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Reading the card in a Cpap

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Reading the card in a Cpap

Postby jim222 » Thu Feb 18, 2010 8:12 am

Hi All,
I have a card reader so I can read the card in my Cpap and print it out for my home care manager.
So what do I have to look out for on the read out so I can adjust the pressure on the Cpap to get the best results?
Cheers
Jim.
:-?
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Postby CrohnieToo » Thu Feb 18, 2010 11:24 am

What makes you think that "you" NEED to adjust the pressure?? Changing your therapy settings when you haven't a clue as to what you are doing is absolutely foolhardy!

Take your data card in to your local DME provider and ask them to do a full download and give you a copy of the printout. That's when you will find out if you have a fully data capable CPAP or one capable of providing only compliance data. Just because a CPAP has a data card does NOT mean it is fully data capable. The local DME provider NEEDS the compliance data to be able to provide proof to your insurance company that you are using your CPAP and not letting it sit in the closet gathering dust IF the insurance company requests it.

IF your CPAP is fully data capable then the download printout will provide not only the compliance data but also the Pressure, Leak rate, AI and AHI averages for the length of time you have used it at your current therapy settings.

The very fact that you had to ask what to look for proves that you still need to do a LOT of learning about OSA and CPAP therapy. CPAPs are NOT toys. CPAP therapy is NOT a game. CPAP therapy is not a do-it-yourself project for the neophyte.
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Postby base2balls » Thu Feb 18, 2010 12:04 pm

:-D :-D :-D I thnink you 'll have to tell your Dr that you think the pressure should be changed and then he or she will call the tech person to have that done. In some cases they might do another sleep study to determin if it needs to be changed. You can't change it your self. There is a reason for that too. If the pressure is on too high, you could injur yorself. This is the reason the sleep studies are done to be able to get a diagnosis and the titration is done so they know what the setting should be. Good luck, Huggies, Fay
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Postby crispian » Thu Feb 18, 2010 12:40 pm

You might want to head into the CPAP forum area for this kind of information, as well as take a look at both the posting guidelines and the thread in Late Night with Sleep Apnea about changing settings. It's a well debated area.

http://www.apneasupport.org/viewtopic.php?t=22699
New recruit to the institute of Hoseheads!

AHI: 43.2
APAP Pressure ~15

APAP - M-Series Auto
Mask: ResMed Mirage Liberty
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Postby jim222 » Fri Feb 19, 2010 9:10 am

Hi All,
My health care manager told me to adjust my pressure for 2 weeks to find a pressure I am comfortable with and to print out my card and come back to see him.
And I think this is the way it should be don instead of going for sleep studies all the time.
A patient should under stand their treatment and if there is a chance of death or serious injury should we be using these Cpaps, we are not little kids
I lost 20 years of my live to apnea because doctors did not diagnose me I was told it was in my head.
So why should I turn over the rest of my live to then?
I have now set my Cpap to a pressure that I am comfortable with I sleep from 4 to 7 hours a night so my sleep manager said that is good and if I have any trouble with it to come back to see him.
People should be aloud to be self-serveishant it is bad enough being tied to the Cpaps.
I bought and paid for this machine I should be aloud to know how to use it I was just asking for levels I know how to set the pressure.

Cheers
Jim.
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Postby CrohnieToo » Fri Feb 19, 2010 11:12 am

Well good on you, Jim222! We're delighted that you are now at a comfortable setting and sleep from 4 to 7 hours a night. Hopefully that will soon be 7 hours every night!!! Congratulations.
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Postby jim222 » Sat Feb 20, 2010 8:29 am

Hi All,
Thanks for that CrohnieToo.
But what I am looking for is like I said the levels.
I could not attach a print out of my card so do these numbers look ok and is there anything I can do to get it better.
And now that you have brought it up what are the dangers of setting the Cpap pressure your self?
Cheers
Jim.
I use a Respironics REMstar Auto with C-Flex (not the "M" series)

Cpap Pressure
11.0

Average Hypopnea
Index
2.5

Average AHI
5.4

Average Vibratory
Index
1.5

Average Max Leak
97.2
Average 90% Leak
44.3
Average Leak
37.2
Average Large Leak
0 secs.
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Postby CrohnieToo » Sat Feb 20, 2010 12:18 pm

Ahhhh, am I to assume then that you have the REMstar Auto previous to the M Series? Or the new PR System One Auto?

The "ideal" AHI is considered to be less than 4.0 and the "ideal" AI is considered to be less that 1.0. Leak I can not comment on as that varies w/the mask used. You would need to read the literature that came w/your mask to see what the allowed vent rate for your mask is at your set pressure. Or your 90th percentile pressure if you are using it in Auto mode.

The most obvious undesirable side effect of too high a pressure is disturbed sleep, another is the risk of too high a pressure inducing central apneas, yet another much more RARE would be too high a pressure blowing a bleb on your lung (if you had a bleb) and lung collapse.

The obvious result of too low a pressure is reduced therapy and increased sleep disturbance. Just the opposite of what you are trying to achieve.
ResScan 3.10 - Resmed S8 ResLink & oximeter
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Postby jim222 » Sun Feb 21, 2010 7:33 am

Yep, I have the REMstar Auto previous to the M Series and a ResMed Mirage Activa Nasal CPAP mask
Cheers
Jim
:oops:
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Postby CrohnieToo » Sun Feb 21, 2010 11:42 am

Arrrggghh! I made a typo!!! The "ideal" AHI is less that 5.0 NOT the 4.0 I mistakenly typed above!!!!

Ha! You have the better device. I wasn't at all impressed w/the M Series. In fact, when I wanted a backup for my Resmed VPAP Auto and it was so new the prices weren't about to come down any time soon I searched high and low for a lightly used Respironics pre-M Series REMStar Bi-PAP Auto w/Bi-Flex despite there were a lot of new and lightly used M Series available.

The thing is, if your health care manager told you to adjust your pressure for two weeks then your health care manager should have told you HOW to adjust your pressure. We have no way of knowing how well you've educated yourself and how knowledgeable you are w/xPAP therapy - and even if we did forum rules would not allow us to tell you how to change your pressure.

All that being said, I agree w/you COMPLETELY that it is a crock of horsepuckies that we are considered less intelligent than diabetics and asthmatics and incapable of learning how to adjust and manage our CPAP therapy w/the supervison and oversight of our sleep professionals as the diabetics and asthmatics receive. Certainly those two conditions can be much more life threatening than OSA and CPAP therapy in the short term.

My opinion is that the manufacturers keep developing better and better devices w/more and better data, they provide a way for us to access our data - but have to leave it up to the sleep doctors to allow access to that data. But sleep medicine is such a good "cash cow" sub-specialty requiring little time w/patients or patient consultations, if any, and the RPSGTs (sleep techs) doing the real work of collecting and scoring the PSG data and the doctor only having to initial the scoring (altho they are SUPPOSED to also score it themselves) and then dictate an interpretation of the results and many even take advantage of not consulting w/the patient at all but just send their recommendation to the referring doctor. Whereas, in my not at all humble opinion, they should be consulting w/their patients, actually looking at and understanding the data AND either personally or providing an experienced, knowledgeable RN, RRT, nurse to go over our results in detail w/us, provides answers to our questions, education about our condition, be available to answer our questios and assist in finding answers to any problems we encounter. Instead these sheisters pawn that responsibility off on the local DME providers.

The heroes of sleep medicine in my, again not so humble opinion, are the manufacturers and the RPSGTs. The sleep doctors and the RRTs at the DME providers and the DME providers are at the bottom of the barrel. There are exceptions, of course, but not enough of them.
ResScan 3.10 - Resmed S8 ResLink & oximeter
ConTec CMS-50D+ oximeter - Philips EverFlo 5L Oxygen Concentrator
PR SystemOne BPAP Auto w/Bi-Flex & Humidifier - EncorePro 2.2.14.0
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Year Diagnosed: 2006

Postby jim222 » Mon Feb 22, 2010 8:47 am

Hi All,
CrohnieToo
I bought it with a new mask still in its sealed packet for $500 and when I read the card I could see that it had been used for 2 mouths.
But my health care manager said it was !@#! and was angry with me for buying it.
As for him telling me how to set the pressure he had no idea.
Lucky for me, I got the clinician’s manual with it.
He at first told me to get the manufacture to read the card and to print it out for him.
The manufacture lived in anther state that is why I had to buy a card reader.
It takes me 10 sec’s to change the pressure and an hour to go and see him + $20.
I am just wondering if their as been any scientific research don on the Cpap.
Because I am thinking if the air is being blown in to keep the airway open how much oxygen is getting in to the lugs because I am still waking up with ringing in my head.
But when I wear the special mouth guard I have made that dose not happen.


Cheers
Jim
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Postby CrohnieToo » Mon Feb 22, 2010 9:52 am

Whew. How do I explain this? The device is providing air pressure. It is the same level of 02 in the air pressure as room air. It is not supplying additional 02.

Hey, I bought a lightly used xPAP as a backup to my S8 Elite - and when I was switched to my S8 VPAP Auto I bought a lightly used bi-level auto as a backup. Nothing wrong w/that as long as you do your homework first so you don't get taken by an unscruplous seller.

Well, then, since you can check your data, what is your Leak rate? And just exactly what mask are you using? It could well be that you're losing a lot of your therapy thru leaks. There is a "built-in" allowed vent rate w/each mask and it differs w/each mask so you need to know your allowed vent rate at your set pressure or 90th percentile pressure to know if you have too high a mask or mouth leak rate and are thus losing therapy thru the leak.

It could also be that you are tightening your headgear straps too tight. OR, it could also be that you should be examined by an ENT doctor to be sure there isn't an anatomical reason the air pressure causes the ringing.

For some weird reason, I have absolutely no problems w/my CPAP and pressure - as long as I am NOT sitting upright. If I sit upright w/my CPAP and mask on my ears fill up like I'm in an airplane or at the top of a very high mountain. And yawning does NOT stop it - I should say TRYING to yawn, who can yawn w/air pressure being blown in your mouth and/or nose? But immediately I lay down the ear pressure is gone.
ResScan 3.10 - Resmed S8 ResLink & oximeter
ConTec CMS-50D+ oximeter - Philips EverFlo 5L Oxygen Concentrator
PR SystemOne BPAP Auto w/Bi-Flex & Humidifier - EncorePro 2.2.14.0
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Humidifier: Resmed H3i
Year Diagnosed: 2006

Postby jim222 » Tue Feb 23, 2010 9:24 am

Hi All,
I get the ringing in my head even when I sleep with no aids, :idea: but when I use the mouth guard I have invented I don’t get it.
I know a little about generated air and there is very little oxygen in it.
Just like air conditioning did ever notice in confined places like trains busies and planes people are always sleeping that’s because there is very little oxygen in the air that is why they say when driving long distances to roll down your window, but this subject is not widely discuss.
All I can tell you about my mask is it look like a ResMed Mirage Activa Nasal

Cheers
Jim
Average Max Leak
97.2
Average 90% Leak
44.3
Average Leak
37.2
Average Large Leak
0 secs.
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Postby Mrs Rip Van Winkle » Tue Feb 23, 2010 9:55 am

Jim..is your health care manager a Sleep Specialist?

We are not medical professionals and we are not aware of your medical background. The ASAA nor any posters using this forum, are not in the position to help you determine what your proper 'dosage' of therapy should be. Crohnie said the key words in an above post...
w/the supervision and oversight of our sleep professionals
and
The thing is, if your health care manager told you to adjust your pressure for two weeks then your health care manager should have told you HOW to adjust your pressure. We have no way of knowing how well you've educated yourself and how knowledgeable you are w/xPAP therapy - and even if we did forum rules would not allow us to tell you how to change your pressure.


Your health care manager sends a script to the DME to have them adjust the pressure..the same as he/she would send a script to your pharmacist to increase/decrease your dosage of a med. Two of the main things that can happen with a pressure that is too high for you..as Crohnie stated..are 1) pressure induced central apneas..this is when your brain forgets to tell your body to breathe and 2) pulmonary problems that could potentially cause your lungs to collapse, cause a clot ..or blow them out. Granted, we have the right to know our equipment...but on the other hand..we did not attend medical school. Back yard mechanics do not work in this case. By your posts it sounds as if you are going into this blindly..without any guidance from a medical professional. Turning to the internet for something that could potentially cause you to lose your life is not a good idea. Setting your own pressure is not as intrinsic as it seems.

As for the ringing in your ears...you need to address that with your Dr...there are a few things that could be happening....and any increase/decrease in pressure may cause adversity.

Please refer to the ASAA posting guidelines....

http://www.apneasupport.org/viewtopic.php?t=600

This section in particular:

Posts about CPAP adjustments and self-treatment:
Although the ASAA advocates being proactive in ones treatment, we can not advocate or encourage making pressure adjustments or other CPAP clinical adjustments without consulting with your physician. Please do not post instructions or how to guides for making adjustments or entering clinician menus to make adjustments. We thank you for your understanding. Do not post links to clinician menus or similar menus not authorized for access by manufacturers; these sorts of posts will be moderated.

The ASAA advocates being proactive in ones treatment by coordinating patient medical treatment with qualified and knowlegable healthcare professionals. Being proactive in ones treatment is not the same thing as self-treating or self-medicating ones medical condition. Self-treatment/medication is defined as treatment without medical care. People owe it to their health and well-being to coordinate their medical care with healthcare professionals familiar with their medical history. We do not want readers of this forum to be convinced, from comments advocating self-treatment, to ignore or forego medical consultation and treatment. Self-treatment/medication is a private, individual choice. Forum discussion promoting self-treatment and self-medication may be moderated. Your cooperation with this is greatly appreciated.


Hope you can get this all squared away and on the road to good, SAFE, therapy!

Tami
I'm only a sufferer, not a medical pro. What I post are my thoughts as a sufferer, not that of the ASAA. As a moderator on these forums I oversee the posting rules. This is the internet, always discuss what you read with your medical team.
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Postby jim222 » Wed Feb 24, 2010 8:15 am

Mrs Rip Van Winkle wrote:
Jim..is your health care manager a Sleep Specialist? Yes


Hi All,
I am from Australia the experience I have had over here is all threats and no advise.
It all seems to be about control
Mrs Rip Van Winkle you don’t need to post me the rules like I keep saying I am not asking how to change the pressure.
I am trying to understand the card read out so I have an under standing of what mite be going wrong if anything.
I lost 20 years of my live to apnea because doctors did not diagnose me I was told it was in my head.
So why should I turn over the rest of my live to then?
I tried asking for advice but just got silence so I tuck matters into my won Hand.
We are taught at an early age to drive cars, all I am saying is we are not incapable of learning how to use the Cpap and that we should be taught
But I did not start this post to harp on about this, I just wonted to get an under standing of the card readout.
Cheers
Jim.
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