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Permalink Reply by Mike on May 7, 2009 at 1:27pm

so the meds are anti-anxiety meds? doesn't seem as if they're working. have u talked to your doctor about lorazapam?

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Permalink Reply by RockRpsgt on May 7, 2009 at 3:20pm

I agree, this seems to be more of a psychological issue than CPAP issue. Have you tried nap therapy? This is when you try to take a nap during the day using your CPAP. I would not stop taking the meds before talking to your PCP.

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Permalink Reply by Belinda Haman on May 8, 2009 at 9:01am

So you don't think that the increased air pressure has anything to do with this problem.....I slept better when my machine was set on autoset instead of ramping.....I think I am anxious but, why was I able to sleep with my mask before the air pressure was increased????

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Permalink Reply by Judy on May 8, 2009 at 9:21am

What was your setting prior to this pressure raise? Were you using Ramp prior to this pressure change? Was the starting Ramp pressure the same it is now? Most likely it is the change in meds. But if you weren't using Ramp before or if the starting Ramp pressure was lowered that change could be making making you just anxious enough that the change in meds at the same time are contributing to this new problem.

I was just thinking that if you didn't use Ramp before it is difficult for many to breathe comfortably at 4 cms pressure and even tho the pressure raises over that 45 minute period you become unueasy at it being less comfortable to breathe at the start and then can't relax enough to get to sleep. The Elite is not an APAP so my understanding of what you've said is that you were more comfortable w/o Ramp being turned on.

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Permalink Reply by Belinda Haman on May 8, 2009 at 9:53am

Judy:

I didn't have a ramp setting prior to this--it was on autoset at 4.4.....Okay I need to ask a silly question here, what it is the difference in cpap and apap....

You are so right I was much more comfortable w/o the ramp....how effective is this for my sleep apnea.....right now I feel like I can't breathe very well, last night I actually slept two hours with the mask on, but I had to take it off so uncomfortable....

Thanks Juday

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Permalink Reply by Judy on May 8, 2009 at 11:06am

A CPAP is set at one set pressure and can only provide that one set pressure allowing for a Ramp setting which can start at a lower pressure and gradually build up over a set period of time to the set pressure. If that CPAP has a form of expiration pressure relief (EPR for Resmeds, C- or A-Flex for Respironics) the set pressure can be dropped up to 3 cms during exhalation depending on that setting and then back up to the set pressure on inhalation.

An APAP (auto PAP) can be used in CPAP mode or in auto mode in which it has a pressure range setting, for instance 6 to 10 cms, and the auto mode provides the pressure needed anywhere w/in that range. If the set up person or ordering doctor properly understands an APAP, the range is usually set 1-2 cms below the titrated pressure and 1-2 cms above the titrated pressure to better determine or fine tune your pressure need and then reset in CPAP mode at the auto titrated pressure. Far too many, ignorant of the proper use of an APAP, set it wide open w/a range of 4 to 20 cms. IF there has been no in-lab titration then a pressure range of 6 to 12 cms or even 6 to 15 cms is the wisest course of action. Data collected over a reasonable period of time can then allow narrowing of the pressure range and eventually determine the proper pressure setting. Some APAPs can also utilize EPR or C-/A-Flex if needed or wanted.

Maybe Rock Connor or Daniel Levy or Rock Hinkle, etc., our professinals, can explain this better than I am doing.

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