How much do sleep techs care if you change your own settings?

[Colbatros]

I have an appointment in two weeks to try out some full-face masks to help with mouth breathing and being able to comfortably sleep on my side. I have cheek piercings, so I'd like to try out the masks in person to make sure I can find one that doesn't overlap with the piercings, hence why I booked an appointment with my sleep clinic to see if I can find one that fits. I've changed my pressure settings from what my original prescription was and now I'm sort of anxious the sleep tech will get on my case about messing with my machine without going through them first. My original prescription was honestly kind of a joke (min 4cm, max 16cm) and was starting to lead to higher and higher AHI, but with the chances I've made myself, I'm averaging an AHI score of below 2 now. 

Has anyone ever had a bad experience with a tech once they saw your settings differed from your original prescription? What did you tell them? The clinic I go to is a private clinic that recently started offering to look at your data uploaded from an SD card and suggest pressure changes (so literally what I've already been doing with OSCAR), except it costs $300.

[Nightynite]

I only used my nurse practitioner and she thought it was the responsibility of the DME to monitor my settings. It took about 2 weeks before I realized what was going on and just educated myself with the help of this board and that was that. Been over 6 yrs now.

[SarcasticDave94]

Here's how most here handle their own settings, use OSCAR which is free to see sleep therapy data. This gives you the data to know how well therapy is or isn't working. Much like a map, you need to know where you're going and that your chosen path is correct.

From there, you want to get the clinical guide for your specific machine. Know how to get into the clinical menu and what all the settings do. Next, start driving you own settings free.

You combine OSCAR charts with comments and questions on your therapy thread. We come in and comment, guiding therapy a bit. And it's free.

There's your self advocacy in action by following those steps. No appointments, no fees.

PS don't worry much about the sleep specialists, etc. It's your therapy, like your car, you drive it. They don't benefit by it and lots of times get it wrong.

[Colbatros]

That's pretty much how I've been handling on my end, yeah. Read as much as I can, ask as many questions as I have, find as many of the guides for my machine as there exist out there, and monitor how I feel after each change I make. I know there's nothing inherently dangerous about changing my own settings — at worst, I just have shittier sleep, notice pretty quickly, then either go back to the data to see what could've gone wrong, or drop a question in the board – but man are these DMEs and sleep clinics greedy and predatory as hell. 

I'm only booking an appointment for a 'mask fit', essentially being able to try different full face masks to see which one I like since I've been wanting to try one out for various reasons. I just hate dealing with the DMEs and clinics since they never seem to actually listen to me and my experiences, just go back to the data and whatever guidelines tell them is good enough for therapy (i.e. unless your AHI is over 5, then you've got nothing to complain about). Last time I had to deal with them was when I first started my therapy and was struggling finding a mask that worked. No matter how many times I would tell them their recommendations felt uncomfortable and leaked like crazy, they'd just look at the data from my CPAP, saw there were no outrageous leaks, AHI was under 5, and basically told me there was nothing wrong.

[jsmit86]

As others here have noted, OSCAR is a great resourse, as is Sleep HQ.
My original prescription for my Airsense 10 was OK, but I was able to use Oscar to get some tweaks that improved my results.

In 2022, I got a new Airsense 11.
I posted to SleepHQ, and got a few additional tweaks. (SleepHQ is very easy to use, but you only get a trial period befor you have to pay)
I got some great advice there.  My original RX was 8-12 Pressure, no EPR. Typical AHIs were about 2to 4
Now I am using 12-17, with EPR 3. Many nights AHI is 0.0. and almost always less than 0.5.

My doc knows I self adjusted, and he was fine with it.  "As I see your data, it's working great for you"

[Sleepster]

I've changed my pressure settings from what my original prescription was and now I'm sort of anxious the sleep tech will get on my case about messing with my machine without going through them first.

That's not your problem. Only an inflated ego would cause a sleep tech to object to you changing your settings.

Just tell him "It's done." Let him rant to his heart's delight if you want to, but his job on that day will be to fit you with a mask. If he can't do that job because of his inflated ego then ask for a different tech who can.

There are many doctors who allow their patients to adjust their own pressure once they listen to their patient and understand they are doing it in an educated, non-haphazard way.

[car54]

I told my tech about the Apnea Board Forum and what they do. She was highly insulted and said that she is college educated and the forum are nothing more than basement hacks even though she new nothing about the forum. Basically, techs and doctors do not have time or interest in fine tuning a therapy.