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after two weeks of lousy sleep.....
#1
Angry 
Two weeks ago, my provider lowered my pressure settings, and wanted me to see how I felt. Tonight, I finally broke down, busted into the clinical settings, set it to auto, with a range of 6-15 (pressures have been adjusted at spots between 7 and 13 at constant pressure.) Let's see what happens, and let's hope BCBS, my DME, and my sleep Doc don't have a conniption fit over it. Also, it's 1:30am mountain time, and I'm still freaking awake. Someone knock me on the head, so I'll zonk out.
"I am not a Doctor, but I DID stay at a Holiday Inn Express last night.Coffee
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#2
Too bad you waited two weeks before taking action. I wouldn't worry about the DME, but your sleep doc may be a little upset. If we could roll the clock back, I'd offer the suggestion that you contact your sleep doc after only 3 or 4 nights of no sleep at the new, lower pressure setting and tell him/her it's not working at the new pressure.
What I've read from others as well as seen from my sleep doc is that pressure changes should be made in small steps (as in one or two points) allowing enough time to see how it goes at the new pressure. My sleep study pressure was 7, but a couple years later, I was snoring in the mask and reported the problem to my sleep doc. He tried raising the pressure (CPAP machine) a couple of points on two or three of my return visits, but it wasn't yet where it needed to be. He then suggested another sleep study, and I made him a counter offer that instead of another sleep study he write me a script for an APAP machine. To my delight, he accepted and wrote the script. Even though the APAP has been great, my doc has told me that to date there is no clinical evidence indicating that APAP offers better therapy than CPAP. My view is that this may be true, but APAP is so much nicer for the pt. Who needs high air pressure blowing in your face or up your nose and making mask seals more difficult when your body doesn't need that much air at that time.
I don't know if any of this is at all helpful, but sharing experiences is what it's about. Hope you are making progress in finding your best pressure(s).

David
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#3
Sometimes it's best to start with a pressure that is somewhat less than the ideal therapy level so that the user can get accustomed to the new device attached to the face while trying to sleep. Perhaps your doctor lowered your pressure for that reason. Just playing doctor's advocate here. Wink

Dude
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#4
(02-22-2016, 07:59 PM)surferdude2 Wrote: Sometimes it's best to start with a pressure that is somewhat less than the ideal therapy level so that the user can get accustomed to the new device attached to the face while trying to sleep. Perhaps your doctor lowered your pressure for that reason. Just playing doctor's advocate here. Wink

Dude

I have been using CPAP since November, and we had a hiccup with the settings that the DME accidentally set me to 10 (the reason I was ripping the mask off in the middle of the night) for a while, and now, we are adjusting back to what works the best. So far, on auto, my 90% pressure is about a half up from the last "set" pressure, so I am going to ride it out again, see where the machine settles as far as the 90% and go from there....
"I am not a Doctor, but I DID stay at a Holiday Inn Express last night.Coffee
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#5
I had the same frustration. I joined the board after three weeks; started looking at my own data, and adjusting my machine. I don't even deal with the respiratory specialist anymore it was a waste of time. I am briefing my doctor on taking control of the settings. ( I took control of my diabetes years ago and have never regretted it.)
My original script was ramp for 40 min from 4 to 7 and APAP 6-15 with EPR off for 5 hours a night 6 days a week. During those 3 weeks my average AHI was 27 and I had difficulty go to sleep. I was awakened multiple times a night by leaks and felt like crap except on the days I did not use the device.
After joining the board getting good advice and adjusting my machine I have adjusted it in small increments every couple of nights.
Now my AHI is .7 (last 7 days). I no longer have leaks that wake me up. And I go to sleep quickly.
My current settings are; ramp off, start on mask fit to adjust for with leaks@ maximum pressure allowing machine to cycle back to 11.6 on it’s own, APAP set at 11.6 to 13.6.
I plan to keep creeping the APAP in small increments (.2 ) as the AHI keeps going down

Hope this helps- I am on day 54-
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