought provoking. Name calling and criticism are not necessary. If you do not like someone's posts I suggest not reading them. If you don't understand, just ask. If you take issue with me, it's easy to make a comment on my page.
Mollete, we tend to be simple people here ( no offense to the Professionals and those with more knowledge) and attract a lot of newcomers. I am not new, but have never learned how to interpret the graphs, unfortunately, so they are lost on me, too. Your commentary is very understandable. I know other forums are very big on graphs, but they are pretty foreign to us. I for one have learned the EPR may affect treatment, that a sleeping pill is not appropriate for someone with severe desats, and the CPAP library however helpful should be used with full knowledge of the possible consequences.
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Mary Z said:Please lets stop this infighting.
No prob, Mar. I'll take care of ol' wrinkle-ass there. He's just like all the rest of the geezers, hoping for a peek at "the goods", and THAT ain't gonna happen.The medication point is extremely complex. Overall, one would argue about the use of sleep medications in ANY study. I mean, if a person does not normally use sleep aids, why take them in a sleep study and create an entirely different scenario from what normally happens?
That said, they can be very helpful in some cases to achieve sleep if the ONLY problem is overcoming lab effect.
Further, zolpidem might very well help in central and/or complex sleep apnea.
However, in Noah's case, once he said head injury, seizures and medications, a big red flag should go up. Indeed, if he still was on phenobarbital 300 mg and zolpidem was added, there could have been a BIG issue.
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Good reply Charles.
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mollete said:
That said, they can be very helpful in some cases to achieve sleep if the ONLY problem is overcoming lab effect.
However, in re: long-term use of NBZD hypnotics to improve CPAP compliance, it appears unlikely that would be of benefit:
An Oral Hypnotic Medication Does Not Improve Continuous Positive Airway Pressure Compliance in Men With Obstructive Sleep Apnea
http://chestjournal.chestpubs.org/content/130/5/1369.abstract
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And yet, this may not always be the case, either:
Effects of a short course of eszopiclone on continuous positive airway pressure adherence: a randomized trial.
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mollete, I am not sure where you are going with the "screw yourself" andI'll take care of ol' wrinkle-ass there. He's just like all the rest of the geezers, hoping for a peek at "the goods", and THAT ain't gonna happen."
You don't even know who I am. But since you did make those comments and I don't know you, how about i just say that I don't think much of any person who tells someone to "screw themselves". That comment is ignorant and stupid and probably reflects the type of person you are. How can anyone even begin to accept anything you post with comments like that.
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