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Do we know how many people don't/can't continue CPAP?
#11
RE: Do we know how many people don't/can't continue CPAP?
In other words, it's a wonder to me that anyone succeeds without taking matters into their own hands and resources like this site.

I had it relatively easy. I tolerate pressure well, don’t seem sensitive to CO2 washing, and my doc’s educated-guess Rx based on the home sleep study wasn’t far off the mark (for being fixed pressure). On a GOOD night, it did ok, but I struggled to get enough sleep, and felt horrible after the not-so-good nights.

Kim really had no chance of succeeding if not for all that I learned here.
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#12
RE: Do we know how many people don't/can't continue CPAP?
The machine I was issued by the NHS in the UK was a Resmed S9 Escape it’s a CPAP brick. It has no efficacy data, blows at one fixed pressure and records how long it blew for.. isn’t that great.



I purchased my own Resmed 10 Autoset which showed I had complex sleep apnoea some nights my treated AHI was as high as 30 all centrals. I worked with my consultants team and eventually purchased my own ASV now my AHI is 0-0.1 most nights, and my blood pressure has dropped back to normal levels and I don’t fall asleep watching the tv at night.


Do I like using the machine no.... do I go a night without it no. It’s helping my health.
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#13
RE: Do we know how many people don't/can't continue CPAP?
Depending on who you ask, between 29% and 83% of people who start PAP therapy wind up quitting. What would treatment look like if it were designed to help patients stick with it? Except for the sickest patients, or those with the most severe AHI, it would introduce treatment gradually, humanely, and informatively. AHI might remain fairly high for many patients during the early weeks of treatment, but the payoff would be in the benefits of life-long treatment.

Of course some lucky souls take to treatment right away, but clearly most don't. So among the measures I personally would recommend:

Don't perform split-sessions studies, and don't begin therapy with 4-20 "titration." These are often lousy experiences and are a horrible way to introduce patients to a new routine.

Before patients begin home use, do a lot of work with them on selecting and fitting a comfortable mask, trying out each mask on easy pressures and in the patients' preferred sleep positions.

Involve spouses/partners at every step along the way.

Start with a week of just using the machine a few hours a day while watching TV or reading. Help the patient get ready for night-time use with tips on pillows, hose management, neck collars, humidity, dry mouth, etc., as well as further work on mask fit and comfort.

Start with easy settings and expectations for night-time use, e.g., settings of straight 7 with EPR of 3 and use of a few hours. Then review the data and the experience with the patient and start tuning the settings and working on full-night usage. Encourage active patient participation for those who want it (OSCAR, note-taking, problem-solving, adjustments to settings).
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#14
RE: Do we know how many people don't/can't continue CPAP?
To [Image: avatar_56431.jpg?dateline=1491419120]

SarcasticDave94

Hi Dave,
I see that you have COPD and I wonder whether you get Hyperinflation.?

I have IPF and Oscar has shown I have significant flow restrictions, to counter this AB suggested I use EPR. I tried but my lungs became irritated which I put  down to hyperinflation, my reasoning is that on expiration the air is sucked out rather than pushed out by diaphragm and rib cage. I probably dont know what Im talking about , just guessing.  

I assume that ASV is a turbocharged form of EPR?

My OSA has really improved and my daytime energy and alertness is very much better from the treatment, I certainly know its important for me to persevere through , mask leaks, head clamp aches, sweaty nights through summer and aerophagia. The results are worth it and couldnt have  got this far with out help from AB, thank you AB members.

While I know Im doing ok and current treatment is working well, IPF is a progressive disease and know that my treatment will change over time. I like to have some knowledge of what going on with my body and have idea of how CPAP and other associated treatments
work.

wesozzzz
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#15
RE: Do we know how many people don't/can't continue CPAP?
That's certainly possible and one aspect I'm investigating.

I think ASV could be described as turbocharged. Like EPR? Not exactly I'd think because I see EPR as a deduction from your base pressure. On ASV, it's PS added on top of EPAP, so maybe EPR in reverse...
NICE pic in that post!
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#16
RE: Do we know how many people don't/can't continue CPAP?
From Dormeo...

Start with a week of just using the machine a few hours a day while watching TV or reading. Help the patient get ready for night-time use with tips on pillows, hose management, neck collars, humidity, dry mouth, etc., as well as further work on mask fit and comfort.

Start with easy settings and expectations for night-time use, e.g., settings of straight 7 with EPR of 3 and use of a few hours. Then review the data and the experience with the patient and start tuning the settings and working on full-night usage. Encourage active patient participation for those who want it (OSCAR, note-taking, problem-solving, adjustments to settings).

I didn’t want to copy everything, but this is pure genius. Why not start someone at a lower pressure? Prior to being on CPAP the person was getting zero therapy. If non-treated AHI is 50 and low pressure takes it to 25, that is a relative success. Especially in light that quitting is zero success.

My wife had open heart surgery a couple years ago. The PT wanted her to walk 1 yard distance and back for a week, then 2 yards, etc. he said to only go that far even if she felt great. Obviously walking 125ft would not be a success for her now, but she needed to build up slowly. It should be no different with any therapy, including CPAP. FWIW... 5 weeks after her surgery we got on a plane to Hawaii.

Additionally, sleep centers should have seminars, or meetings where people can get together and work through issues as they go through therapy.

It is so stupid that Resmed and other mfg’s don’t champion indusyry changes to ensure success. Doubling the success rate seems like a no brainer business model.

John
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#17
RE: Do we know how many people don't/can't continue CPAP?
John, groups—yes! And you wife’s experience is a great example of how slow and steady gets us there, literally step by step.
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#18
RE: Do we know how many people don't/can't continue CPAP?
While people who don't continue their treatment is definitely a bad thing, the silver lining is that they sometimes dump their equipment for a pittance. I'm on an
AirSense S10, with a 2019 manufacture date and a total of 250 hours that I bought off Craigslist for $175. As much as I would have liked for that gentleman to have continued with therapy, at least his machine isn't collecting dust in an attic somewhere.
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#19
RE: Do we know how many people don't/can't continue CPAP?
Same here. My VAuto is a lightly used machine I bought privately to address my flow limitations. My AHI was way too good for me ever to get a prescription for a VAuto.

Are you by any chance in the philosophy biz?
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#20
RE: Do we know how many people don't/can't continue CPAP?
Such good advice here. It's hard to imagine why people are generally just issued (sold) some equipment and sent home to figure it out. Again, I am lucky, as some others, that I didn't have major problems adjusting, but I've had friends who have given up, typically near the beginning, and so are still suffering the effects of sleep deprivation. Some early support would make such a difference. I suppose there are suppliers who go the extra mile, but it seems as if they are few and far between. I had one doctor visit, one sleep study, pick up the equipment, and I was on my own. Probably just like millions of others, many of whom quit therapy before being able to reap the benefits.
Kathi D.
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