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[CPAP] Control of breathing rate - me or machine?
Newb with my second post. I had read somewhere that certain CPAP machines attempt to control your rate of breathing, sometimes making you feel either rushed or suffocating. I don't think I'd like this, but rather let my body decide what breathing rate is correct.

Is this a thing, and what do I look for in the equipment specs to make sure I am in control of my breathing rate?

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I can only tell you that the 560 auto, the Resmed S9 auto and the Airsense Auto do not control your rate of breathing. However, sometimes when you are awake and suddenly breathing really slow or really fast, you notice that it doesn't quite catch up. If you wait another 20-30 seconds it does.
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there are 2 types of machine that do that. One is a bilevel with a timed backup; the other is the ASV machine.
Primarily they are for treating central apneas. If obstructive apnea is the treatment goal, then the cadre of machines for OA do not do that.

Have you had a sleep study? If so, what type of apnea was diagnosed? And, what is your doctor recommending?
You need to be working with a doctor; as you need a prescription to buy a machine -- even in the Republic of Texas.
(Also, it makes good sense because you don't want to procure the wrong machine for your particular situation.)

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(07-11-2016, 07:41 PM)justMongo Wrote: Have you had a sleep study? If so, what type of apnea was diagnosed? And, what is your doctor recommending?
You need to be working with a doctor; as you need a prescription to buy a machine -- even in the Republic of Texas.
(Also, it makes good sense because you don't want to procure the wrong machine for your particular situation.)

Thanks for the added info. Being a newb, I can't post a link, but see my earlier post entitled:

Nasal Exhale Blockage & Machine/Feature Choice

It should answer your question for the most part. The results of titration have yet to come back but I wanted to be informed when the time comes to start making decisions.

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A normal CPAP or APAP machine leaves the breathing up to you. It simply adds enough pressure in your respiratory tract to keep the passages open and prevent blockage. If you use EPR it can feel like the machine is pushing you to breath because the pressure drops when you exhale and increases when you start to inhale, which feels a bit like being pushed but isn't actually. If it bothers you it is optional so turn it off.

If your illness requires it, you can get machines that will push you to breath. That will only happen if you have mostly central apneas which normal CPAP or APAP machines can't handle.
Ed Seedhouse

Part cow since February 2018.

Trust your mind less and your brain more.

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Got it:
(07-11-2016, 06:37 PM)txpap Wrote:
  • Start with lower pressure and increase when it senses you falling asleep.
  • Reducing pressure for exhale
Regarding the first item - I have often been aware that my exhale blockage starts occurring just as I am falling asleep, thus waking me up. Seems to me I need to start out on whatever pressure will keep my airway open. Thoughts?
Regarding the second item, perhaps it is obvious. I NEED my airway to be forced to remain open during exhale, so it would seem reducing the pressure at this time would be the exact wrong thing to do. Musings?

Regarding 1) Your pressure can be set to start at or near your therapeutic pressure.
Regarding 2) EPR (Expiratory Pressure Relief can be zero. i.e. -- no drop on exhale.
Third option -- perhaps a full face mask.

Your other post says your study showed obstructive apnea. That puts your machine needs into the subset of the most common types.

Best advice at this time -- make sure you get a fully data capable machine.

Here's an article written by member Archangle on machine choices:

Admin Note:
JustMongo passed away in August 2017
Click HERE to read his Memorial Thread

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(07-11-2016, 09:15 PM)justMongo Wrote: Third option -- perhaps a full face mask.
On my first "failed" titration, they tried me on a full face mask. It failed because I could never get to sleep. Reason being, I would start off breathing through my nose, then as I was falling asleep my first event would occur. This would cause me to waken enough to open my mouth to exhale, but when I did that the mask would essentially "thud" me on the face. That would REALLY wake me up.

It was miserable. I think the tech that night was a fill-in for others that really knew what they were doing. Maybe the mask was not adjusted right, or we should have tried something different. I tried to explain to her what I was experiencing but she just kinda shrugged.

While we are at it, my second failed titration was due to me feeling hot. I complained 3-4 times and finally gave up and stopped the test. When they came in to remove the sensors, I found it FREEZING in the room. I can only assume the heated humidifier was making me feel hot. Again, you'd think a skilled tech would know this if the room temp was down to 65 already and I am complaining about being hot.

All this being said - this is why I am doing research. I DO NOT want to give this same firm my equipment business. They are trying to charge me for the 2 failed titrations and insurance is also balking. So, I want to have a good understanding of equipment and features going in.
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A cpap maintains a steady pressure whether you inhale or exhale. If it is set at 8 it will remain at 8 no matter what you do. Unless you set a c-flex or a-flex (different term for different manufacturer). If set it will reduce the pressure a bit WHEN IT KNOWS YOU ARE EXHALING. It responds to your cues.

An auto cpap will increase the pressure if it senses that you have an obstruction. This might be what you are thinking about in your earlier post about the machine "sensing you are asleep". The machine does not know if you are awake or asleep. Or you may be thinking about the ramp feature that allows the machine to start at a lower pressure and gradually increase over a set time period. That is used by people who have a hard time falling asleep at a high pressure so it allows them to fall asleep (hopefully) before it reaches therapeutic levels. That is OPTIONAL and in your case you wouldn't use it.

A bipap has different set pressures for inhalation and exhalation but again it changes in response to your breathing at your own rate.

A bipap ST or bipap ASVs do control your breath rate but they are not very common. They are used for central apnea or other problems. Even then there is some leeway. They are titrated to try to maintain the users normal breath rate within specific parameters. As long as I breathe at least 8 times a minute my ASV will gently try to increase pressure to get me to inhale but stop increasing if it senses that I am still exhaling. It's set on auto. Others have theirs set at say 12 breaths per minute and the machine will maintain a rhythm of 12 inhalation and exhalation changes in pressure every minute.

As long as your sleep study showed regular "patient inspired breathing" you will be prescribed most likely a cpap or possibly a bipap.

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They all seem to like heat and humidity and most/many people do. I do not and have been known to put ice in the water tank. Most sleep tests are HE** to try and sleep through, the objective is not to have you sleep-it is to get you to have apneas and see what it takes to stop them. My last study I slept a whopping 30 minutes, barely enough time to get any data.

Unless you have something special you will get an APAP, make dang sure its the auto and not fixed CPAP model and is data capable. If you cannot tolerate that they will do another study for BiLevel (VPAP). To get the breathing assist machine types you either have to be obvious (ie all centrals) or fail the first to and have whats known as complex. or mixed apnea (ie treating the OA's causes you to have CA's) or of course you can need the higher pressure 30CM instead of 20cm, but I doubt that you need that.

The temperature thing could have been stress, not like CPAP testing is normal or anything. "she just kinda shrugged" they don't care, they figure you don't know what is up anyway and just want to get the job done so they can write the report.
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On my third titration attempt, on the sleep center's suggestion I finally got my doc to prescribe an Ambien generic. 5mg did not do the trick so about midnight took the second one for a full 10mg dose. Was off to sleep in no time and slept like a baby until 5am. I honestly don't think I moved the whole time while normally the sheets are in a knot and a pillow often on the floor (though I do sleep with 3 of them). As others say, it was the best sleep I can remember.
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