Can I change the pressure on my Resmed S8?

[kurtchan]

Thank you all for your great suggestions regarding my recent bout of difficulties with using the CPAP for more than a few hours each night. The concensus seems to be that I try to reduce the pressure and see if that helps. However, I'm not entirely sure that's possible with the CPAP I have.

If anyone can give me the step-by-step instructions, I'd love to give it a try!

Thanks,

Kurtchan

PS - As a last resort, I pulled out my old ComfortCurve mask and used it last night with limited, but better success. I've always felt that the CC provided the least "invasive" flow of air which definitely seems to help.

[GoofyUT]

You should ABSOLUTELY NEVER hold down the down and right keys for three seconds until you gain access to the "clinical" menu, and then use the down key to scroll through options in the clinical menu including "settings". Then the left key would allow adjustments, and the right key applies those adjustments, as they are labelled.

BUT DON'T DO IT!!! Only our DOCTORS should be messing with our health!!


Cheers!!

Chuck

[Snoredog]

this is one of the rare times I agree with chuck, you shouldn't be doing that.

[kurtchan]

Thanks for the highly specific warnings! I'll bear them in mind when I get home tonight and confront the machine!

[Wulfman]

Recent posts by GoofyUT:

DON'T MESS WITH YOUR LIFE. Period.

Its HIS life and I AIN'T GONNA DO ANYTHING TO HELP HIM POTENTIALLY COMPROMISE OR END IT!!!

And then you give him the instructions to change his pressure.....

Hmmmmm......Does anybody see an hyprocrisy here?

Den

[TXKajun]

Gosh, I LOVE this forum!

Not only do we help folks with what TO do, but we are just as helpful on what NOT to do! Only on cpaptalk.com!

Kajun

[Snoredog]

Recent posts by GoofyUT:

DON'T MESS WITH YOUR LIFE. Period.

Its HIS life and I AIN'T GONNA DO ANYTHING TO HELP HIM POTENTIALLY COMPROMISE OR END IT!!!

And then you give him the instructions to change his pressure.....

Hmmmmm......Does anybody see an hyprocrisy here?

Den

I think there is a distinct difference between using an autopap for obtaining a diagnosis and doing a self-titration.

Kurtchan has been a member here reading and responding to posts for some time and I have no doubt is familar with OSA, self-titration and warnings posted.

It is that non-PSG "autopap diagnosis" that I don't totally agree with because you simply cannot see if you have other sleep disorders besides OSA such as central apnea, RLS or PLMD. Then my experience is nearly ALL autopaps on the market today screw up every now and then and incorrectly score central events as obstructive, snoring and snore detection with pressure response only increases that risk failure, so for that reason I believe every patient should at least have one PSG so they know where they stand disorder-wise. Once you know where you are at, I have no problems with self-titration, hopefully one is knowledgeable enough to spot when the machine screws up. I don't think anyone wants to use more pressure than they need.

[neversleeps]

I agree with you, Snoredog. If one has insurance to cover the cost of a PSG, or if one doesn't have insurance but can afford to pay for a PSG out of pocket, and if one is actually able to sleep during the test, and if it is set up and scored accurately, it is the gold standard for diagnosing sleep apnea.

However, if one does not have a PSG (whatever the reason) the use of an auto-titrating machine is the next best method to obtain an accurate diagnosis. I think discouraging its use for this purpose might lead people to believe it can't do the job. We can reference medical studies showing auto-titrating machines have been proven to be as accurate as PSGs in diagnosing OSA. I understand your point about centrals, PLM and RLS. My point is, in the absence of having a PSG, an auto-titrating machine is the best alternate we've got.

Not being diagnosed at all (either by a PSG or an auto-titrating machine) has grave and potentially deadly consequences. We can reference medical studies proving untreated sleep apnea kills.

As to whether or not someone is familiar enough with OSA, self-titration and analyzing the data to be entitled to know how to go about changing their pressure.... that's not my call to make. I wouldn't withhold information from someone because they never had a PSG, or because they were borrowing their brother's machine for a couple months, or because they bought their machine on Yahoo, or because they never made a post before on cpaptalk. People here share their experience and this exchange of information is done with the caveat, on each and every page, "The information provided on this site is not intended nor recommended as a substitute for professional medical advice."

I agree with you, Snoredog. It would be optimum for everyone to have a PSG. It would also be wise if everyone had a complete physical and a battery of tests to rule out all other possible ailments, disorders or diseases. I understand making that suggestion and it is a wise one. But for those who can't or don't do that (whatever their reasons might be) I think it is extremely important to point out CPAP therapy has been proven to be safe and effective. My fear is people might believe the statements someone else made about how CPAP therapy is unsafe and that it could kill you. For those who are about to begin CPAP therapy (self-directed or not) and for those who are already struggling to adapt to this treatment (self-directed or not) that kind of irresponsible misinformation is the only push they need to stop altogether or never start-- and that's what is unsafe and could kill you.

[billbolton]

However, if one does not have a PSG (whatever the reason) the use of an auto-titrating machine is the next best method to obtain an accurate diagnosis.

Given that the Mayo Clinic research (recently referenced here again) showed that ~15% of apnea sufferers have complex sleep apnea syndrome, then my understanding is that use of an auto-tritating machine will probably not give an accurate diagnosis. 15% is a non trival precentage!

Cheers,

Bill

[neversleeps]

Given that the Mayo Clinic research (recently referenced here again) showed that ~15% of apnea sufferers have complex sleep apnea syndrome, then my understanding is that use of an auto-tritating machine will probably not give an accurate diagnosis. 15% is a non trival precentage!

Agreed! 15% is not trivial. But in the absence of a PSG, an auto-titrating machine is the next best thing we've got!

[DreamStalker]

It is not trivial that 100% of apnea sufferers will die of apnea or its complications (regardless of whether it is obstructive, central or mixed) if left undiagnosed or untreated. I too agree that a PSG is better than using an auto machine (plus software) … but I also agree with neversleeps that using an auto machine (plus software) is better than 100% chance of death.

[Wulfman]

However, if one does not have a PSG (whatever the reason) the use of an auto-titrating machine is the next best method to obtain an accurate diagnosis.

Given that the Mayo Clinic research (recently referenced here again) showed that ~15% of apnea sufferers have complex sleep apnea syndrome, then my understanding is that use of an auto-tritating machine will probably not give an accurate diagnosis. 15% is a non trival precentage!

Cheers,

Bill

Assuming that a person was using an APAP and software (Like the REMstar Auto and Encore Pro), Central apneas SHOULD show up on the software as a "Non-Responsive" (NR) event or a longer apnea event.

One of my points has been that Kaiser (healthcare) is doing precisely this very thing with issuing APAPs as a diagnostic tool and nobody's calling what they're doing a "bad thing".

Even on APAP/CPAP/Bi-PAP therapy, we ALL still experience a "certain number" of apneas and hypopneas. The goal is to keep the AHI under 5.0. That can STILL be a lot of apneas and hypopneas (IMO).

15%?......I'd be willing to bet that at least that many of the titrations done by sleep doctors are WRONG.
I'd even be willing to bet that they're either prescribing or supplying simple CPAPs to people who SHOULD have Bi-PAPs.
I also know they're handing out CPAPs that don't have EPR or C-Flex when those technologies would be helpful

When someone tells ME that I shouldn't be able to have any determination on my OWN health and well-being by putting it in "absolutes" (all capital letters in this case).....and to leave it COMPLETELY to the doctors.....well, them are fightin' words.

When the users of the APAPs (Autos) set their machines for a range of pressures (either doctor prescribed or set by patient).....is is going to KILL the user if the machine just HAPPENS to go to the "wrong" pressure? NO!

Best wishes for a good night's sleep.

Den

[Goofy-guest]

Man, Den!!!!! I thought that you had MORE of a sense of humor than this, and that you weren't SO BLIND that you couldn't see my tongue BULGING my cheek out!!!

Relax, bro!!!

Chuck

[Snoredog]

Wulman wrote:

Assuming that a person was using an APAP and software (Like the REMstar Auto and Encore Pro), Central apneas SHOULD show up on the software as a "Non-Responsive" (NR) event or a longer apnea event.

yes they should but they don't and therein lies the problem; how do you know if those other hypopnea or apnea events logged on that same report are not central?

If you look at the NR detection circuit works, it takes (3) non-responding events in a row for the machine to determine if the event(s) were Non-Responsive. Then again the way the algorithm works those 3 that are found to be NR are ALWAYS after the fact.

so IF there was only 2 out of the 3 that failed to respond to prior pressure increase(s), then NR detection algorithm would NOT log them as such. So if you had say 10 total events and it only detected one NR from those, that is 3 out of 7, but if there were 2 more included in that 10 they wouldn't be logged as NR because it needs to see 3 in a row or a triple event to determine they didn't respond to pressure. Then once it does detect the NR event, it disables that circuit for 15 minutes. So the next 15 minute period could easily have another series of non-responsive events and the machine would never see them.

But 3 out of 10 is only 30% detection rate at best.

One of my points has been that Kaiser (healthcare) is doing precisely this very thing with issuing APAPs as a diagnostic tool and nobody's calling what they're doing a "bad thing".

Not necessarily bad just a cheap route chosen by an HMO medical/insurance company. Keep in mind they are one of the same, both a medical establishment with their own clinics and hospitals, on staff doctors etc. You can be assured if they cut costs with tests, they will cut costs with doctor qualifications as well and any other aspect of the field they can cut costs.

When insurance premium rates are the same from them as another company like Aetna where you can choose your own doctor, clinics and hospitals, I wonder why some continue to choose them. It demonstrates to me what kind of care you can expect from your premium dollar. Kaiser could just as easy buyout some old apartment building and convert it to a sleep center but they choose and even a cheaper route. Is it as effective or accurate? There is no way it can be. Kaiser is making money hand over fist, they purchased 4 out of 6 of the old Peoplesoft 5-story buildings in Pleasanton to house their headquarters.

Then once they do make the diagnosis (how ever that is) they group the patients like cattle in a room with a dozen others so they can further cut costs. Most of us that go for a diagnosis of OSA are pretty much already diagnosed before we ever have the PSG (all the questionnaires and medical history etc. we fill out), but the PSG remains the more thorough way of diagnosing OSA and other associated disorders that go totally missed by Kaisers method. I would never select them as my medical provider.

[rested gal]

Man, Den!!!!! I thought that you had MORE of a sense of humor than this, and that you weren't SO BLIND that you couldn't see my tongue BULGING my cheek out!!!

Relax, bro!!!

Chuck

Hey Chuck, you didn't have tongue planted in cheek when you typed "COMPLETELY" in that other thread...right? You did mean that other "COMPLETELY". completely...right?

From: viewtopic.php?t=15318
Nov 23, 2006 subject: Hello & A Few Questions

I agree COMPLETELY with Snoredog (and others who have expressed similar sentiments here). Your econimic considerations not withstanding. DON'T MESS WITH YOUR LIFE. Period.