CPAP Problems

[nmbugs]

I am having some real problems with my CPAP. First my provider gave me the wrong CPAP. My doctor ordered me an Escape S-9 because I have problems handling the pressures. I was given a Respironics System One which cannot adjust pressures but can ramp up over 45 minutes (as I am sure most of you probably already know ).

Anyways just a few nights after using the respironics (just got it 12-24) I started waking up with my low oxygen headaches. I guess I should mention I am on 24-7 oxygen for PAH. My husband had some work he could do at night so he monitored my oxygen saturations for 2 nights and it went in the 70s both nights. This I think, that caused my right leg to swell up (which happens when my oxygen levels go wacky) so the last two night I haven't used my machine.

This has been very frustrating because I felt like I got my best night sleep in years when I had my titration study. I was looking so forward to getting my machine but now it seems like it's only causing more problems. My cpap provider was supposed to order my correct machine, the day I picked up the wrong one but I found out yesterday they dropped that ball too so it's going to take another 2 weeks to get the right one (which is going to mess up my insurance report!!).

I guess I have a couple questions. First, should I try just taking my pressure down to 6 and don't let it ramp up to 13? I am thinking maybe I can tolerate a lower pressure. Also from what I am reading on these two machines there are huge differences. The model I have right now has no bells or whistles the respiratory therapist described as a pinto and said the one my doctor ordered is more like a camry. But then the office staff is telling me they are the same. Any thoughts on the two models?

I appreciate all your help!
Racquel

[Tez62]

Nmbugs, welcome, if your going with a Resmed you want the Autoset not the Escape. The Escape is the base model in the range, fixed pressure and not data capable. It sounds lik you want a Auto so you can adjust the high and low pressures and in the future you may want to look at the data. There is free software called Sleepyhead that you can download from here and you can take your therapy into your own hands.

[me50]

I am having some real problems with my CPAP. First my provider gave me the wrong CPAP. My doctor ordered me an Escape S-9 because I have problems handling the pressures. I was given a Respironics System One which cannot adjust pressures but can ramp up over 45 minutes (as I am sure most of you probably already know ).

Anyways just a few nights after using the respironics (just got it 12-24) I started waking up with my low oxygen headaches. I guess I should mention I am on 24-7 oxygen for PAH. My husband had some work he could do at night so he monitored my oxygen saturations for 2 nights and it went in the 70s both nights. This I think, that caused my right leg to swell up (which happens when my oxygen levels go wacky) so the last two night I haven't used my machine.

This has been very frustrating because I felt like I got my best night sleep in years when I had my titration study. I was looking so forward to getting my machine but now it seems like it's only causing more problems. My cpap provider was supposed to order my correct machine, the day I picked up the wrong one but I found out yesterday they dropped that ball too so it's going to take another 2 weeks to get the right one (which is going to mess up my insurance report!!).

I guess I have a couple questions. First, should I try just taking my pressure down to 6 and don't let it ramp up to 13? I am thinking maybe I can tolerate a lower pressure. Also from what I am reading on these two machines there are huge differences. The model I have right now has no bells or whistles the respiratory therapist described as a pinto and said the one my doctor ordered is more like a camry. But then the office staff is telling me they are the same. Any thoughts on the two models?

I appreciate all your help!
Racquel

Don't accept an Escape is about all I can suggest. If you are going with the Resmed then at the minimum take the S9 Elite which is a set pressure and better off taking the Resmed S9 Auto set where a pressure range can be set. If I were you and my leg is swelling up and my O2 is dropping in the 70's, I would be on the phone to my primary doc and report all of this. I am sure someone else will have more suggestions for you.

[zonk]

Any thoughts on the two models?

Hi Racquel, welcome aboard
I,m astonished your doctor ordered an S9 Escape, the Escape models don,t report other than how many hours using the machine each night, so you and the doctor will have no useful data to see how the therapy is working

Whats the model number of PR System One, model number printed on the label at the bottom of the machine (remove the water tank before checking). Model numbers below 450 or 460 are not data capable machines

[zonk]

Your user profile shows .. CPAP Pressure: 6-13, in that case the machine would be PR System One Auto , either model number 550 or 560 (60 series machine with the heated hose option)
PR System One Auto is superior to S9 Escape or Escape Auto (on par with Resmed S9 AutoSet)

Philips Respironics System One user instructions and how to obtain the clinical manual via email, the manual explain the ins and out of the machine
http://www.apneaboard.com/pr-system-one-...structions

[DeepBreathing]

Hi nmbugs, welcome to the forum.

Both Respironics and Resmed (S9) are good brands with a wide range of machines available. However, within both brands there are less capable machines. The capabilities fall into two main areas - data and pressure.

• Data capable machines keep a detailed record of your breathing, events and pressures on a breath-by-breath basis. This is valuable information for you and your doctor to monitor your progress and make necessary adjustments to your therapy.
  
• The non-data capable machines only keep a record of the hours used, for "compliance" purposes. The S9 Escape is non-data capable. You should avoid getting this machine and insist on a data-capable one (Resmed or Respironics - they're both good brands).
  

The pressure capabilities are plain vanilla CPAP, autoset, bi level and ASV.

• Plain vanilla means the pressure is set to a constant and remains at that pressure all night (except for the ramp up). This is adequate for many people.
  
• An autoset machine allows you to set a minimum and maximum pressure, and the machine will vary between these as required to treat your apnea events. Generally an autoset is preferred as it is more comfortable for many people, running at a lower pressure unless there is an actual need to go higher. The autoset machine can also give you a night-by-night titration - you can see what pressures are actually required to treat your apnea and adjust the range accordingly.
  
• Bilevel machines (Bipap or VPAP) are more complex, allowing different pressures to be set for inhale and exhale. These are more expensive and usually only prescribed if you can't achieve effective treatment on the CPAP or autoset.
  
• Automatic servo ventilation ASV machines are very expensive and only prescribed if you have intractable central apnea or other breathing disorder like Cheyne-Stokes respiration
  

In your case, we don't actually know what sort of apnea you have (obstructive, central or mixed), nor how severe, nor what the prescribed pressures are. If you can share that information with us, we would be in a better position to make a recommendation. However, I do agree with Me50 - if you are experiencing leg swelling combined with very low saturations, you should be seeing your doctor ASAP! Don't wait for the machine to get sorted out.

[robysue]

nmbugs,

You need to clarify which System One you are using. There's a whole family of them, from the bare-bones System One SE to the top of the line System One Auto CPAP. Here's how to do that:

1) Take the humidifier tank out of the unit.

2) Turn the whole thing over so you're looking at the bottom.

3) Examine the bottom of the blower unit. There should be a tag with a model number. The important thing in the model number is the 3-digit number in the middle. It will most likely be one of the following numbers:

150, 151, 220, 221, 250, 251, 450, 451, 460, 461, 550, 551, or 560, 561

The important part is the first two digits, the third digit is not important.

If your machine has a model number >= 450, it is a machine that is superior to the S9 Escape, and you might as well keep this machine because it does do everything the S9 Escape does. If the model number is 220, 221, 250, or 251, it is equivalent to the S9 Escape. If the model is 150 or 151, then the machine has no Flex (exhalation relief) and is worse than the S9 Escape.

But as others have said, you don't want an S9 Escape anyway. You'd be better off with the S9 Elite or the S9 AutoSet.

[trish6hundred]

Hi nmbugs,
WELCOME! to the forum.!
What robysue and the others have said.
Best of luck to you in getting things sorted out.

[nmbugs]

Sorry for my delayed response and thank you for all the replies. It was the base model Respironics which only did ramp up. I contacted my doctor because I got even worse so he switched me to ResMed AutoSet. I just picked it up today so I will start my therapy tonight and see how it goes.

My history is may be a bit different than most since I have so many other problems going on like pulmonary arterial hypertension, pulmonary emboli, respiratory failure and tachy-brady syndrome which from my understanding can be attributed to untreated apnea, or at least cause it to worsen or something...this all new to me and I still don't understand most of it. I started getting sick last Jan (2013) and it has been going downhill rapidly ever since!

As for my sleep study my AHI was 25.6. I had to have the study done twice (both sleep and titration) because the first lab messed up and left my oxygen on and because of this only got an AHI of 4. Here is the strange thing. The first lab got a few centrals and a ton of RERAs but apparently medicare doesn't allow for reras anymore. When they did the titration I failed the cpap because I couldn't breathe out and it increased my centrals but reduced my RERAs. The second lab conducted the sleep study without oxygen BUT I didn't get any central or obstructives but got 144 Hypopneas. I desaturated to 69% without the oxygen that night.

I am not sure if I gave too much information now, I apologize in advance if I did .

Hopefully all will go well tonight and I will wake up feeling like a human being tomorrow.

[Surly]

Hi Nmbugs,

Do you normally sleep with Oxigen? If so, some CPAP masks have a port for your O2 line, or alternatively, there's cheap connectors available to place between your CPAP mask and hose that enable continued O2 use while sleeping with your CPAP device.