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do I have the right machine (and settings)
#1

I'm new to this forum, and I am new to CPAP use. I really could use your advice:
I am in the process of being "fitted" for the proper mask... I have been using the DV54 for about 2 months now, and have not adjusted to the high pressure, which wakes me up 1 or 2 hours after I go to sleep. The maximum pressure is set to 20 cmH20 and I that's the pressure that wakes me up each night. I usually leave the mask off for the rest of the night, or I have to reset (on/off) so that I can get back to sleep with a lower pressure but then I just wake up in a few hours again from the high pressure.

I've done a little reading and have noticed that there are CPAPs that automatically adjust to the needed pressure (APAP) -- my DV54 is suppose to be "autoadjusting", but maybe that just means that the pressure is "ramped" (I don't know). Anyway... I would have thought that if I wake up and the pressure is at it's maximum, that I should be able to lower the pressure by breathing "normally" -- but this does not happen.

Before I purchase this machine I would like to know if it really is the appropriate one for me.
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#2
(10-30-2016, 11:48 PM)JaminV Wrote: I've done a little reading and have noticed that there are CPAPs that automatically adjust to the needed pressure (APAP) -- my DV54 is suppose to be "autoadjusting", but maybe that just means that the pressure is "ramped" (I don't know).
...
Before I purchase this machine I would like to know if it really is the appropriate one for me.
The DV54 is the IntelliPAP AutoAdjust, which is an APAP that records some efficacy data.

Your machine can be set up to run in either CPAP mode or APAP mode. You need to figure out which mode yours is running in. Your machine also has a "ramp" feature that allows the machine to increase gradually as you fall asleep.


Quote:I've done a little reading and have noticed that there are CPAPs that automatically adjust to the needed pressure (APAP) -- my DV54 is suppose to be "autoadjusting", but maybe that just means that the pressure is "ramped" (I don't know). Anyway... I would have thought that if I wake up and the pressure is at it's maximum, that I should be able to lower the pressure by breathing "normally" -- but this does not happen.
If your APAP is set to run in AutoAdjust mode, then it should be adjusting the pressures during the night in response to the specific events the machine detects.

But your APAP machine cannot tell when you are awake and when you are asleep. Once it raises the pressure up to 20cm, it's going to leave it there until the machine is happy that your breathing looks good. I don't know enough about the IntelliPAP's auto algorithm to know how aggressively it increases the pressure or how stubborn it is about decreasing the pressure once it has increased it. But in general, APAPs are not going to reduce the pressure just because you wake up. And since wake breathing is naturally more ragged than sleep breathing, your normal wake breathing is probably not going to be "clean" enough for the machine to decide that it is safe to reduce the pressure if you do not restart the machine.

If you want to lower the pressure, the easiest way to do that is to just turn the machine OFF and back ON. That will lower the pressure back down to the min pressure setting if you have an APAP and the beginning ramp pressure if you use a ramp to start the pressure at a level that is below your prescription setting. There is nothing wrong with doing this, by the way.


Quote:I have been using the DV54 for about 2 months now, and have not adjusted to the high pressure, which wakes me up 1 or 2 hours after I go to sleep. The maximum pressure is set to 20 cmH20 and I that's the pressure that wakes me up each night. I usually leave the mask off for the rest of the night, or I have to reset (on/off) so that I can get back to sleep with a lower pressure but then I just wake up in a few hours again from the high pressure.
You are better off turning the machine OFF and back ON and keeping the mask on when you wake up and the pressure is too high to get back to sleep. Taking the mask off for the rest of the night is just going to make it take longer for you to learn how to sleep well with the machine.



Questions about SleepyHead?
See my Guide to SleepyHead
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#3
If you have a choice on machines to purchase, you may want to consider the list of machines compatible with SleepyHead software. Your machine can provide efficacy data, but does not provide detailed waveform data. This may not be a problem. I would encourage you to download the software and look at the data from your machine and see if you can determine why your pressure is going so high. You can obtain a copy of the supplier manual so you can limit the maximum pressure to something you tolerate. If you need the higher pressure to suppress obstructive apnea, then I would recommend that you get the Resmed Airsense 10 Autoset which provides up to 3 cm of exhale pressure relief, or even consider using a bilevel machine. Links for CPAP setup manuals and Sleepyhead are at the top of the page.

Philips Respironics
450P models and above, lesser model numbers are not data capable!
50 and 60 series BiPAP models
950/960 BiPAP AutoSV
1060 BiPAP S/T
DreamStation, CPAP/BiPAP "family0" models (Not ASV yet)
ResMed
S9 families
(Not the Escape models, as they are not data capable)
Elite, AutoSet, VPAP, VPAP auto, VPAP adapt
AirSense 10 support as of 0.9.8
including "For Her" models
AirCurve 10 support as of 1.0.0-beta-1
Fisher & Paykel
Icon (It's still a work in progress)
DeVilbiss
Intellipap CPAP/Auto DV53/DV54 (These machines don't store flow waveforms)
Weinmann
SOMNOsoft2 / Balance machines support is currently on hold until I get some spare time
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#4
It is also possible that your machine is defective. It is worth mentioning what is happening to your supplier and trying different machine or a different brand. Personally, I would be pushing for a Resmed or a Phillips, if for no other reason than more people use them so they are better supported by SleepyHead and by the people here.
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#5
Hi JaminV,
WELCOME! to the forum.!
I wish you good luck with your CPAP therapy and getting it adjusted to better meet your needs.
trish6hundred
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