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[Diagnosis] They want me to use a CPAP with oxygen concentrator
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Krull Offline

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Joined: Aug 2015

Machine: None yet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Rested AirCurve 10 Auto
CPAP Pressure: 15/10
CPAP Software: Not using software Other Software

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Sex: Male
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Post: #31
RE: They want me to use a CPAP with oxygen concentrator
(04-17-2016 08:45 PM)green wings Wrote:  Krull,

I just read your post and the replies, and I'm a little confused. When you did the overnight O2 test, did you compare the results to data from your BiPAP machine to see if the O2 desats coincided with obstructive apneas?

What kind of data did your doctor use to make the recommendation to increase your BiPAP therapy pressure?

What kind of AHI/RDI numbers do you typically see from your BiPAP machine?

Any thoughts to my response?
04-19-2016 04:13 PM
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bwexler Offline

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Machine: PRS 1 BiPAP autoSV Advanced, with Heated Tube humidifier
Mask Type: Nasal mask
Mask Make & Model: Sleepweaver Élan
Humidifier: Resperonics Heated Tube humidifier
CPAP Pressure: Max pressure 25.0 cm H20, Max
CPAP Software: SleepyHead EncorePro

Other Comments: CMS 50i with Software for SpO2

Sex: Male
Location: San Marcos, CA, USA

Post: #32
RE: They want me to use a CPAP with oxygen concentrator
Another happy EverfloQ concentrator user here on 3 LPM.
My Medicare Advantage plan approved a replacement concentrator but would only offer a perpetual rental. Since my old one had lasted 5 years, I did some quick math with my copay. I did some shopping and paid out of pocket. Just my copay will get me a break even in less than 3 years.
So the insurance wins big and I win also.
I do own and use a CMS 50i oximeter and with AHI below 3 I still have desats below 88, which seems to be a magic number. My average seems to be around 91 or 92. With 3 litters of O2 my average is 93 and I seldom dip below 90.
I recommend you ge a recording oximeter and lear to use it with SleepyHead. with a week of data it will become clear to you weather you need a concentrator. mY guess is you will.
I keep mine in the bathroom and use 90 feet of air hose to get to my pap machine. There are several minor tricks that minimize the hassle of adding the O2.
First the O2 injector/adapter is available with a 90' elbow to connect the O2 hose, this allows the air hose to run parallel to the CPAP hose so you can tie them together with Velcro or a hose cozy or ???.
Second get a mask with a short 18" very light weight hose between the mask and the PAP hose. This separates the O2 adapter and hose fro the mask, and greatly reduces any pull on the mask.
I hope you enjoy many years of PAP and O2 therapy, and that it allows you to enjoy a long healthy happy life.
04-22-2016 10:45 PM
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DariaVader Offline
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Machine: Resmed S9 AutoSet
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CPAP Pressure: 8-15
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Other Comments: diabetes II, Thyroidectomized, Primary Immune Deficiency, and the list goes on :P

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Location: Oregon

Post: #33
RE: They want me to use a CPAP with oxygen concentrator
(04-18-2016 06:27 AM)Krull Wrote:  As for the AHI/RDI score, do I need to remove the media from my Resmed and use the sleepyhead SW to interpret that? What should I be looking for?

yes, install Sleepyhead and import the data into it. Once you have done that you can post a typical daily report, and board members can start with that to see what is going on.

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
04-22-2016 11:00 PM
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DariaVader Offline
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Posts: 1,820
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Machine: Resmed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: Airfit P10 for Her
Humidifier: H5i humidifier with ClimateLine heated hose
CPAP Pressure: 8-15
CPAP Software: SleepyHead

Other Comments: diabetes II, Thyroidectomized, Primary Immune Deficiency, and the list goes on :P

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Location: Oregon

Post: #34
RE: They want me to use a CPAP with oxygen concentrator
For help with posting:
http://www.apneaboard.com/forums/misc.php?action=help&hid=22

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
04-22-2016 11:01 PM
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mckee105 Offline

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Machine: airsense 10
Mask Type: Full face mask
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CPAP Pressure: 14
CPAP Software: ResScan SleepyHead

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Sex: Male
Location: South Carolina, USA

Post: #35
RE: They want me to use a CPAP with oxygen concentrator
Hi All,
I use CPAP with a pressure of 14. I still have night time O2 issues. They prescribed an O2 concentrator. It is hooked inline with the CPAP hose just before the mask. I have my own oximeter. It registered no change between with O2 and without. I don't know how this is supposed to work. CPAP at 5-14 seems to block the O2 flow rather than pull it in. I tried putting on a cannula under the mask. Very uncomfortable, but much better results my average O2 went from 93 to 95-96.
What am I doing wrong with the inline connection? My O2 prescription is 2 liters per minute. The flow out of the concentrator feels like 1-2 PSI. With CPAP at 5-14, the air flow goes back to the concentrator vs joining the flow. This backflow causes the concentrator (Invacare Perfecto2 V) to stop supplying O2 (with no alarm). I have to turn it off and back on to get flow again. I had the equipment supplier swap the unit for another story.
Any insight anyone can provide would be helpful. I do feel better with the cannula method (so more O2 is the answer). I can't seem to get it to work.

Larry
11-06-2016 01:00 PM
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Tubaman Offline

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Other Comments: Supporting equipment: CMS50EW pulse oximeter & Digital audio recorder, 3.5 lpm Oxygen

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Post: #36
RE: They want me to use a CPAP with oxygen concentrator
Hello Larry,
I had problems with my initial concentrator setup also. The person who set it up supplied an adapter for the o2 line that fit between the auto CPAP hose and my mask. They also replaced my ResMed hose with a 'generic' hose (no bells & whistles such as heat). The 1st night I tried it, the o2 tubing came off 3 times because my head was moving around.

I contacted the equipment supplier and got into a good argument with the woman who apparently runs that operation. She eventually tried to end the argument by telling me to hook it up the way I was shown. I argued with her (continued) that the o2 tubing kept pulling off and I did not think I was getting the full benefit of the o2 even when it was on because the o2 was not getting thoroughly mixed with the CPAP's air. I felt that much of it was being expelled (blown out) by my breathing and not reaching me. I told her the oxygen should be injected into the CPAP hose well before the mask to mix it adequately with the CPAP air and to prevent the o2 tube from coming off during the night. She finally gave in (after putting me on hold for several minutes) and told me how to install the o2 injector fitting immediately next to the CPAP machine's air discharge / hose connection so the o2 would have plenty of time to completely mix with the air before reaching my mask (and me).

Subsequently, I decided I did not like the generic hose they gave me and asked if I could get the ResMed hose with heating, etc. I was told I would have to wait until I qualified for it (Medicare). Since I already had a ResMed hose (sans oxygen fitting) I looked at a picture of the hose with the o2 fitting and decided it would be easy to install a fitting at the same place the ResMed picture showed it. I carefully drilled a hole in the ResMed hose fitting (same as the picture showed, next to the CPAP machine outlet) and carefully fit a nipple into my hole. Since I made my hole to have a very tight fit with the nipple, by the time I got the nipple inserted it didn't leak and would not come out without significant force.

That was back in August 2016 and it's been working fine ever since -- even my %SpO2 subsequently improved (after I adjusted the o2 flow from 2 lpm to 3 lpm) since I was never given any documentation defining what it should be set at by my sleep doctor. Note: The oxygen generator was initially set up at about 1.7 lpm and I knew it was supposed to be 2 lpm (I'd heard my sleep doctor say this previously). My Pulmonologist (sp?) subsequently told me to keep the setting at 3 lpm since my o2 had finally improved (did not improve @ 2 lpm -- same as no o2 at all).

One other thought: I don't think the pressure from the concentrator is 1 to 2 psi. I suspect it is much lower than that (unless your concentrator is defective).

Hope this helps!
Carl
(This post was last modified: 11-06-2016 11:15 PM by Tubaman.)
11-06-2016 11:08 PM
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mckee105 Offline

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Machine: airsense 10
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CPAP Pressure: 14
CPAP Software: ResScan SleepyHead

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Sex: Male
Location: South Carolina, USA

Post: #37
RE: They want me to use a CPAP with oxygen concentrator
Hi Carl,
Quite a saga with an inventive solution. I elected to get the Resmed heated hose with the O2 connector. The contraption they have built for me keeps disengaging from the mask during the night and I lose O2 until morning.
I hope my new hose works out as well as your DIY hose.

Larry
11-09-2016 07:18 PM
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srlevine1 Offline

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Post: #38
RE: They want me to use a CPAP with oxygen concentrator
(05-04-2015 01:22 PM)eseedhouse Wrote:  Also I can listen to music through them when I am on the road and they reduce the traffic roar. They were expensive, but to me they were worth it. These days I can't imagine living in the city without a decent pair of sound cancelling headphones.

Except here in California where earphone use while driving is generally outlawed. Hell, in California they wanted to eliminate breathing without taxation --- but that's the People's Republik of Kalifornia.

"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius
11-09-2016 08:01 PM
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Sleeprider Online
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Post: #39
RE: They want me to use a CPAP with oxygen concentrator
The excess air flowing in the CPAP circuit is at least 3-times the flow needed for respiration alone, with most of the flow exiting the exhalation exhaust vent. So this dilutes any oxygen put into that circuit tremendously. Dosages estimated based on the use of a canula will not work. Most members using oxygen need to turn up the Lpm to get a noticeable effect in the mask or oximeter.

The location in the circuit for adding oxygen should not make much difference. Putting the oxygen lead at the mask just means juggling 2-hoses. If you add oxygen near the mask, try putting a fleece CPAP hose cover over both the CPAP hose and the O2 tube. Another alternative is to purchase an "Oxygen Bleed Adapter", which is a $5.00 part to the CPAP hose at the machine. Then you don't have to deal with both tubes by your face. The Resmed ResMed ClimateLine Max Oxy hose tubing should be able to be ordered by your supplier, or is available online. This gives you the heated hose capabiltiy with a port at the humidifier or machine rather than your face. Ask for it.

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11-10-2016 10:09 AM
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justMongo Offline

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Post: #40
RE: They want me to use a CPAP with oxygen concentrator
(11-06-2016 01:00 PM)mckee105 Wrote:  The flow out of the concentrator feels like 1-2 PSI. With CPAP at 5-14, the air flow goes back to the concentrator vs joining the flow. This backflow causes the concentrator (Invacare Perfecto2 V) to stop supplying O2 (with no alarm).

This is erroneous. The CPAP pressure is 5 to 14 centimeters of water. The concentrator can flow "uphill" against as much as 5 PSI. The units of measure make the pressure of the concentrator >> than that of the CPAP. Backflow will just not happen.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
(This post was last modified: 11-10-2016 11:14 AM by justMongo.)
11-10-2016 11:06 AM
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