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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?


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I'm catching up reading here and noticed this question was not answered:

99 said:

what is the other measurement in is it pascals
and is it more or less accurate

j n k said:
You may have missed it, but what Rooster wrote had a decimal point in front of it, meaning 0.34 psi, or 34 hundredths of ONE psi, or more technically, 0.34136023937086956 psi, for 24 cm H2O at 4 degrees C.
PSI is pounds per square inch and is commonly used by engineers.  It is not more or less accurate than cmH2O; a particular measurement's accuracy reflects the equipment used to take the measurement.

I don't self tweak mine because I wasn't shown how by the CPAP people. I don't feel that I really need to because I'm doing fine with it. When I see my doctor for a follow up, I take my memory card from my machine and the doctor downloads it and is able to see if I'm compliant. 

I hadn't seen him since December but he was able to download my card and see all my sleep since then. The amount of hours I was sleeping, etc. It was pretty neat. 

 

 

I had an unusual problem with CPAP when I was under-titrated -- I was hungry all the time.

I don't mean I was eating for energy; I do that sometimes, of course.  But when I went onto CPAP in Sept'97, my stomach would growl a lot.  For example, I could go to a buffet, eat a bit more than I should (but not really pig out), leaving the place at 7:30 - 8pm.  By 10 pm, I'd find I was hungry and my stomach would be growling.  As a consequence, I found it very hard not to eat too much, and I gained 50 lbs between Sept'97 and April'99.  I was initially set at 8 cm H2O; in about Feb'99, I began increasing the pressure very slowly.  In April'99, I was at about 11 cm and was doing a lot better -- and the nearly constant stomach growling had stopped.

Prior to Sept'97, my weight was actually pretty stable, staying within a 10 lb range over the year before.  After April'99, my weight has varied more.  I have never gotten to the point where weight loss has happened consistently, as it has for some sleep apnea patients once on cpap.  I have found that I can lose weight now, though, if I count calories.  I couldn't before, with my stomach growling so much and still being pretty tired.  I was less tired on the 8 cm than I had been before I went on cpap, but I was still pretty tired.

The last time I had a titration study, the tech said she could not titrate me to a single pressure that would work for me thru an entire night.  I am on autopap.

 

Since '99, I've told this story to a lot of people but until recently, had found no one who had a similar experience. Now, I have a friend who has become more hungry since going on cpap.  She has not tried self-titrating but is planning on getting a new sleep study.

Mary, I agree with you more than you know. The medical industry is set up to treat the averages and the normals. It is a system that helps many. Unfortunately not all of us fall into those catagories.

 

The problem that I see is that the information is so easy to get for the newbie. So many of these people end up screwing up their therapy more then they help it. There needs to be a little more education with the recieving of that info. If you are passing that info it is just as much your responsibility to make sure that the knowledge is given as well. There has to be give and take on both sides.  

Mary Z said:

I think the whole point is that some of us are going to self titrate.  Some who should not be touching their machines will be changing their numbers during the first week and some with a lot of knowledge and experience will be carefully tweaking.  The sleep industry has failed some of us either through carelessness, complicated situations, misdiagnosis or whatever.  True some of us haven't given the sleep industry (our docs specifically) a fair shake.  But I am going to tweak.  You can help me to do it safely, you can warn new people to give it some time, you can encourage us to see our doctors.  Whatever, but I have done my part as far as the medical community and now I'll take it on myself.  Three years, six sleep studies, two doctors.  I'll go once a year and keep my script up to date and that's it for now.

Will Sleep Techs support Light Techs?

 

There is pending legislation that will make candles available only if you have an Rx. It turns out that some body on the West Coast (naturally) committed suicide by shoving a candle down their throat. Further we are all familiar with the death toll from house fires many of which are caused by candles.

 

If passed this legislation will require the candle owner to take their candle to a licensed Light Center where a highly trained Light Tech will change you candle's setting from unlit to lit; this is similar to what my bartender does for me personally, but I digress.

 

WaxMed will be opening a Light Center in your neighborhood soon.

 

PS: To get an Rx for a candle complain to your doctor about darkness after sunset.

Shoving a candle ..........................................ACk coff coff erk!  you sure It Was not murder? 

 

Tom Cannon said:

Will Sleep Techs support Light Techs?

 

There is pending legislation that will make candles available only if you have an Rx. It turns out that some body on the West Coast (naturally) committed suicide by shoving a candle down their throat. Further we are all familiar with the death toll from house fires many of which are caused by candles.

 

If passed this legislation will require the candle owner to take their candle to a licensed Light Center where a highly trained Light Tech will change you candle's setting from unlit to lit; this is similar to what my bartender does for me personally, but I digress.

 

WaxMed will be opening a Light Center in your neighborhood soon.

 

PS: To get an Rx for a candle complain to your doctor about darkness after sunset.

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