Question About Starting Pressure

[Chibi's Dad]

I received my machine on Wednesday and have used it for two nights. I have found that it feels like I am not getting enough air into my lungs as I try to fall asleep, especially the second night. I haven't looked at the time, but I think this feeling really begins at the end of the ramp up time. My machine is currently set with a low pressure of 4 CM H2O and high of 20 CM H2O. My ramp time is set to 30 minutes. Should I adjust the lower pressure to something higher than 4? I believe my 90% pressure the first two night was 7.5 or 8. Any suggestions would be greatly appreciated.

[Pugsy]

If your settings are 4 cm minimum with max of 20 the ramp is useless because the lowest the machine will go is 4 cm.

Go into the clinical setup menu and confirm for sure what your settings are.
If you don't know how to get to that menu go here and request the clinical/provider manual as it explains how.
https://www.apneaboard.com/adjust-cpap- ... tup-manual

And yes, the feeling of not being able to move the air adequately or suffocating is quite common when lower pressures are used like the 4 cm.
Usually increasing that minimum to something around 6 or 7 is sufficient to make it easier to move the air and be more comfortable.

Another trick is to move up a size in nasal pillows if at all possible.

[Chibi's Dad]

Thank-you for the suggestions. That made a world of difference. I changed the minimum pressure to 6.0 and when up one size on the pillows. Much, much better night. I didn't feel like I was struggling to get enough air at all.

[D.H.]

That's good. Since you have a data compatible machine, you can analyze your sleep with Sleepyhead.

Since you were given a range of 4 to 20 (which is the full range of the machine), they really didn't determine the optimal setting in the first place. I never heard of anybody being called for changing the settings, only for not using the machine "enough."

[Chibi's Dad]

Here's a question: Since my provider (the VA) didn't optimize the settings, can they remotely adjust/optimize the settings via the installed modem after they've reviewed a week or two's data?

[Pugsy]

The ability to adjust things remotely is available but whether or not anyone is actually doing it at your VA supplier system is unknown.
Most likely not going to be done though unless you bring it up to them. Someone would have to go looking for the data that is available via the modem and then evaluate and then transmit whatever is needed to change something remotely.
I wouldn't be holding my breath as to having someone at the VA do that. I would be doing it myself if it were me so that I would know for sure it got done. It's not hard.

[beepsilver]

Here's a question: Since my provider (the VA) didn't optimize the settings, can they remotely adjust/optimize the settings via the installed modem after they've reviewed a week or two's data?

Going off of what I know about my VA, here's what I think (disclaimer word=think). With thousands of local patients, I doubt the VA scans patient data very often other than to check compliance (monthly reports, etc.). Perhaps as a new patient, they'll look at your therapy scores in the short term, but that's about it. When a patient contacts them over the phone about changing masks or other modifications, the VA asks that the entire setup (machine/hoses) be brought in to the clinic. This leads me to believe they cannot make remote setting changes via the modem, only receive data transmitted to them by your machine. Knowing what I know about government staffers, if they COULD make remote setting changes they would, for no other reason than to cut down on visits to their office, but not to tinker with an individual's settings because they may have seen a minor modification. One final thought. A respiratory tech set your machine up after your sleep study. It's very likely the machine was then transferred to a non-technical employee who issued you the equipment. This employee is likely responsible solely for equipment management and not any technical aspect. Let's assume for a second that they DID notice your settings were different from the norm, in my mind there's no way they would jeopardize your health or their job by remotely making an adjustment (if they could) without contacting you first.

Just my two cents.