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How Dangerous are CPAP Machines?
Peter Farrell, the Founder of ResMed, is notorious in the Sleep Medicine establishment for saying “The only way you can get injured by one of our machines, at least the low level ones, is if somebody picks the goddamn thing up and slams you over the head with it.”
But still RTs and other sleep professionals cringe at the idea of letting a patient adjust his or her own pressure settings, based on the notion that high pressures can kill you. Furthermore, they say that no amount of disclosure to the patient of possible risks will justify letting the pressures change without a doctor's say so.
What's the truth?
Views: 15045
Replies to This Discussion
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Permalink Reply by Mark Douglas on
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I was very content letting my sleep doctor control every aspect of my apnea treatment -- until he showed himself to be incompetent, uncaring, and only interested in how much he could charge my insurance. And talking to other CPAP users, I find out, this is not unusual.
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Permalink Reply by Mary Z on
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I have to agree, my last Sleep Doc proved himself to be totally incompetant, besides falsifying medical records, e.g. using a history and physical over a year old as a new H&P, plus lack of documentation resulting re: ridiculous pressure changes. I ended up getting the bums rush out of the office when he could not treat me successfully. I now have a doctor I can work with and will give him a chance to prove himself. I have changed such setting such as rise time and TiMax that were set totally counterintuitively and too short.
Mark Douglas said:I was very content letting my sleep doctor control every aspect of my apnea treatment -- until he showed himself to be incompetent, uncaring, and only interested in how much he could charge my insurance. And talking to other CPAP users, I find out, this is not unusual.
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Permalink Reply by lia deneau on
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Sure.... lets just let everyone tweak their own..thats just brilliant!
Yes, over titration CAN CAUSE DAMAGE.... I have personal witness to patient that was once viable, energetic, ceo that traveled the globe for business and pleasure and mountain climber.... an avid sports man...no he was not obese, just had mild - moderate apnea...
his pulmonologist had the brilliant idea to just slap him on auto pap... then the doc just pulled a pressure number out of thin air...and on and on... the gentlemen ended up haveing to take medical/early retirement and watched his health take a fast nosedive... long story short....he ended up back again in the sleep lab and I performed the study myself...having just noted the man was at the end of the rope ( i say that i did the study myself , because i work days..not nights) so I took it into my own hands... started him out as a diagnostic study...which noted the man in fact did not have central apneas...just mild osa... and then titrated him to 7 cm H20 ...that was his 'SWEET SPOT" he was titrated higher...and then began having the CENTRAL APNEAS .... he was infact overtitrated...
he used his cpap for 2 years at 14 cm H20...that was his problem... his life has been devasted and he blamed the doc...because the doc was the one that made the decision to pap him and not allow the patient to be titrated from the lowest pressure...the doc just as i said before plucked some number out of the air, said start his pap at 12 cm and it was just a mess......
so, in my opinion, expertise...high pressures can be dangerous... now? is the technology of our pap machines good enough to REALLY recognize the diff between osa or central...i sure hope so... tweaking your own pressures...thats a sore subject... just because most all patients THINK their pressure is too high...they note this while awake...not asleep... so they lower it until they think that they can handle it.... this pressure is not necesarily theraputic.... its all trial and error...
i have to also say that having watched my husband closely for years on his cpap I most certainly think, and know that his autopap which is set at a high and a low pressure definatly is better than the straight cpap that he used for years... but, he had a titration study in a sleep lab that gave the doc the perameters to work with.....
in the end, self dosing, self tweeking is it bad?... is it bad to tweek your own insulin, blood pressure meds, blood thinners???
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Permalink Reply by RockRpsgt on
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Well said Poly.
lia deneau said:Sure.... lets just let everyone tweak their own..thats just brilliant!
Yes, over titration CAN CAUSE DAMAGE.... I have personal witness to patient that was once viable, energetic, ceo that traveled the globe for business and pleasure and mountain climber.... an avid sports man...no he was not obese, just had mild - moderate apnea...
his pulmonologist had the brilliant idea to just slap him on auto pap... then the doc just pulled a pressure number out of thin air...and on and on... the gentlemen ended up haveing to take medical/early retirement and watched his health take a fast nosedive... long story short....he ended up back again in the sleep lab and I performed the study myself...having just noted the man was at the end of the rope ( i say that i did the study myself , because i work days..not nights) so I took it into my own hands... started him out as a diagnostic study...which noted the man in fact did not have central apneas...just mild osa... and then titrated him to 7 cm H20 ...that was his 'SWEET SPOT" he was titrated higher...and then began having the CENTRAL APNEAS .... he was infact overtitrated...
he used his cpap for 2 years at 14 cm H20...that was his problem... his life has been devasted and he blamed the doc...because the doc was the one that made the decision to pap him and not allow the patient to be titrated from the lowest pressure...the doc just as i said before plucked some number out of the air, said start his pap at 12 cm and it was just a mess......
so, in my opinion, expertise...high pressures can be dangerous... now? is the technology of our pap machines good enough to REALLY recognize the diff between osa or central...i sure hope so... tweaking your own pressures...thats a sore subject... just because most all patients THINK their pressure is too high...they note this while awake...not asleep... so they lower it until they think that they can handle it.... this pressure is not necesarily theraputic.... its all trial and error...
i have to also say that having watched my husband closely for years on his cpap I most certainly think, and know that his autopap which is set at a high and a low pressure definatly is better than the straight cpap that he used for years... but, he had a titration study in a sleep lab that gave the doc the perameters to work with.....
in the end, self dosing, self tweeking is it bad?... is it bad to tweek your own insulin, blood pressure meds, blood thinners???
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Permalink Reply by Robert Woods Mann on
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I think a doctor's OK is a good idea, just for insurance reasons if nothing else. Chances are a personal physician would make a note in his chart letting someone make a (1-2 pound) increase in the the pressure on the cpap because of daytime drowsiness. I would consider this fine tuning by the person closest to the problem.
If a doctor is not able of willing to do that, some people face waiting for an appointment with a specialist 20 miles away, then waiting for an appointment with a sleep clinic 20 miles a way, then driving 20 miles, losing a night's sleep, and driving 20 miles home. If they are old, experiencing daytime drowsiness, and have other health issues, this seems like too high a cost to make a minor adjustment within the normal pressure range.
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Permalink Reply by Jeffrey Donaldson on
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My take on this is that the medical community looks at users adjusting their own c-pap machines just as they would playing around with their meds. I know people that say " my blood pressure has been low the last few days. I'll take a half a pill, or only take it every other day". This is certainly a recipe for disaster. I will admit that I myself have adjusted my own machine from time to time. I used to adjust my own glasses by bending the nose pads until they nearly broke off. I wear plastic ones now that have no adjustable pads. I consider it obsessive behavior. If you want to adjust your c-pap machine, then have at it. Personally, I leave that kind of stuff to the experts now.
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Permalink Reply by Rock Conner RRT on
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I would never professionally advise anyone to vary from their prescribed CPAP pressure. There are potential problems, and there is sound evidence that staying on a medically managed PAP is the proper path to OSA treatment.
If, however, I were having a beer with a friend in a completely off-duty, non-clinical & personal setting, I would say that if you notice a return of symptoms symptoms from a simple OSA condition first make sure your that mask/machine system is in order. If that's not the problem, the high road is to see your sleep professional for advice. Should you want to tweak on your own, increase the pressure a couple of cm. at a time.
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My younger brother uses a CPAP as well- has used it for several years. When I told them I now had one, he said "Don't even THINK about drinking while using the CPAP. You could die".
Umm did he mean don't drink alcohol AT ALL and then use the CPAP. . .or don't go on a binge and then use the CPAP?
Really? I was like "Umm right then."
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I certainly wouldn't go on a binge, but I don't think moderate drinking would cause you to die. Maybe he's thinking of vomiting into a FFM. That could be deadly or just downright disgusting.
yogariffic said:My younger brother uses a CPAP as well- has used it for several years. When I told them I now had one, he said "Don't even THINK about drinking while using the CPAP. You could die".
Umm did he mean don't drink alcohol AT ALL and then use the CPAP. . .or don't go on a binge and then use the CPAP?
Really? I was like "Umm right then."
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is if somebody picks the goddamn thing -
i do not like the fact that this language has to be used in a medical site - but then i guess most don't think taking God's name in vain is a bad thing
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Yoga,
Like Mary Z said most likely he was thinking about if you vomit into a full faced mask you could aspirate...you can drink and use cpap....no you wont die as a direct result of using cpap and having drunk alchohol, it would have to be extenuating circumstances as a result of the drinking....
yogariffic said:My younger brother uses a CPAP as well- has used it for several years. When I told them I now had one, he said "Don't even THINK about drinking while using the CPAP. You could die".
Umm did he mean don't drink alcohol AT ALL and then use the CPAP. . .or don't go on a binge and then use the CPAP?
Really? I was like "Umm right then."
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