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Lowest CM at start with ramp machine?
#1
Lowest CM at start with ramp machine?
Hi folks, 

First post.  Diagnosed at the borderline of mild to moderate apnea.  The sleep issue appears to have been what was causing my PVC's on my heart, which were driving me nuts.  Finally just started taking an over the counter sleeping pill which caused me to struggle to get up in morning, and as such was able to get 10 hours on average total.  Appears that the excess amount of sleep has offset the poor overall sleep, and the PVC's have mostly gone away.  So that's good...

Reason for the post is this.  While I intend to drop about 30 pounds, I'd still like the option of the CPAP like machine in the interim.  I can't however fall asleep with the pressure setting of 4 CM.  I was hoping to find one with a 1 CM or 2CM that would ramp up after 30 to 60 mins to prescribed pressure.  The doc was trying to tell me that the 4CM is basically normal atmospheric pressure, which is clearly wrong otherwise we wouldn't need to create a negative pressure in our lungs to inhale in the first place.  Thus far I've found one higher end machine that starts at 3CM, but nothing else.

It just seems to drive the air in when I try and breathe at the time of going to bed.  The only solution I can see at this point would be to tweak the prescription to a slightly higher than current high CM after ramp up, then constrict the hose to cause lower air pressure at the start.  Basically I could constrict the hose so the 4CM turns into a 1 or 2CM, then once the ramp up happens it would drive up to higher.  I highly doubt I can get the doc to sign off on this though as he'd ultimately have to script a higher pressure than would actually be needed.

Thoughts?

Thank you,
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#2
RE: Lowest CM at start with ramp machine?
4 cm it too low for many (most?) people and makes them feel like they are suffocating. Try 7 to 8 cm minimum, and if getting there all at once most machines let you set a ramp time over which the pressure will gradually increase.
Ed Seedhouse
VA7SDH

Part cow since February 2018.

Trust your mind less and your brain more.


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#3
RE: Lowest CM at start with ramp machine?
How long have you been using it? Most people find 4 cm does not supply enough air. I would not restrict the hose, could cause re breathing issues. Keep trying.
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#4
RE: Lowest CM at start with ramp machine?
It was sent home with me for a week to test.  I guess I must be an odd one then, as it felt like the air was being driven into my lungs at the lowest 4CM setting.

Technically looking for a setting that is a strong enough pressure to offset the hose itself, and ultimately feel like breathing normal air at normal pressure.  This would be to allow me to fall asleep.  Once asleep, ramping up to a higher setting would presumably much more tolerable since I'd be in that groggy fall back asleep state if I was awakened by it.

Research not showing any machines with lower settings, so thinking I just need to focus on diet to lower intake and building muscle to ramp up metabolism.

Thank you! Smile
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#5
RE: Lowest CM at start with ramp machine?
Hi Sliight and welcome to the forum where you will find answers to your qeustions if you participate and stay with it. As eseedhouse and Dave Paulson said you should increase your pressure to at least 8 cm. Also, many users find it to be more comfortable to omit or minimize the duration of ramp time. That has been my experience. A pressure of 4 cm or lower and an extended ramp time just isn't going to result in any kind of a comfort level.

There are some questions; is your machine through insurance and are you being monitored for compliance? You don't list a machine in your profile but from the wording in your post you are actually using or have attempted to use a machine. Go ahead and fill out your profile so we can see more details. If you do not know how ti change pressure settings on the machine you are using you can download the clinician's manual for most machines from this forum. You should also obtain a copy of any sleep study report as well as a copy of any Rx written by your doctor. These documents should be in your permanent files.

Keep reading and posting and you should start making progress. Wishing you success in your treatment,

Stan
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It is what it is. But, it will be what you make it.
Pat Summitt
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#6
RE: Lowest CM at start with ramp machine?
For your reference adding 4 cm h2o pressure adds 0.003 871 364 039 3 atmosphere [standard]. So as your Dr. said, its pretty much atmospheric pressure. That is 0.057 PSI pressure over the normal 14 psi atmospheric pressure.
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#7
RE: Lowest CM at start with ramp machine?
Hi Sliight,
WELCOME! to the forum.!
Good luck to you as you start or consider CPAP therapy, hang in there for more responses to your post.
trish6hundred
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#8
RE: Lowest CM at start with ramp machine?
Thank you for the replies.  Maybe I'll just try it again.

I'm not sure of the machine, only that it was set to a steady "4" setting with no ramp up.  The ramp was something I wanted as I felt as if the pressure was too strong.

I guess I'm a bit confused.  Everyone is stating to set the pressure higher to be more comfortable.  

Now, I've stated 4CM, but ultimately it was just a "4" on the machine which I've presumed to mean 4CM.  The doc stated it was the lowest setting, so I'm fairly sure that is in fact 4CM as the machines specs show that as lowest.  It was a Resmed I believe, and the doc says it is supposed to be the state of the art one.  I believe it adjusts pressure based on events.

Ultimately though, I didn't really have an opportunity to see if it would benefit me as I fell asleep once, for about an hour in the entire 7 days I had it.  Even took the thing out on the couch and just watched TV for a few hours before bed to try and get my body used to it.

So where I'm confused is this:  On the setting of 4 (presumed 4CM) it feels like the air is being driven into my lungs when I try and inhale, vs the traditional feeling of inhaling in normal atmospheric pressure.  Everyone here is stating I should increase the pressure... but wouldn't that drive the air that much harder?  If so, is it people's experience that it actually makes it more comfortable to breath with higher pressure even when it feels too high already?

Thank you!
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#9
RE: Lowest CM at start with ramp machine?
(06-26-2017, 04:49 PM)Sliight Wrote: Thank you for the replies.  Maybe I'll just try it again.

I'm not sure of the machine, only that it was set to a steady "4" setting with no ramp up.  The ramp was something I wanted as I felt as if the pressure was too strong.

4 cm is as low as these machines go and it is the rare person that doesn't need more.  Even 10 cm is only about 1% of normal air pressure at sea level. 

You need enough pressure to keep your airway open and 4 cm is rarely enough.  I find 13 cm hardly noticeable now that I am used to that.  Your body will rapidly adapt if you give it  a chance.  Setting a ramp time can help.

I don't doubt that 4 cm seems like a lot to you, but the body is adaptable and you will get used to a higher pressure quickly.  Try moving it up by 1cm and see how that goes - give yourself a few nights to get used to it and then move up again.  You can do this yourself as the links at the top of the page here will tell you how to take control of your machine, as you have a right to do.  You want enough pressure to open your breathing tubes so you feel like you are getting enough air - that will help you sleep better.

There are lots of helpful links here - start using them!
Ed Seedhouse
VA7SDH

Part cow since February 2018.

Trust your mind less and your brain more.


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#10
RE: Lowest CM at start with ramp machine?
Many people feel starved for air at lower pressures, that does not seem to be what you are describing. If your symptoms are bad enough it will be worth continuing to try, you will get used to the pressure, you could try raising the pressure a little and see what happens you could always change it back. Good luck with your weight loss, I am in the process of losing weight too. Most people who lose weight do not stop needing a CPAP, your mileage may differ since you have mild to moderate apnea and better still if you are younger.

Dave
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