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New CPAP User Questions (Icon Auto)
#11
Ark, are you using the ICON Auto in straight CPAP mode or auto-mode?

If your AHI is still well above 5.0, you may want to consider operating the machine in auto-mode. If your titrated sleep lab pressure recommendation is 9.0, using the ICON in auto mode with a pressure range of something like 8.0 - 12.0 might punch through some of the more stubborn obstructive events, thus lowering your AHI. That's the whole idea of auto-CPAPs - to automatically adjust to your pressure needs, because your needs change throughout the night, throughout the week, etc.

If you are already using the ICON in auto-mode, what are your current pressure ranges set at?


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#12
(03-25-2012, 03:25 PM)SuperSleeper Wrote: Ark, are you using the ICON Auto in straight CPAP mode or auto-mode?

If your AHI is still well above 5.0, you may want to consider operating the machine in auto-mode. If your titrated sleep lab pressure recommendation is 9.0, using the ICON in auto mode with a pressure range of something like 8.0 - 12.0 might punch through some of the more stubborn obstructive events, thus lowering your AHI. That's the whole idea of auto-CPAPs - to automatically adjust to your pressure needs, because your needs change throughout the night, throughout the week, etc.

I am not using the auto mode at this point, and when I had asked my DME clinician about auto mode she said I (or at least she) would need doctor permission to do that (apparently it is considered a change of prescription). I do like the auto mode concept and think my doc would go along, so it is something I will look into once I get the mask situation settled and acquire a little more data/experience with the current CPAP setup.
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#13
(03-25-2012, 03:44 PM)ark Wrote:
(03-25-2012, 03:25 PM)SuperSleeper Wrote: Ark, are you using the ICON Auto in straight CPAP mode or auto-mode?

If your AHI is still well above 5.0, you may want to consider operating the machine in auto-mode. If your titrated sleep lab pressure recommendation is 9.0, using the ICON in auto mode with a pressure range of something like 8.0 - 12.0 might punch through some of the more stubborn obstructive events, thus lowering your AHI. That's the whole idea of auto-CPAPs - to automatically adjust to your pressure needs, because your needs change throughout the night, throughout the week, etc.


I am not using the auto mode at this point, and when I had asked my DME clinician about auto mode she said I (or at least she) would need doctor permission to do that (apparently it is considered a change of prescription). I do like the auto mode concept ( makes great sense) and think my doc would go along, so it is something I will look into once I get the mask situation settled and acquire a little more data/experience with the current CPAP setup.

what you will usually find is that you don't hit the titrated pressure that much in auto. my cpap pressure is 12. in auto mode my doc set pressure at 8-12. the fact is i have reached 12 , four times since december when i started with the auto machine. so for the rest of the time i'm rolling around 9 and 10. the lower the pressure you are really using, the easier the mask issues are to deal with. if i was using straight 12 i would have alot more leaks and problems adjusting. so get your doctor to write a prescription for the range in auto and the cpap number in cpap mode as required so you can get it set in the range and if you don't like it you can get it set to cpap pressure without returning to him. you sooooooo need the book to set your own.
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#14
(03-25-2012, 11:35 AM)ark Wrote: 1. ....
2. I obtained the setup manaul for the ICON Auto by email thru this Board (thank you!), but the displays on my machine don't seem to quite match the pictures in the manual. I have software version 1.05. Either the manual I received is based on a different Software version, or perhaps another possible explanation is that currently my DME has the USB drive that is usually in the machine. I wonder if certain setup options are only available when the USB drive is in the machine?

I figured out (probably should have known) the answer to my question #2 above from my original post, so in case anyone else with an Icon Auto machine is interested:
-- if the machine is in the Flight mode (low power mode, aircraft symbol is displayed) humidity is essentially off ( that's how they save the power), AND the Humidity adjust menu option is no longer available or displayed.
-- The SensAwake feature, which reduces pressure if the machine thinks you are waking up, is not operational if the machine is in the fixed CPAP (vice Auto adjust) pressure mode, AND the SensAwake menu option (on/off) is no longer available or displayed.
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#15
(03-25-2012, 03:06 PM)ark Wrote: Thanks to everyone for your suggestions and ideas.

My AHI score last night (2nd time with the nasal pillows) was 9.8. Sleep study measured an AHI in the mid 50s without CPAP help. So while 9.8 is a definite improvement, it still is about twice the goal of being at 5 or below. I did wake up with a dry mouth so I'm sure there was some mouth breathing going on. I like the nasal pillow approach, so the addition of a chip strap, or perhaps going to a hybrid type mask might be the answer for me. I'll try anything to avoid having a mask across the bridge of my nose.
And just to clarify, the issue of somehow closing the airway between my nose and mouth when awake is just something I observed when using the nasal pillows for the first time. I woke up and realized my mouth was open but there was no rush of air coming out like it did at other times when I opened my mouth. It surprised me that it was happening (possible), and so I'm trying to understand what was going on. It is not something I'm trying to do or want to do.

The openings of your nose and mouth connect near the base of your tongue. The part coming from your nose is the nasopharnynx and the part coming from your mouth is the oropharynx. They join at the base of your tongue.

I suspect that you are pressing the back of your tongue against the oropharynx, which would be the back part of the roof of your mouth. This would allow you to breath through your nose, but not your mouth. Try it- put your tongue on the roof of your mouth, breath through your nose with your mouth open, then pinch your nose shut. You should find that you cannot breath through your mouth. This would also keep the positive pressure of CPAP from escaping from your mouth when wearing a nasal mask.

It is unlikely that we would be able to maintain this when asleep, since our muscles tend to relax. Likewise, you certainly can sleep while CPAP pressure is escaping through your mouth- my wife kicks me when this is happening, since he noise bothers her...
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#16
(03-25-2012, 07:01 PM)Ltmedic66 Wrote:
(03-25-2012, 03:06 PM)ark Wrote: Thanks to everyone for your suggestions and ideas.

...
And just to clarify, the issue of somehow closing the airway between my nose and mouth when awake is just something I observed when using the nasal pillows for the first time. I woke up and realized my mouth was open but there was no rush of air coming out like it did at other times when I opened my mouth. It surprised me that it was happening (possible), and so I'm trying to understand what was going on. It is not something I'm trying to do or want to do.

The openings of your nose and mouth connect near the base of your tongue. The part coming from your nose is the nasopharnynx and the part coming from your mouth is the oropharynx. They join at the base of your tongue.

I suspect that you are pressing the back of your tongue against the oropharynx, which would be the back part of the roof of your mouth. This would allow you to breath through your nose, but not your mouth. Try it- put your tongue on the roof of your mouth, breath through your nose with your mouth open, then pinch your nose shut. You should find that you cannot breath through your mouth. This would also keep the positive pressure of CPAP from escaping from your mouth when wearing a nasal mask.

It is unlikely that we would be able to maintain this when asleep, since our muscles tend to relax. Likewise, you certainly can sleep while CPAP pressure is escaping through your mouth- my wife kicks me when this is happening, since he noise bothers her...

Yes! What you describe fits what is happening, and the little experimernt you suggest "works" as you said.
Thanks very much for explaining this!
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