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Thoughts on adjusting own pressure?
#1
Hello, I was diagnosed with mild sleep apnea after an overnight sleep study. AHI of 25. At my follow-up titration--another overnight, sleep doc determined a setting of 10 was ideal. My AHI was below 5. After that one night with CPAP, I literally felt 20 years younger the next day. I went for a 20 mile bike ride, cut the grass for over an hour, and didn't need my ritual weekend nap. I was psyched!

I then got a Resmed Escape set to 10. After a few days of no major improvement in sleepiness and some googling, I discovered I could monitor own AHI using Sleepyhead, but not with the Escape. I also had to show compliance for at least a month for the unit to become "mine" and not a rental. So after a week on CPAP and without any arm twisting, my DME switched me to the Elite.

Now I can use Sleepyhead but find it just as convenient to have the Elite report my AHI on the screen. I had my 6 week follow-up today and my average AHI with CPAP is 6.7 which isn't news to me. I have better than 93% compliance. I reported to the DME that I hoped to be feeling better and so he prescribed another overnight titration and that they'd probably have to increase the pressure.

My insurance covers 85% of the studies and machine. 15% is still a lot. I told him that even at 15% for another study, it was adding up. He immediately reduced my burden to 7.5% and I scheduled the appt.

So I realize this number of 10 is a prescription and even with traditional medications, doctors may have to adjust the dosage. But considering that I am capable of adjusting my own pressure and that these fine tunings aren't cheap, would it be OK to just try it and monitor my AHI for a few days after each adjustment to see if there is an improvement? I haven't read up if the pressure can be adjusted in decimal or whole number increments but does going to 11 (insert Spinal Tap joke here) sound reasonable? If I can get below 5 consistently, I'll cancel the appt.

Thanks,
Paul
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#2
Pressure adjustment explained here .. http://www.apneaboard.com/adjust-cpap-pr...re-on-cpap

Ask the doctor to write you a script for "S9 AutoSet" and include "dispense as written"

The AutoSet take all the guess work out of the equation and make life that much easier

Welcome and best of luck
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#3
better to spend your money on an APAP. It can bring your AHI down with the minimum pressure necessary, and adjust up as needed.
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#4
Small increments. That machine can be adjusted in 0.2 cm-H2O increments.
http://www.apneaboard.com/adjust-cpap-pr...re-on-cpap
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#5
Welcome to the Board!

Please take this with a grain of salt. It is just my opinion. At this point in time, I'd follow your doctor's advice. Put yourself in your doctor's place. How would you feel if you were trying to help somebody and they ignored you and went off and did something else? Give him/her a chance, hopefully they've had more experience than you do at this point. After you have some mileage on the CPAP and have a track record of sleep data, you might use it to suggest modifications.
______________________
Useful Links -or- When All Else Fails:
Posting SleepyHead Charts in 5 Easy Steps
Robysue's Beginner's Guide to Sleepyhead
Apnea Helpful Tips
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#6
Hi sleepypaul,
WELCOME! to the forum.!
Much success to you with your CPAP therapy, hang in there for more responses to your post.
trish6hundred
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#7
It is illegal as heck and the CPAP police will come after you!

Okay, they don't exist but some suppliers and doctors like to make us think that we do.

I'd hesitate to pay yet more for another sleep test. The supplier is also the sleep center? That's not often a good thing. That's like a state auto emissions inspection place also just happening to sell mufflers and catalytic converters and various vacuum sensors.

Take that 7.5% and see if you can get an Autoset from Supplier #2 on our Supplier's List (link at top of every page). You don't need one with a humidifier since you have one with the Elite. Or, better yet, tell the supplier/clinic that you would rather do the titration at home. Get them to give you or loan you an Autoset.

Yes, you can adjust the pressure on your own, titrate yourself. It takes time but it's cheap.
PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

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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#8
If you want your AHI down and pressures correct in a short time youll do it yourself.

If you want it take a long time to never you will have a doc prescribe a new pressure each time. Each change will usually take a week to actually get done. And it will probably be wrong as they seldom do what you ask without adding something of their own to it.

Get an auto pap watch your software. No need for 2nd or 3rd titrations or really even the first except to rule out complex or central apena. Pressure wise they are basically useless as they are normally wrong. And auto machine treating OA will do as good or better job helping you get the right pressures as one night in a sleep lab. JMO
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#9
The Auto PAP is nice, but in terms of finding "THE" right pressure, you can probably do that fine by just adjusting your pressure on your Elite and seeing what makes it better or worse.

Don't make really big pressure adjustments in a short period of time.

Also, don't get overly concerned about having a really low AHI number.
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.
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#10
There were these two buzzards sitting on a power line over a desolate road in west Texas; lot's of those. They stayed, no cars for a long, long time. One buzzard looked over at the other buzzard, and said, "Patience, HELL! Let's kill something! I have learned recently that you need to be proactive in your treatment. In 3 months, I have seen my doctor three times. That was not often enough to find a sweet spot; to make me feel that the "stupid mask thing" was working. With the help on this forum, I can at least see the numbers down lower than they ever have been. The rest, I am confident, will come.
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