(07-19-2012, 01:11 PM)iTeachCpap Wrote: If you change your pressure and it's too low or too high and something happens to you, the company that cares for you can be sued.
Welcome to Apnea Board, iTeachCpap...
Don't want to sound rude, but I'd like to challenge your thinking on this:
Here's the thing: We get a lot of these
assertions here on Apnea Board, but with nothing to back them up in the way of evidence or documentation.
Just to clarify, theoretically in the U.S.
anyone can sue
anyone else or
any company for
anything,
anytime they wish. Suing someone does not mean that the party being sued is guilty of any wrongdoing. Nor does it mean that the suing party will win the lawsuit.
On a purely real-world basis, I'm not aware of any lawsuit anywhere in the U.S. where a patient actually sued a DME/HME after the patient changed
their own pressure, and was actually harmed by that pressure change. (where the patient brought a lawsuit against their DME/HME for something that the patient themselves initiated).
If you can find such a case, please post a verifiable link to it.
Quote:Also, if you bump it up too high, it can cause what sleep techs call, centrals.
Again, we get this assertion a lot also: Many "sleep professionals" use this as evidence as to why a patient should never, ever change their own CPAP pressure.
Sure wish there was a single solid, documented scientific study to indicate that increased pressures
cause true central sleep apnea events, (where a central event is defined roughly as a "
neurological event where patients stop breathing because of a malfunction in the brain's signaling processes"). So far in the 8 year history of Apnea Board, not one member has been able to link to a
verifiable,
statistically significant scientific study that proves beyond a reasonable doubt that increasing a patient's pressure
causes true central events.
There's a lot of
personal opinions, official-sounding "
articles" and anecdotal small-sampling "
evidence" offered by various sleep professionals, but little else in the way of statistically significant studies. I think there were two studies where a handful of patients were involved in the studies - maybe 10-30 or so if I'm remembering correctly, which is not a large enough sampling to be statistically significant. And the primary goal of those studies was concerning a completely different subject, and the info concerning centrals was only secondary to the aims of the studies. And again, those studies
didn't come to a
solid conclusion that increasing pressures was the main culprit behind increased centrals amongst the participants... they admitted that there could have been other reasons for the central events, in addition to the increased pressures.
Again, if you have a link to such a study, please post it. (and I don't mean a link to a
summary of someone's
personal opinion or an
article about the subject, or someone who quotes a
supposed study that no one can find or verify... I mean a link to the
study itself). I've had a couple people send me links to what they claim were actual studies, but end up being a summary of a supposed study - somewhere - by -someone- done -at some point- but no one can find any reference to the studies except to the article that is quoting one or two paragraphs of a "supposed study".
Let me add that I'm not saying that central sleep apnea events don't exist, or that no one has CSA. I'm just saying that I haven't seen reasonably conclusive proof that increasing CPAP pressure
causes CSA.
Yeah, I know you can probably tell me of instances during a titration where a particular patient had increased centrals when you increased their pressure. But again, that does not prove
causality, especially when one considers that it's not in a controlled study group, (where variables are minimized), and not using a large, statistically-significant sampling group.
Also, so folks don't think we recommend that patients change their pressure "willy-nilly" without taking precautions, I'd advise all those who'd like to change their CPAP pressure to read our page on
How to Find Optimum CPAP Pressure.
