I'm sorry that things are going so rough for you. It took me a very, very long time to start feeling better with PAP than without it----as in months and months. But perseverance does pay off and now PAP therapy is finally a net positive in my life rather than a negative.
mothersongbird wrote:I'm trying to figure out if I have APAP, BPAP, or CPAP. Lots of letters, sheesh... My doctor told me that the machine senses when I'm breathing out and lessens pressure. Is that BPAP?
Chances are the doc means that your machine has something called EPR (Exhale Pressure Relief) on it. Chances are he assumes the tech turned it on OR set the machine up so that you can turn it on.
Because I don't notice a change in pressure. Nor do I see a change in pressure on the machine. I sat and watched it for a few minutes.
Even when EPR is turned on, the machine is only going to tell you what the current pressure setting is when you are breathing through the mask. As for noticing a change in pressure: Some people notice it right away and others don't. Some only notice the EPR-drop in pressure after they've compared how it feels to breath against the machine when EPR is turned completely OFF. The whole idea behind EPR is to make it easier to exhale, not to make the drop in pressure so noticeable that it calls attention to itself. More on this later.
He also said that the machine would sense when I needed more pressure and give it to me. Is that APAP? Not terribly sure it matters- I'm just curious.
Since the machine is supposed to figure out when you need more pressure, my guess is that you've been set up with an APAP machine. (But is it the Escape Auto
or the AutoSet
? Makes a big difference in the data that's recorded.)
I read the manual cover to cover, but I can't seem to find an option on ramping. Is this something I have to have turned on or does it just not come on all models? With all the stuff this machine is supposed to do, I want to see if it will make me breakfast or send my faxes.
You need to get to the point where you feel as though CPAP is something that you choose
to do for your health rather than feeling like CPAP is something being done to you
. One stop in that process is learning about your equipment and your prescription.
So: Call the sleep doc's office on Monday and ask exactly how your prescription worded. In particular, you want to know what your prescribed pressure is and whether it is a fixed number (7cm) or a pressure range (4-10cm) Ask for a copy of your prescription by the way. You might need it at some point in the future.
Now to get much more comfortable with and more knowledgeable about your machine, do the following far away from bedtime:
1) Unplug the machine and take the humidifier tank out. (Dump the water while you're at it and maybe even wash the humidifier tank.) With the humidifier tank out of the machine, you can turn it every which way.
2) Turn the machine over and examine all four sides. Write down all the information you find listed on the machine's various tags even if you don't fully understand what they mean at this point. Locate the slot for the SD card. Pop the SD card out and put it back in. Practice taking the humidifier and the blower apart and putting them back together. Find out where the air filter is. Take it out and put it back in.
3) Turn the machine back upright and look carefully at the top of the blower unit. Somewhere near the On/Off button the machine should say one of the following: Escape
, Escape Auto
, or AutoSet
. There's also a small chance that it says VPAP S
or VPAP Auto
. This is the name of the model of the S9 series that you are using. Write this down. The capabilities of the machine depend on the model name. Once you know what the model is, post here and we'll tell you what kinds of information you can get off the machine's LCD.
4) Now put the machine back together. Put water into the humidifier tank. Now plug the machine back in and let it boot up. And attach you hose and mask as usual. You should see the Home screen
on the LCD. On the LEFT side of the LCD you should see a House icon, a Tear Drop/Tear Drop with Thermometer (Humidifier/Climate control) icon, and a Triangle (Ramp) icon. On the RIGHT side of the LCD there is the Info
button and Set up
button that has two check marks on it, along with the so-called Push Dial
---the large button that twists and can be pushed into to select a menu item. On the home screen, these buttons are labeled.
5) Turn the Push Dial
. Watch how the House icon is unselected and the Ramp icon is selected. Click when the Ramp icon is selected. And the LCD display should change to the Ramp set-up menu.
IMPORTANT NOTE ABOUT RAMPING: If your pressure is set to 4cm OR if you are using an Auto range where the minimum pressure setting is 4cm, then the ramp will be disabled. The reason why is simple: The minimum, initial ramp pressure is 4cm. So if you are starting out at 4cm, there's no where to ramp up to.
You will see the Ramp icon with a Ramp time listed. By turning the Push Dial you can increase or decrease the Ramp time. (You are not allowed to change the initial Ramp pressure; that can only be changed from the clinical menu.) Once you have the desired ramp time showing in the window, click the Push Dial to select the Ramp time. The Ramp will come on anytime you turn the machine on. If you wake up in the middle of the night and want to turn the ramp on, just hit the power button twice---once to turn the machine off and then to turn it back on. If there is no Ramp icon on the Home menu, that means the tech who set up the machine locked you out of controlling the ramp. You need to take the machine back to the DME and have the tech unlock the ramp setting.
6) Once you are back to the Home menu, use the Push Dial
to select the Humidifer/ClimateControl icon. What you see here will depend on whether you are using the ClimateLine heated hose or just the default SlimLine hose. Play around with the settings for a few minutes and go back to the original setting. If you decide you need more/less humidity or a warmer/cooler air temp, this is where you set them. Notice that to pre-warm the humidifier, you can press the On/Off button and hold it down for 3 seconds.
7) Now push the Info button
by itself. The icons on the left side of the screen should change. Step through each of these icons using the Push Dial to select them. You'll be able to get at the Short version of the Sleep Quality report from this menu, among other things. If the Sleep Quality menu does NOT show an AHI value, then the tech has locked you out of your own data OR you have an S9 Escape. If you see an AHI value, the tech has given you access to the therapy data recorded by the device. If you want more data than is shown on the short Sleep Quality report and your owner's manual is confusing, post here and we'll let you know how to get to it.
8) Now push the Set-up button
by itself. The icons on the left side of the screen should change. As you step through the icons on this screen you will have the option to change the patient comfort settings the tech has allowed you to change. Since you are switching back and forth between two mask types, the mask type setting
is important to know about. Other options the tech may have allowed you to change include: Ramp time (if you're not starting at 4cm), hose type, the EPR level, the ClimateLine settings, the Mask Fit, and SmartStart settings. Before changing any of these settings, write them down. That way if the change makes you less comfortable, you can always change it back.
NOTE ABOUT EPR: You've asked specifically about EPR---the setting that allows the machine to drop the pressure when you start to inhale. If your initial starting pressure is 4cm, then EPR will not kick in until the machine raises the pressure: The minimum pressure at all times will be at least at great as 4. And that may explain why you are not noticing any pressure drop. Once your pressure has been adjusted up to 5, the EPR will provide a 1cm drop (back down to 4cm) on exhale. If we assume that EPR = 3, then once your pressure is increased to 6, the EPR will provide a 2cm drop on exhale. And once your pressure is increased to 7 (or more), the EPR will provide a 3cm drop on exhale.
If the tech has allowed you to control the EPR, you will see a menu item for EPR under the Patient Set up Menu
that is one of the items you should see when you press the Set up
button. If EPR is not set to 3, then increase it to 3 and see if you can then feel the drop in pressure when you are exhaling. If EPR is already set to 3, turn it off (i.e. set it to 0), and see if you notice a difference when you are exhaling again. But keep in mind, that if your pressure is currently at a level less than 7, the pressure will NOT drop below 4cm on exhale.
Best of luck