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Doctor Ordered Pressure Change
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BillPedley Offline

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Posts: 4
Joined: Jul 2014

Machine: Remstar 1 auto
Mask Type: Full face mask
Mask Make & Model: Quatro FX med
Humidifier: Remstar series 1
CPAP Pressure: 8-18
CPAP Software: SleepyHead

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Sex: Male
Location:

Post: #1
Doctor Ordered Pressure Change
update,July 26 2014

well I have been on cpap for 6 months now. use Apria DME and I've been fighting an uphill battle with them. Finally convinced my sleep Dr.to switch to an auto machine Remstar auto system 1 still but auto instead of reg cpap with a steady pressure of 11 initially. Machine is now set to 8-18 Big deal. I feel much better..but...now the Dr.calls and say being I'm doing good AHI from 120 to 3.7,that we'll just go to 12 pressure steady from now on..go figure. I feel much much worse and am at a loss here. Any suggestions?

[Moderator Note: Thread has been split so issue can get the attention it deserves.]
07-26-2014 09:01 AM
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Sleepster Offline
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Posts: 4,991
Joined: Feb 2012

Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #2
RE: Your Personal CPAP Success Story - Post Here
Hi Bill, welcome to the forum. If you were doing fine at a pressure range of 8 - 18 I wonder why the doc is switching you to a constant pressure of 12. Call or email the doctor and ask for an explanation. If you can't get one I'd say it's time to get a second opinion.

Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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.
07-26-2014 09:05 AM
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BillPedley Offline

Members

Posts: 4
Joined: Jul 2014

Machine: Remstar 1 auto
Mask Type: Full face mask
Mask Make & Model: Quatro FX med
Humidifier: Remstar series 1
CPAP Pressure: 8-18
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location:

Post: #3
RE: Your Personal CPAP Success Story - Post Here
Thanks Sleepster, I did exactly that..the person who takes care of that is conveniently on vacation but her associate told me to call my insurance. LOL the answer she gave me was the report said i was doing great on an average of 13 cfm so i really can't figure out WHY she would change to a steady pressure
07-26-2014 09:15 AM
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robysue Offline
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Machine: PR Dreamstation BiPAP Auto
Mask Type: Nasal pillows
Mask Make & Model: Swift FX
Humidifier: PR Dreamstation humidfier
CPAP Pressure: min EPAP = 4; max IPAP = 9;
CPAP Software: SleepyHead EncoreBasic EncorePro

Other Comments: Papping since September 2010

Sex: Female
Location: Buffalo, NY

Post: #4
RE: [split] Doctor Ordered Pressure Change
(07-26-2014 09:01 AM)BillPedley Wrote:  update,July 26 2014

well I have been on cpap for 6 months now. use Apria DME and I've been fighting an uphill battle with them. Finally convinced my sleep Dr.to switch to an auto machine Remstar auto system 1 still but auto instead of reg cpap with a steady pressure of 11 initially. Machine is now set to 8-18 Big deal. I feel much better..but...now the Dr.calls and say being I'm doing good AHI from 120 to 3.7,that we'll just go to 12 pressure steady from now on..go figure. I feel much much worse and am at a loss here. Any suggestions?

Get the clinical manual for your machine. And change the machine back to Auto with a range of 8-18.

And prepare to be whipped with a wet noddle when you speak with the sleep doc and/or the DME.

When they bring out the wet noodle for whipping you about being a foolish person for changing your settings, simply tell them over and over: I feel better when I use APAP at 8-18 than I feel when I sleep with CPAP at 12 ....

Questions about SleepyHead?
See my Guide to SleepyHead
07-26-2014 10:32 AM
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retired_guy Offline

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Posts: 2,744
Joined: Jan 2014

Machine: ResMed S9 Autoset
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: ResMed
CPAP Pressure: 10.6/14, EPR 3
CPAP Software: ResScan SleepyHead

Other Comments: Is it bedtime yet?

Sex: Male
Location: Beautiful, albeit very wet Oregon Coast

Post: #5
RE: [split] Doctor Ordered Pressure Change
Very much agree with Robysue. It sounds like they had their head on straight when they ordered you the auto machine, but somehow forgot where they put it when they decided to revert you to standard CPAP. I think docs like to pigeonhole patients too much. But around here we believe in patient empowerment, and you know what works for you better than anyone else. So go get 'em Bill, and good job!
07-26-2014 11:04 AM
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me50 Offline

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Posts: 2,559
Joined: Aug 2013

Machine: resmed S9 VPAP Auto
Mask Type: Nasal mask
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Humidifier: resmed H5i
CPAP Pressure: 18/8
CPAP Software: SleepyHead

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Sex: Undisclosed
Location: USA

Post: #6
RE: [split] Doctor Ordered Pressure Change
(07-26-2014 09:01 AM)BillPedley Wrote:  update,July 26 2014

well I have been on cpap for 6 months now. use Apria DME and I've been fighting an uphill battle with them

I had a nightmare experience with Apria. I returned my machine and went to another DME. My insurance company said that they knew of the problems with Apria and were trying to work with them to fix them. I suspect they haven't had a lot of success.

Watch closely what Apria bills your insurance company for. I got billed for things that I never received and some that I never ordered if I remember correctly.
07-26-2014 12:05 PM
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me50 Offline

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Posts: 2,559
Joined: Aug 2013

Machine: resmed S9 VPAP Auto
Mask Type: Nasal mask
Mask Make & Model: Wisp and Silicone Head gear
Humidifier: resmed H5i
CPAP Pressure: 18/8
CPAP Software: SleepyHead

Other Comments:

Sex: Undisclosed
Location: USA

Post: #7
RE: [split] Doctor Ordered Pressure Change
I agree with robysue and retired_guy
07-26-2014 12:05 PM
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trish6hundred Online

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Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #8
RE: [split] Doctor Ordered Pressure Change
Hi BillPedley,
WELCOME! to the forum.!
Good job sticking up for yourself, keep up the fight and best of luck getting this situation straightened out.

trish6hundred
07-26-2014 03:20 PM
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archangle Offline
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Machine: ResMed S9 AutoSet
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Mask Make & Model: ResMed Swift FX
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CPAP Pressure: 16-20
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments: Happy PAPper

Sex: Undisclosed
Location: USA

Post: #9
Doctor Ordered Pressure Change
The medical mafia dislikes auto CPAP (APAP) and using the efficacy data automatically collected by modern CPAP machines every night.

There are some limitations to APAP and CPAP generated data, but the arguments are mostly specious.

APAP's can be adjusted to work in a narrower pressure range and eliminate the problems that "untamed" APAP can cause. All it takes is a little analysis of the in-home data the machine provides and a little effort on the part of the doctor. The argument is made that the APAP may not find the "right" pressure. That's drivel. It assumes that a manual pressure (probably chosen from a one night $leep $tudy in the lab) is right and an auto pressure in a properly chosen range by examining the actual sleep data is wrong.

The medical mafia also tends to ignore the in home CPAP data and go exclusively with the data from in lab $leep $tudies. This is downright disingenuous. In some ways, an in-lab $leep $tudy is better than home CPAP data. However, it's not an either/or situation. Looking at the home data doesn't mean you can't have or use an in-lab $leep $tudy. Home CPAP data may very well alert a good doctor that the patient actually does (or doesn't) need a new $leep $tudy.

In short, the medical mafia doesn't like APAP and home data analysis because they're not as profitable as the alternatives and it does take a little more effort and learning on the part of the doctor. Many of them also have delusions of grandeur and don't want to hand over part of the control to some machine, especially since the machine does this control without generating as much ongoing revenue as the manual process.

Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
07-26-2014 04:21 PM
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Sleepster Offline
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Posts: 4,991
Joined: Feb 2012

Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #10
RE: [split] Doctor Ordered Pressure Change
Moreover, there's no monetary motivation for doctors to learn how to interpret CPAP data, and in fact there is monetary motivation for them to not learn.

There are a lot of good doctors out there who do learn how to interpret CPAP data because it's a better standard of care for the patients, but you cannot simply assume that your doctor is one of them. As in all cases of patient care, it's the patients who must check to see that we're getting a better standard of care.

Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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.
07-26-2014 04:35 PM
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