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New to the board and using a bipap
#21
RE: New to the board and using a bipap
Sleeprider: The data from last night looks a little better. Smile


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#22
RE: New to the board and using a bipap
091017
Sleep rider: Stats from last night. Trying to link to imgur.
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#23
RE: New to the board and using a bipap
Thanks for the update. These things have a tendency to settle down after a while. Hopefully you feel as good as your numbers look.
Sleeprider
Apnea Board Moderator
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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.
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#24
RE: New to the board and using a bipap
So I received an email from my RT. Seems not to be happy that I changed my machine. Thoughts?

"We only advise changing PAP machine settings per the sleep physicians orders.  Yes many clinicians manuals can be found online, but it isn’t always a good idea to change settings if you are not an RT or sleep physician.  For instance:  You only have a pressure support of 3cmh20.  For the use of a true bilevel the pressure support minimum should be 4cmh20.  If using a pressure support less than 4cmh20 it is advisable to use cpap instead (that would save you money too).  You might want to speak to your sleep physician regarding your current settings if you prefer that so the order reflects it correctly."

Also in regards to rainout:
"To prevent rain-out you’ll want to increase your tubing temp to higher than 72.  Also turn your humidity up higher to help with dry mouth and turn the climate control to auto and that will give you more humidity."
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#25
RE: New to the board and using a bipap
Your RT MUST follow what your Dr says (Rx). When YOU change it he (RT) does not have control.

Typically a BiLevel is used if a CPAP cannot work, a higher pressure is needed (or you are close) or you need more PS than is available on CPAP (EPR) oops, that is a COMFORT feature that we sometimes use for PS when needed. (Your RTs comment about PS greater than 3), and Auto CPAP machines are cheaper than BiPAP, auto or otherwise.

The question that you need to answer is Who do you want to control your CPAP therapy, you, yourself, or your Dr and RT?

Fred
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#26
RE: New to the board and using a bipap
(09-18-2017, 07:19 PM)disnynerd Wrote: So I received an email from my RT. Seems not to be happy that I changed my machine. Thoughts?

"We only advise changing PAP machine settings per the sleep physicians orders.  Yes many clinicians manuals can be found online, but it isn’t always a good idea to change settings if you are not an RT or sleep physician.  For instance:  You only have a pressure support of 3cmh20.  For the use of a true bilevel the pressure support minimum should be 4cmh20.  If using a pressure support less than 4cmh20 it is advisable to use cpap instead (that would save you money too).  You might want to speak to your sleep physician regarding your current settings if you prefer that so the order reflects it correctly."

Also in regards to rainout:
"To prevent rain-out you’ll want to increase your tubing temp to higher than 72.  Also turn your humidity up higher to help with dry mouth and turn the climate control to auto and that will give you more humidity."

[sarcasm]"Oh gosh, your AHI is less than 1 and we didn't do it"[/sarcasm]. 

No one is taking your machine, it works great and you are optimizing your results.  The RT is out of line here. Results count! And results, especially comfort and quality sleep, beat policy and bureaucracy every time. All we did was enable your potential...something your RT should think about.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
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Organize your OSCAR Charts
Attaching Files
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How To Deal With Equipment Supplier


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.
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#27
RE: New to the board and using a bipap
I am so frustrated with my RT. 

Question: By changing my settings on my new bipap, could this affect my approval for my new bipap by my insurance company?

I thought compliance was using the machine for more than 4 hours per day for 21 days out of 30 days. Can they possibly not approve me for my new bipap because I am not using the exact prescribed set pressures?
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#28
RE: New to the board and using a bipap
I would change your settings to a PS of 4 because a CPAP cannot do that. (As long as you handle that well.) Part of the reason I'm using a PS of 5 on the same machine.

Fred
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#29
RE: New to the board and using a bipap
(09-18-2017, 09:30 PM)bonjour Wrote: I would change your settings to a PS of 4 because a CPAP cannot do that.  (As long as you handle that well.)  Part of the reason I'm using a PS of 5 on the same machine.

Fred

On the other hand, this thread started because of a complaint of discomfort from the PS of 4, and an AHI of 1.95.  By cutting back the PS setting, the AHI was cut in half and as far as I know, Disnynerd is more comfortable.  Hmm.  Tough choice, and the more subtle adjustments might not be all in yet.

This is someone who was prescribed bilevel with a fixed pressure prescription. All we did was modify that to auto bilevel consistent with the machine capability and lower the PS. It worked. Why was bilevel prescribed and the auto CPAP returned? I don't know, but hey, if this works the doctor simply change the prescription to what works.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
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#30
RE: New to the board and using a bipap
(09-18-2017, 09:38 PM)Sleeprider Wrote:
(09-18-2017, 09:30 PM)bonjour Wrote: I would change your settings to a PS of 4 because a CPAP cannot do that.  (As long as you handle that well.)  Part of the reason I'm using a PS of 5 on the same machine.

Fred

On the other hand, this thread started because of a complaint of discomfort from the PS of 4, and an AHI of 1.95.  By cutting back the PS setting, the AHI was cut in half and as far as I know, Disnynerd is more comfortable.  Hmm.  Tough choice.
Good catch, but he went from S mode w PS 4 to auto w PS 3.  I think it is worth a try with VAuto and PS of 4 (GT 3).  The fall back is PS of 3.
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