"please keep me updated about oximeters "
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AutoPap Algorithms
Can anyone explain to me why AutoPap machines are set to a base pressure of 4 cm? It seems to me that this is too low, and that if you are prone to having RERAs (Respiratory Event-Related Arousals) (microarousals), the machine does not have adequate time to respond. So even though the machine handles the longer apneas and hypopneas quite well, you could still be having enough RERAs to significantly impair sleep quality. Does this make sense?
Also, adding to what Mike said about deregulating CPAP, why is it necessary to get a doctor's approval to adjust the pressure? If my theory in the previous paragraph is correct, then simply adjusting the base pressure on my AutoPap might eliminate the microarousals. When I do wake up during the night and check the pressure that the machine is putting out, it's somewhere between 6 - 8 cm. It seems to me that increasing the base pressure by a couple of centimeters for a few nights would be a valid experiment would do no harm.
BTW, I am using the ResMed AutoPap most recent model. I use the machine all night, every night, and I am able to check my results the next morning. My AHI is incredibly low, in the range of 0.6 - 0.8, but unfortunately, I have experienced no relief, which accounts for this post.
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Replies to This Discussion
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Permalink Reply by 99 on
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to stop you suffercating
EG any lower you would suffercate
but this does not take into account of children variation of breathing
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Permalink Reply by Rooster on
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Danny Heller said, "Can anyone explain to me why AutoPap machines are set to a base pressure of 4 cm?"
Short answer: Incompetence in the field of sleep.
By all means, change the minimum pressure to 6 and closely monitor the results. You may need to take it up another few notches.
You don't need a doctor's permission to change the settings, but sleep professionals do. Prior to 1930, nurses were not allowed to check patients' blood pressure. It required a doctor. Sleep medicine is in a similar stage of development.
What pressure were you titrated at? Which pressure range is set currently? Were any central apneas noted on your PSG? Exactly which ResMed model do you have?
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Permalink Reply by Danny Heller on
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Sorry, but I don't understand your post. What is EG, and why would I want to set it lower?
99 said:to stop you suffercating
EG any lower you would suffercate
but this does not take into account of children variation of breathing
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Thanks, Rooster. I am using a Series 9, which is I believe the most advanced. I do not know how to change the pressure settings. I was titrated at 7 c.m., with no central apneas. My current pressure range is 4 - 20 c.m.
Rooster said:Danny Heller said, "Can anyone explain to me why AutoPap machines are set to a base pressure of 4 cm?"
Short answer: Incompetence in the field of sleep.
By all means, change the minimum pressure to 6 and closely monitor the results. You may need to take it up another few notches.
You don't need a doctor's permission to change the settings, but sleep professionals do. Prior to 1930, nurses were not allowed to check patients' blood pressure. It required a doctor. Sleep medicine is in a similar stage of development.
What pressure were you titrated at? Which pressure range is set currently? Were any central apneas noted on your PSG? Exactly which ResMed model do you have?
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it has got to be four or aboveto stop suffercation
EG =mean that is or for example
Danny Heller said:Sorry, but I don't understand your post. What is EG, and why would I want to set it lower?
99 said:to stop you suffercating
EG any lower you would suffercate
but this does not take into account of children variation of breathing
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Permalink Reply by RockRpsgt on
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You probably should have asked about the centrals before giving him advice on raising his pressure Rooster. One of these days somone on this site is going to get sued. My bets are on you and Banyon.
I understand the significance of what you are saying Rooster, but you should also explain the legal ramifications that go along with changing pressures. Without your doctors permission it is prescription tampering. No one has gotten in troouble yet, but things are heating up in the sleep world.
By the way all I need to raise pressure is proof of need and employment by a physician.
Rooster said:Danny Heller said, "Can anyone explain to me why AutoPap machines are set to a base pressure of 4 cm?"
Short answer: Incompetence in the field of sleep.
By all means, change the minimum pressure to 6 and closely monitor the results. You may need to take it up another few notches.
You don't need a doctor's permission to change the settings, but sleep professionals do. Prior to 1930, nurses were not allowed to check patients' blood pressure. It required a doctor. Sleep medicine is in a similar stage of development.
What pressure were you titrated at? Which pressure range is set currently? Were any central apneas noted on your PSG? Exactly which ResMed model do you have?
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I said there were no central apnea events.
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In a little bullying mood last night Rock? (I did ask Danny about centrals and he did say there were none noted - if you are going to be a bully on the fourm get your facts straight.)
Bring on the lawsuits. I would like to drag the sleep medicine field through the courts and expose them for the sorry work they are doing. I am prepared to retire for the third time to take it on full time.
You say you can change patients' pressure if you have "proof of need". What proof do you have when your practice does not prescribe data-capable machines for all of your patients? You don't have proof - you are just guessing.
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Rooster,
I did not mean to be a bully in my post. I meant no one any disrespect. In re-reading my post I can clearly see the lack of respect in my wording. For that I apologize.
My intent was to stress the importance of knowing about central apnea prior to giving anyone advice on changing their pressure. In your post you advised on a pressure change prior to having the central question answered. There is always a risk of causing or increasing central apnea with any pressure adjustment. I did not feel that the advice was proper for the amount of knowledge provided.
For the record I have yet to work for a doc that would not prescribe fully data capable or auto machine. For that reason I have rarely had to guess. I would say never, but there was that one time at bandcamp. I also have no problem with tweaking pressures once some understanding of how things work has been demonstrated.
I beg you to remember that not all bad sleepers have had bad experiences in a sleep lab, or with PAP therapy. Just as I must remember that not all patients have had the same experience that I strive to provide. I am sorry that your experience has been so awefull. If I could correct the situation for you, or anyone else I would.
Rock
Rooster said:In a little bullying mood last night Rock? (I did ask Danny about centrals and he did say there were none noted - if you are going to be a bully on the fourm get your facts straight.)
Bring on the lawsuits. I would like to drag the sleep medicine field through the courts and expose them for the sorry work they are doing. I am prepared to retire for the third time to take it on full time.
You say you can change patients' pressure if you have "proof of need". What proof do you have when your practice does not prescribe data-capable machines for all of your patients? You don't have proof - you are just guessing.
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OK, guys, let's try to stay "on message", shall we? :)
The point is that I'm 100% compliant with AutoPap, and if I were to go exclusively by AHI, then I must be doing terrific. But I'm just not getting the kind of restorative, good quality sleep that I need, and I feel pretty crappy most of the time.
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What is your range Danny? How long have you been on PAP therapy?
Danny Heller said:OK, guys, let's try to stay "on message", shall we? :)
The point is that I'm 100% compliant with AutoPap, and if I were to go exclusively by AHI, then I must be doing terrific. But I'm just not getting the kind of restorative, good quality sleep that I need, and I feel pretty crappy most of the time.
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Danny Heller said:
The point is that I'm 100% compliant with AutoPap, and if I were to go exclusively by AHI, then I must be doing terrific. But I'm just not getting the kind of restorative, good quality sleep that I need, and I feel pretty crappy most of the time.
What was your diagnosis?
What are your pressure settings?
Do you have any comorbidities?
What is your BMI?
Which machine do you have - exact model?
Are you using the software and checking the daily details report?
What is your leak level?
Which model mask are you using?
What is your subjective feeling of how well you sleep at night - do you awaken often at night, how many hours do you sleep, etc.?
How do you rate your lifestyle in terms of stress - low, high, etc.?
Anything else important affecting your feelings?
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