G'day mates If you use a ResMed AirSense 10 or 11 you can now register for a free www.sleephq.com account. It's super easy to upload, review and share your cpap therapy data. We're adding new CPAP machines to the platform every month so join our mailing list and we will let you know when your CPAP is compatible cpap.review/sleephq-newsletter
Hello I just joined the SleepHQ group and am loving it. Looking forward to the comment section being up and running. Thanks for all your doing, and your honesty.
I'm a Retired Registered Respiratory Therapist, (RRT) I helped start a sleep center in 1997 & worked there until 2010. I'm looking forward to being in this group, and thankful for it.
Nicko, you were one of my mine sources of information. I remembered when I was diagnosed with Sleep Apnea my doctor prescribe me the pressure to be 13, I woke up every day feeling like a balloon, a lot of air in my stomach, farts, was really uncomfortable, I watched the video where you said that we can regulate our pressure until you felt comfortable and your values were ok, I dropped the pressure from 13 to 8.5 day by day, i changed my mask too for a nasal pillow, leakages dropped too. I wake up every day feeling amazing and without feeling like a balloon and less farts lol. My doctor check the values related of apnea episodes and they were great. Regards from Argentina Nicko.
Hi there, i think it's good for people to know. Gonna save them a lot of time as it's a pain in the ass going in for an unnecessary night in the lab. All the best. Nicko
This is completely true I got a home sleep study and they went the lazy way of making it so i had a huge range 6/25 ps4. And suggested a full face mask. Felt like every time I was nodding off it would ramp up the pressure and blow off my face and blow me up like a balloon. Also when I asked if there was a setting to reduce the pressure they didnt give me any useful information because I didnt buy the Bilevel from them just said to ask the people I bought from. Found your channel and a few others and started piecing together what really would work like if you understand how to min max in a video game thats exactly what I did and it worked. I was at 99 apnea events a hour down to .5 now and thanks to your video on pressure and figuring out what reslex and the other settings do to soften my sleep. Thank you Niko.
Pressure requirements even change with body position. Only auto cpaps should be prescribed. Teach us to self-titrate at home. Heck, if diabetics can determine how much insulin they need, there's no reason we can't dial in our own pressure regime.
Only auto? Absolutely not. In my experience most people don't even notice the difference between auto and a properly set fixed pressure machine. Fixed pressure can also resolve many of the issues caused by an auto machine. There is a use case for each of them and knowing the difference is important.
@@td6576 First, good data-capable auto machines help you dial in your data faster at titration than a single pressure machine. It's the best way. Why suffer over months of slow single-pressure self-titration when you can do it in weeks with a decent auto? Even if you do eventually end up with a single pressure, it's easy to make the auto emulate a single pressure machine. It's totally flexible. Second, I question the anecdotal suggestion that everyone does better on straight CPAP. I did terrible on a crappy Respironics for over a year before I switched to a Resmed auto. It was a gamechanger. My AHI plummeted. It's not like I have a drastic difference in my upper and lower pressures, but that slight difference accommodates me better at different positions. I suspect the only reason why some champion single pressure machines is because they're sold/rented cheaper. That way medical equipment suppliers (DME's) make a better return on investment because health insurance pays the same for a cpap as an apap, even though the apap is more expensive. The US system of healthcare is messed up, and sleep medicine is directly in the crosshairs of some vampiric DME's who want to make the fattest ROI, regardless of the needs of their patients. Same with cheap crummy nasal masks.
@@LaughterOnWater titration should be done on an automatic machine before a finalized prescription for ongoing therapy is signed. That would just be silly on a fixed pressure. Figure out your needs before commiting to purchase of a machine. Reread my comment and you will see I never said "everyone" I said most. Meaning more than half. My anecdotal evidence is based on the hundreds, if not thousands of therapy titrations I've conducted. In Canada, insurance companies usually set a limit which would cover an auto machine. Service providers make about $400 less profit selling a fixed pressure machine in order to save people money. Why pay extra for auto if it isn't something youre going to use. In many cases, auto can be problematic.
@@td6576 I suspect we mostly agree and that we're simply arguing semantics. Nick's video segment seems to suggest a prescription for pressure is less helpful than simply teaching users to self titrate. A single night of titration should be viewed more as a starting point than a "prescription". Also, losing weight, getting sinus or throat surgery, differences in diet... all of these things can affect required titration. Going to a sleep specialist for something like this is like a diabetic going to a specialist every time they dose. _Stuff changes._ CPAPers should be trained to determine their own titration to save headaches and stop the needless office visits. In this instance, I agree with Nick. Give us the tools to empower ourselves. The cpap should work for _us._ We shouldn't work for the cpap.
I had a lot of mask leaks on my nose mask and I found the flimsy straps were stretching. A new head strap cost $70 so I made my own out of leather with an easily adjustable bottom strap ( which I tighten after putting it on ) works really great. I have a S9 machine and bought a Air Sense 10 because the " motor has exceeded hours" came up on the screen. Since then , after watching all your videos I am confident that I understand these machines better and know what I need if I have to replace it again They are excellent devices, I did my first test 2011and it was the first time I slept 8 hours straight (during the test), since I can remember. Had nose damage at about 5 years old and now at 71 Thanks for you great information
Most useful video on CPAP, explains why I was waking up tired for over 1 year with my previously set pressure setting. Luckily I replaced it with and auto setting machine without the sleep study. Thanks for the video.
I agree 1000% They had my machine set at 6 - 15. 15 us insanely HIGH. and I have adjusted mine to 10 and I sleep well. Recently had an upgrade to airsense 11 and I tried to explain that 15 was too high, and she gave me some BS speech about what the prescription is. I'm sooo happy to find how to adjust my own settings.
I totally agree with you. I just had a titration study and it was terrible. I only had 2 hours of sleep. Thanks for the information when I go see my doctor. I really love your videos. Thank you for making them.
Been on bipap 20 years the last 9 on auto. Big difference! I wish everyone had auto. But other than new patients the studies would be unnecessary. Right? My Dr told me that a few years back. Great info as usual. You're appreciated. Bless you and yours.
Hi Penny, great to hear my friend. Yeah PSG studies are fine for new patients but once you a CPAP i don't feel it's necessary to go back into the lab every year or so to get the pressure update. It's just a way the hospitals / labs / doctors keep clipping the ticket and making money. Cheers for the kind words. Nicko
I had a one set pressure at one point. Felt like I was starving for air after a few months. They reset my machine to a range now. I rarely get to the max unless a strap comes off, but I do use a range most every night. Everyone should be able to have the range. Blessings!
I did two sleep studies each about eighteen months apart. Reason I did two was I lost my job and could not afford the machine. The second time I bypassed the specialist as it was going to cost $385.00 for a fifteen consultation. So Rude. So both studies cost me over nine hundred dollars. Yes I know they saw me coming. But I did buy a machine, I took my results to where I bought it and they explained the results for FREE! Now I have found Nick, I am learning so much every single time MATE Thanks so much.
I only got one night of sleep test which I thought was not long enough, I was told I only had apnea when on my back but the machine tells a different story! As I have no contact with my sleep specialist your channel has been a God send for me, thanks Nick for all your help.😁
Greetings Nick, great information. It wasn't until I was put on a Auto CPAP machine and educating myself with SleepyHead, now OSCAR that my sleep apnea found a better equilibrium.
This is true. When I went in for my setup at the sleep center they had my pressure cranked up to 18. I had a problem sleeping because the pressure was way too high. When they gave me an auto adjusting CPAP they set it between 12 and 18. After 1 year they looked at the data and found that the machine rarely went over 14. Now my machine is set between 10 ad 16 and it averages out around 11 or 12.
@@NoughtVun my first machine that I am referring to in this comment was a Respironics 'M' Series. This was back in 2007 so it may have been before Philips bought Respironics. I now on my second Resmed Airsense. I got the Airsense 10 in 2014 and I just got the Airsense 11 in February of this year.
I only went in to the VA once for the sleep study and they prescribed my max to 25. Way too high. All kinds of side affects. Thanks to your channel Nick, I’ve learned how to adjust my bipap machine to Max 19 and still keeping my AHI below 4. Thank you!
Great info! I use the Oscar program and I'm trying to get mine and my wife's machines tuned in. Mine was set on AUTO 5 to 20, but I remember seeing a printout on my machine a few years back showing my max pressure was hitting around 16. I turned mine down to 16.6 and after finding a good SD card I'm waiting on a week or so of good readings.
My experience is you have the study, it’s miserable, they start you out low to prove you still have sleep apnea, causing a lot of events, then they play with your pressure all night causing you to wake up a lot. First two studies I got a machine never heard from the doctor again, ever for years! Currently I’m looking at a third night because they say in two nights, they don’t have enough data. So I bought my own auto set and I’ve been able to tweak it enough to get a good nights sleep, following some of the suggestions in your videos, and am learning to use your software.
I had a set pressure of 14 initially - and was exhausted when I woke up. Another sleep doc (second opinion) asked if I'd tried auto CPAP? So she recalibrated my machine and EUREKA! Now I feel great when I wake up - just with that switch to auto CPAP made the difference! Experiment, my friends. Try different types of masks until you're happy, don't let a doctor tell you you're "fine" if your AHI is acceptable. How you feel is MORE IMPORTANT. I agree with Nick - be your own health advocate.
Hi there, great comment. I think what i liked most was 'experiment my friends'. That's the best thing about cpap therapy! It's very very easy to try different settings and then monitor the changes both with data and also how you feel too. Cheers
It sounds like I was lucky to have a good physician. When I got my machine I spent 1-2 months using it in auto mode, the top being something I was not expected to attain. When I had the longer time data they lowered my upper bound, but wanted to lower it to what had been seen as a max. I asked if they would leave a bit more room at the top while still using the slow ramp up and my physician quickly agreed!
When I first started using a CPAP I quickly worked out I could experiment with my pressures to make things work for me. I found I needed to modify my start pressures and the ramp and initial pressure I found was too low. Definitely learn how to use your machine.
I hv an BMC luna G2 auto cpap, I found that even with the auto mode on, it doesn't provide the best pressure for me. I hv to manually set the min and max pressure to my own preference.
Thank you Nick. We are being so messed over by bad business. Medical privacy laws have so many loop holes it is a joke too. Wait till you turn 65 and get all the sr cit mail bc they all have your birthday...makes me sick!
Thanks for the information. I learned from you how to change the pressures and wow I reduce my pressure and am getting longer better sleep than I ever got with the pressures the doctor set up. First night I tried to set my pressure I went up from 13 to 15. On a bi pap and 8 on the exhale. I started to skip breathing and ahi went to 19 in two hours of sleep. Having to much pressure really caused more problems for me. I reduce the pressure to 6 and 11 and have had the best sleep I have had since I went on the machine. Your information is priceless. Thanks.
I finally had a sleep center titration test. It was great! The at home test didn’t work, received the cpap machine after waiting 5 weeks and found it doesn’t work for me. They tested the bipap. Much better. Let’s see what happens once I am on my own with my new bipap!
With auto machines, we are doing the sleep study every night at home! This should be an over-the-counter product. I bet if the market was freed up that box stores could sell these things for $100 for the machine. Some plastic, a small air pump, a microchip board.
Hi Carl, i think you make a very valid point mate. Here in Australia they are over-the-counter however the prices are still very very high unfortunately. Cheers
After the 3rd Sleep study in 2 years, I figured this was just a upsell. I also knew that no useful info could be taken from such a poor untypical nights sleep (if you want to call it sleep!).
Hey brother, not an 'upsell' as much. More just an unnecessary test and profit making exercise. The lab get's a fee, the hospital get's a fee and the reporting doctor gets a reporting fee and normally a consultation fee to discuss those results. Cheers
@@CPAPReviews my sleep apnea dr has been useless. told her I never gave permission for text msgs on my phone telling me I had not used it enough in a night. I took spy chip out of machine. works just as well
Yes had that lab study about 5 times never again hard plastic pillows rock hard bed head full of glue and cold impossible to sleep when you do staff wake you to make some small adjustment best thing to do is learn how to operate every part of your machine and understand how to change settings my best find preheat the water to avoid a dry mouth using distilled water ,thanks for sharing 👍
My experience as well, you speak the truth. My titration study was completely wrong because it was based on minimal data points. Luckily I had self-diagnosed and started self-treating 8 years prior, so just adjusted my BiPAP to where it ought to be.
I only had a home sleep study and they set me 5-15. I didn't even last 10 minutes on that setting and changed it to 8-15. After a few months, I finally looked at my data on Oscar and my machine stayed around 15 most of the night so I raised it to 11-20 and have had no issues.
Ooops sent it too soon. I have found everything helpful even though many hints I have already arrived at through trial and trial and error. Please keep the hints coming mate.
I went in for my sleep study and was chatting with my tech who was wiring me up, a really nice older lady. Near the end we were talking about the people who work there and she mentioned a man who worked there who enjoyed watching women sleep and things he would say about them....and then Good Night me, enjoy your sleep. Needless to say I did not sleep and was told the next morning that I didn't have sleep apnea. I was like, I couldn't sleep for thinking about the pervert behind the cameras! She quietly told me she could fix my paperwork and to just get an auto CPAP, that should fix it. This was a few years ago and I am still paying off the thousands it cost me for that one night in hell. Sleep studies are full on BS. My health improved noticeably after a few months on my CPAP that was fixing my sleep apnea that I didn't have because I didn't fall asleep while being a pervert's personal cable channel.
Nick, thanks for another great video. I visited a new sleep doctor this week and learned more about CPAP & BIPAP in one visit than I have learned in eleven years, Your video really enhanced what I learned this week. I have an AirCurve BIPAP this is set on automatic, and I will review the data like you showed. I agree with you on a one-night test. I am a light sleeper and even with Ambien, barely made it through the six hours required by Medicare. Is that program available to the public? Once upon a time I had a bootleg copy of the ResMed analysis program but lost it.
My auto system goes from about 9 to 12 depending. 12 If I have a few too many adult beverages or if I sleep mostly on my back. Makes sense because if I sleeped on my back before CPAP, I'd get an elbow in the ribs from the Misses. Since CPAP I have not snored once aparranly.
The other benefit for me. I never got diagnosed with sleep apnea but got machine for snoring, after using it, I'm 100% sure I have apnea. The reson for not getting sleep study is I'm now treated but I'm not getting monitored. Even though I have not failed to use the machine once I'd rather not be monitored.
Adjusted my own pressure from original pressure of 17-19 2 years ago. At a self adjusted pressure now at 9 my AHI over a two month period is 4.75. . (in fairness i must confess. I lost 80 pounds. At 18 my mask kept blowing up. The 18 was set from a one night in lab sleep study.
I just had a cpap titration at the end of last month and ended up with a pressure of 20 after having an in home study with an ahi of 114 and my blood oxygen level dropping to 57%. I actually just got my cpap today, the resmed airsense 11, so I'll have to see if it seems good over the long run but the morning after my titration I felt amazing.
Most folks, like me, don't know enough about it to fiddle around with pressure levels. I've struggled through years of aerophagia by adjusting my machine. I got sick many times as I couldn't figure out what was going on. I thought it was a cleanliness issue as I could clean my mask etc or change to my old machine and it would go away.
Hey mate, great point you make. "you don't know enough to fiddle around with pressure levels". That's why i made all the videos so you can know enough as many viewers will testify. It's not like trying to learn some crazy complex super computer. It's no different from learning how to adjust the humidifier up or down to increase or decrease the moisture. I'm sure if you took 30 minutes out of your day you could give it a go and i think you would be surprised. Cheers
@@CPAPReviews Thanks. I did enough research/youtubing to be dangerous to myself and I'm fairly competent on electronic gizmos. I was a electronic tech for 30 years :( . Apparently I had a blind spot when it comes to aerophagia! I never heard of it till my ex looked up burping and cpap. What a relief! :) Now I know! Never in my 25ish years of wearing a cpap had I heard of it. Please tell me you've covered aerophagia and the causes in your youtubes and let me know where to find it. TY in advance! Keep up the great work! Millions of us need more info.
Hi mate, sure here's a little info on Aerophagia and a few things you can try - czcams.com/video/3dBNUxeasTs/video.html but really most cpap side effects are the result of incorrect pressure settings (most of the time too high). Cheers
@@CPAPReviews Thanks. I've since lowered my pressure 6 or 8 months ago from 14ish to 10 or 11. I don't recall seeing AHI numbers but I've only seen resmed data. Where do I find that? Sorry for the annoyance but thanks again and I will be donating :) Edit: I found what I needed I think. I'm in the middle of getting approved for an auto machine from resmed soon so I should be okay. I tried to donate on paypal but not sure it went through. I'll verify and try again.
hi Nick, Great video, I would like to learn more about how to understand the readings to be able to adjust my pressure correctly. I am a paid member with special privileges. with a Lowenstein prisma smart max. I completed your academy. maybe i should do it again. Cheers
Of course my provider set the pressure at 15 and of course it was too high. First CPAP month I was miserable. Almost quit entirely but I did notice a marked difference in my wakefulness during the day so I kept on. Thanks to people like you on YT, I learned to access the clinical settings. I now set the pressure at 9 or 10. My AHI is less than 1 (usually .2 or .4) and I can actually sleep comfortably.
Bingo 😁 I've said this from day one but my doctor's call me nutz 🤪. So many variables considering sleep positions, stress, sickness and even if you took a shower prior or not. 👋😎👍
Nice vid Nicko! PAP forums and PAP vloggers such as your self do have a huge influence towards folks who are curious or yearn for improvement; I am both. Unfortunately the deluge of information out there compiled with key-board warriors and self proclaimed 'know-it-alls' add the to mass confusion. i.e. LeakyLefty (Jason) recommends a steady 'fix' approach to therapy vs. your video example; respects to Jason, but it creates confusion to most. For me, I experiment (but that's me). Some months I go Auto and some months I go fixed (influenced by Jason). There's benefits to both... and there's no 'one' correct or precise approach. The question is; am I getting optimal sleep? Answer: for the most part 'yes'. Has my sleep improved in the past several years? Absolutely. But thanks to diet, exercise, a keen 'frame of mind' and other factors... + PAP, my overall well being has indeed improved. PAPing is one part of a larger scheme to optimize sleep and life.
Great comment mate, i think it's good to have a number of opinions like all topics and the best thing about cpap therapy is it's so easy to try these options, look at your data, see how you feel and then keep working at it. All we can do is provide you with some techniques that have worked for us over the many years of working with patients but at the end of the day everyone is different and everyone has to find what works best for them. Mask, Pressure, Settings and like you said.... It's only one part of a larger scheme. Cheers
I've seen you reviewing the Z2. I have a Z2 CPAP, not an auto CPAP. That really doesn't make any difference I think as to what I am troubled by. When I check my sleep data in the morning, I never see any a h i readings. Now I know from past use of Auto machines and CPAP machines that my AHI, while low, is never absent. Can you please tell me what might be causing the lack of AHI data. I'm using Night Log to see my data. I 'd be very grateful for any help. I have contacted the manufacturer of the Z2 and the company that sold me the Z2. I haven't heard from the manufacturer and the company that sold me the Z2 doesn't even understand that there is software that is supposed to read AHI. And I totally agree with you that sleep studies are a farce. You didn't use the word farce, but I think they are bogus, at least. I have been on CPAP since I was 69, and I am now 85. When I first started using CPAP, I was given a constant pressure machine set at 6 çm. I did my own sleep study, varying the constant pressure over two or three days at a time and looking at it my ahi only encore software. I ultimately selected 9 cm. Later when I got an auto CPAP the software confirmed that 9 cm would be a good constant pressure. So, I am not new to this CPAP business and I just don't understand the Z2 data.
Nick - I'm a fairly new subscriber from the US. I have received a lot of help (none from my sleep tech as they are focused on AHI and usage..). One person who helped me a lot is a fan of set pressure only. I tried this and kept changing it to try and optimize, but I could never make it work and went back to APAP with much better results. You may have already discussed this, but I would like your thoughts on APAP vs CPAP, pros and cons of each as I can't find the cons of APAP, but I am sure there must be some trade-offs.
Thats one thing I liked about the "machine we dont speak of"...my setting were 6-16...and never had an issue...Theres something different about the Resmed...I feel like its trying to blow the skin off my face...lol...Since your video on the settings Ive been "tweeking" my machine...I'll figure it out soon enough!
Hey Scott, it took me about a month for me to get used to the resmed, it felt like I was fighting machine to breath. But now all good. Had to fiddle with starting pressure and I start at 7 and have the auto set to full range 2-20 and I let machine figure settings out when i fall asleep.
Ben Cahill, I came from a Phillips Dream station that just worked great for me. I found that I was quite aware of working to breathing as I was falling asleep. I got my tech to turn off the ramp, and bump up the starting pressure. Much better now.
Haha " The machine that shall not be named " Glad to hear it Scott. Yeah they all have different algorithms that determine the pressure changes. With a bit of fine tuning though you can normally get the same results across the board. Cheers
I highly suspected I had apnea after many years of symptoms. After my initial sleep doctor appointment, but before I had the home sleep study (thank you crap US health insurance), I was given an AirSense10 AutoSet by a family friend. They bought it and had barely used it before their supposedly unfixable underlying condition causing mixed apnea was fixed. It was set for APAP mode and I gave it a try. After a few nights it was averaging a pressure of 11.8. My full overnight study and CPAP titration ended up coming back with a pressure of 12. If I hadn't already met my insurance deductible and had to pay the full ~$875 for the study I would have been pissed. I did change the machine to CPAP mode at a pressure of 12 though to be a good patient. They want 6 weeks of data at that pressure for my followup appointment next week. I'm going to insist the prescription be updated to an APAP one though because I definitely slept better in APAP mode. I'll still switch it back to APAP even if they refuse. I don't plan to stay with this doctor anyway, and I can at least buy a replacement APAP with a CPAP prescription here should this one die on me.
Truth for the majority of OSA patients. However I think it would be good to clarify about complex sleep apnea and central sleep apnea. Those types of apneas can't be fixed with simple auto titrating CPAPs or even bi-level devices. A sleep lab titration would be the only way to fix patients with complex issues with servo ventilation. Most insurancees will require a titration study with the diagnosis of central sleep apnea and complex sleep apnea to do this.
I can call my doctor or machine provider and they can view my readings on a regular basis. My machine records all the time when I use it... so the air and other things can be adjusted as needed. So its not just based on the sleep study
@@CPAPReviews well thats easier to answer. You need the study to prove to the insurance company that the machine is needed. I dont know about anyone else. But I didnt have a machine until i had the study show that i even needed one. Are you implying people have machines and then have a study?
To me, the stranger thing is that insurance programs, sleep physicians and respiratory therapists don't monitor changes over the years and adjust treatment accordingly.
I'm on a aircurve 10 ASV. It's a rare night when I get a good nights sleep. The machine will blast me awake with pressures of 17+ when all night it's been around 10. Not sure I can take this much longer. This BS that I'm going to get a great night's sleep seems to be a sales pitch from Resmed. I learned how to change the settings(no thanks to my gutless respiratory therapist) so I continue to make subtle changes. I go in for my 4th sleep study. They all agree I have central apnea but what to do with it. Thanks for the video, I'm going to make more changes tonight.
Hey mate, just drop your pressure max level. Bring it down to a level you're comfortable with. There's absolutely no point in using the machine if it's disturbing your sleep and quality of life. The RTs have no idea mate. They've never even spent a night using the machine. The whole industry is fucked. You gotta do what's right for you
@@CPAPReviews LOL...I couldn't agree more. After 3 sleep studies it's been more than difficult to find anyone who understands what's going on. Fortunately I'm going in for sleep study #4 and the PA seems to care if I sleep well. We'll see.
I wouldn't lie, I am bit cheapester.🤣🤣. After some studies instead of doing spending like $250 for therapy. I bought a used auto machine in really good condition and less clinical hrs for a good price. Coz what i found all those studies give you auto machines too to have ur data. Howz that different to doing urself when ResMed gives you same data through there app. Well now thanks to Nick, your video's helpful in a way to adjust my pressure settings. Recently, bought pillow mask. Wished would have bought it a while ago,, i things it better than full mask for me. Thanks to BMC for reasonable prices for there mask and quality is as good. 🙂 By the way, what software you using there for full data analysis..☺️☺️
While I don't totally disagree with a lot of what you say, part of the reason I subscribe to your channel, I think calling over night titration somewhat of a scam can be dangerous. APAP's can be a good thing for many people but for obese people with obesity hyperventilation, people with neurological disorders like MS, Parkinson or Muscular Dystrophy, many pulmonary issues and CO2 retainers an Autoset can be severely compromised in it ability to accurately titration someone, pressure cycle or adjust to fast for their body to tolerate. I agree for completely health individuals not much of an issue and Oscar can be a great tool, but many don't know how to interpret the actual flow information and with out an effort channel hard to absolutely call central apnea central even with the fast fluctuations of pressure ResMed uses to try to gauge if an airway is open or not when it sees an apnea. That is why many of the above medical issues are currently not able to use Home Sleep Testing, at least here in the USA, at home along with Insomnia, Periodic or Restless Legs, Rem Behavior Disorder, Complex Sleep Apnea, Etc. Followed by Autoset. Unfortunately we see many Primary Care Doctors and some Insurance companies not understand this and many of the repeat testing and Titrations we see in lab here in the states are people put on Autoset with the above issues and either sleep extremely poorly due to the combination of these health issues, the Autoset and sometimesthe wrong mask for the patient.. I myself sleep much better on CPAP than when my Autoset is on Autoset but have found the combination of Oscar and the Autoset to find a good pressure after gathering information over several nights, generally a week, and then collecting information again for a week or better at different pressures. So I appreciate your view but with certain limitations with certain parts of the Sleep Apnea community with certain health issues or sleep issues that need to work closely with their Sleep Physician and Sleep Tech and even some normally healthy individuals if they are having issues that they have not been able to figure out on their own. Like I said I love your channel and look forward to your future posts but just thought that some might take this information and run with it when they need other modes like BiPAP, ASV or EERs to help them above and beyond CPAP or APAP.
Definitely a scam with insurance. I started out with bipap but kept having issues with centrals. In my case I was suprised the sleep lab titrated me correctly as a trial of lowering my pressures increased my ahi. My sleep doc just wanted to order me an asv and adjust based on what my machine reported. Unfortunately because ASV cost so much my insurance required a third sleep study. Kinda puzzled because it is actually going to cost more with the extra study. To make things even better insurance pre-authorized the study then rejected the claim afterwards.
Hi Shawn, yeah i'm still trying to figure out where insurance fit's into this equation. We have a different system here in Australia. I'm sure they're probably dodgy as well though. It's a little bit different when it's more complex OSA. Probably more need for lab testing etc. Cheers brother. Nicko
I don't know if this changed, but ResMed were totally against anyone messing around with the settings on their machines. (Once to the point of almost being abusive. Got told how they considered their machines like their children. I kid you not!)
Hi there, yes there are Auto Bipap Machines also. You get one by buying it or if you are in the U.S you can probably get one through your insurance etc but you will need to speak with your doctor about it. Cheers
ive been fighting with my doctor on this he keeps trying to get me to come in to one night and im thinking their going to get it wrong i don't need someone screwing with my airway . its maddening and sleazy messing with my lungs that way.
Thank you so much. I started my auto CPAP resmed but I can not get in to see my doctor for my “30 day follow up” for 3 months. I am getting no help at all. So frustrating. Your nasal pillow lesson helped too. I need to turn my pressures down!!
Hi Michelle, you're welcome! Here's a video you might also like to check out on pressure adjustments - czcams.com/video/pL4egwDrvbg/video.html . Best wishes. Nicko
I set my S10 to auto because the high pressure kept registering as high leaks every night. I too found that with auto, there were fewer events at a lower pressure. I always wondered if doing this was a mistake or not.
Here is the thing,, I just figured out myself. Full face mask with high pressure will have more leak.. why? I believe coz when it starts leaking, machine thinks your not breathing, sends more pressure causing more leak. Also, if your EPR is not on, that means while exhaling, machines pressure is still pushing air. That causes more leak. I just changed my mask to nasal one, changed my pressures as seen in Nickos one video. And having EPR settings on. Seen the difference with nasal pillow in 2 days. Which haven't seen in like a year.
@@humbalshah The machine can tell the difference between a mouth leak and an apnea event, Flow is not the same as pressure, If you turn off EPR, your machine will still monitor your breathing and will still not pump air while exhaling unless you have Cpap enabled. If you're having leaks with almost any kind of mask, it's a fit issue (or a mouth seal/chin fall issue) not a mask style issue. Some masks won't fit. That's just the way it is. Full face and hybrid masks are fine with high pressures. If you test your mask at whatever your max pressure is and have an appropriate fit before you go to sleep, you won't cause leaks when the pressure ramps.
Since auto machines seem to respond to flow limitations retroactively, and only increase the pressure after an event happens, is it therefore unrealistic to expect a 0 AHI while using auto? Or maybe there's some other factor I'm not considering. Obviously "don't let perfect be the enemy of good" and all that, more curious than anything.
Personally, I don't care for the auto titrating setting. I feel more well rested with constant pressure. For the past 15 yeas, I've been at 13 and it works great for me. Average AHI is now 1.41 when first diagnosed it was over 50.
I had one sleep study. i did not sleep well at all. i have often wondered whether i didn't actually need a machine. I can't sleep without it now, and i snore like a freight train without it. I bought my machine from someone other than my "specialist" so have not had someone analysis my data in over 3 years, i set my machine up to auto myself. I haven't tried going to another specialist.
How do you get that info? I have the Air Sense 11. Pressure is set at 11. I had 131 events at the study prior to the CPAP therapy part. My AHI is all over the place. Highs around 25s and lows of 3s. Id like to see what goes on through the night.
I am a new CPAP user and have the ResMed AirSense 10. Am getting great results but would love to be able to access the detailed charts that you show on this video. Are they available to users and how would I get them. Thanks again for all the terrific content helping me understand this new world.
And what is ramp-up all about? To lay there waiting for it to get from 4 to 7 is just wasting my time, as I could have fallen asleep in that time. I cannot fall asleep in that time, as I am waiting for the machine to reach a decent level. Probably in my mind, I am a new user? I probably have to watch the 3 part series again. I have turned ramp-up off, auto on, range of 7 minimum (Start at 7) to 16 and epr of 3. Mistake?
Can't you tell if your fixed pressure is right by reading the AHI's when you wake up? Lets say you get AHI's around 0.5 to 2 per day, wouldn't that indicate your fixed pressure is good? When I did my titration in a private hospital overnight, I used a sleeping tablet to keep me knocked out. I looked the the charts on a couple of large screen computers and was amazed at the detail taken to tune your pressure in to suit. My sleep doctor told me that I responded better than most through CPAP for my sleep apnea use, the apnea count being quite high.
I love your videos as they are always really educational and empowering, but for me they are also incredibly frustrating to watch knowing all the data a cpap machine actually records and the functionality they have, and yet my sleep specialist has taken the decision to lock off everything on the airsense 10 auto so I can't see things like the AHI score or use a humidifier. I can't even turn the Wi-Fi on and off, FFS!
The Airsense 10 doesn't have a wifi card installed by default. That's something extra you need to buy separately and has nothing to do with your doctor or sleep specialist. If you flip your machine over, there's a square "battery cover" type thing on the bottom. That's where the Wifi card would go. Generally speaking, there is nothing that a medical supply or prescribing physician can do to "lock off" features of your device that you cannot undo. There is no "god code" menu that would allow you to enable disable features in the way you're describing. There's a theraputic menu, but that's pretty easy to access and is only meant to stop people who don't know what they're doing (children and children who shave) from messing with the settings. AHI score should be available under "reports."
Thanks mate. I've learned a lot about my machine since posting my earlier comment, and much of my frustration was due to not being told about how to access the data, something which I now know how to do. Thanks again for taking the time to reply.
i have been using a ResMed Escape S8 for 15 years which has ramp but only a constant air flow pressure. I really believe I could benefit using the auto pressure feature of the ResMed Auto CPAP you were utilizing in the Video and am now considering getting one. Are the Graphs you generated available for our consumer daily in home use as well via some obtainable software or is there some way the user can see how well the machine performed to build confidence that we are the right track? Appreciate the education and comments from others. Thanks All!
I got lucky that my ideal pressure was found with my titration study since I've tried higher and lower pressures to 12 cmH2O and both cause issues. Now I have an apap set from 10 to 13 and most of the night it hovers around 11-12 range rarely increasing to 13. But again I was lucky and I'm probably the exception.
Hi mate, i wouldn't call it 'Luck' although that's a very tight range for an auto but do whatever works for you and it sounds like you're doing well ;-). Cheers
@@CPAPReviews I know, it's tight as heck. Only reason it"s not broader is because I tried it at 8 and I feel like I can't breathe at that lower pressure. 10 felt like my comfort zone tbh. I may up it to 14 just so my machine has some wiggle room, doe. I've had days where 13 was hit once of twice in the night so it certainly wanted to go a bit higher.
very good info. how can i find out if my machine is auto adjustable. i have a Air sense 10. last February 2021 is when i started using it. it is set to 9. i am located in the US.
Congratulations on the videos. I am learning a lot. I noticed that the pressure graph has only the line in black color and as an oscar user, I can say that you do not use expiratory pressure relief. What about that? I noticed that I have less apnea after I disabled relief in my airsense10 autoset.
@@wxdrones EPR is a comfort setting not intended for therapy. You should use it, or not, depending on whatever your preference is, but you need to remember to increase the titration pressure appropriately, otherwise you'll be under-titrated for the pressure you should be recieving because EPR reduces your pressure. In other words, if you've got a prescription that says 6/16 and you turn on EPR 3 you need to up the minimum pressure to 8/9 so that there's room for you to cut your pressure without being out of range. Also, if your pressure is at 4 with an EPR of 3, EPR isn't doing anything anyway. If you can get away with Cpap 6, upping the pressure to 9 and then enabling EPR is probably not the preferred option from a therapy standpoint. On the other hand, if you're at a 16 and having problems like aerophagia or clostrophobia, enabing EPR is preferrable to dropping your pressure from 16 to 13 for comfort reasons, as the pressure you need is the pressure you need. If we were all robots, the ideal treatment would be the ideal treatment and we wouldn't use comfort settings at all. Every one of them sacrifices "ideal" therapy settings for intangible things like you not breaking your machine with a sledge hammer!
Hello from Canada. I am a long time CPAP user and I have a question for you. Since your pressure requirements change on almost a daily basis, why don't the doctors automatically put their patients onto auto set machines instead of fixed pressure units. I have a ResMed Air Sense 10.
That's a great question. I personally believe that it's because if they put the patient on fixed pressure the patient then has to continuously come back to have the pressure checked which means more consultations, more reports and essentially more money for the doctor. Not all the time but for the vast majority of patients this is the reason. Cheers
@@CPAPReviews I don't know what the market is like in Australia, but in Canada I can say this is not generally the case. There are pros and cons to both fixed pressure and automatic CPAP. Many people do better with fixed pressure. A fixed pressure is generally set after a trial period of a couple weeks in auto so there are lots of nights of data to review and it is based on the average and 90th percentile of pressure, not the maximum. These pressures are much more regular than the nightly peak. Follow up is done to confirm that the AHI is still well treated with the fixed pressure and patient is comfortable. In many cases auto can work great, but in others, a rapid pressure changes can cause arousal from sleep, mask leak and in patients with heart condition lead to central apneas and CSR.
What machine was all of that data coming from and how do you get to it? We get limited info on our screens and be nice to see what’s happening throughout the night. I have an Airsense 10.
G'day mates If you use a ResMed AirSense 10 or 11 you can now register for a free www.sleephq.com account. It's super easy to upload, review and share your cpap therapy data. We're adding new CPAP machines to the platform every month so join our mailing list and we will let you know when your CPAP is compatible cpap.review/sleephq-newsletter
Hello I just joined the SleepHQ group and am loving it. Looking forward to the comment section being up and running. Thanks for all your doing, and your honesty.
I'm a Retired Registered Respiratory Therapist, (RRT) I helped start a sleep center in 1997 & worked there until 2010. I'm looking forward to being in this group, and thankful for it.
Nicko, you were one of my mine sources of information. I remembered when I was diagnosed with Sleep Apnea my doctor prescribe me the pressure to be 13, I woke up every day feeling like a balloon, a lot of air in my stomach, farts, was really uncomfortable, I watched the video where you said that we can regulate our pressure until you felt comfortable and your values were ok, I dropped the pressure from 13 to 8.5 day by day, i changed my mask too for a nasal pillow, leakages dropped too. I wake up every day feeling amazing and without feeling like a balloon and less farts lol. My doctor check the values related of apnea episodes and they were great. Regards from Argentina Nicko.
Man I love the fact you are educating people on this thanks for sharing.
Hi there, i think it's good for people to know. Gonna save them a lot of time as it's a pain in the ass going in for an unnecessary night in the lab. All the best. Nicko
The data these machines put out is amazing
This is completely true I got a home sleep study and they went the lazy way of making it so i had a huge range 6/25 ps4. And suggested a full face mask. Felt like every time I was nodding off it would ramp up the pressure and blow off my face and blow me up like a balloon. Also when I asked if there was a setting to reduce the pressure they didnt give me any useful information because I didnt buy the Bilevel from them just said to ask the people I bought from.
Found your channel and a few others and started piecing together what really would work like if you understand how to min max in a video game thats exactly what I did and it worked.
I was at 99 apnea events a hour down to .5 now and thanks to your video on pressure and figuring out what reslex and the other settings do to soften my sleep.
Thank you Niko.
Thank you so much for explaining all of this. I have never had anyone involved in my medical care explaining any of this. This is truly eye opening.
Pressure requirements even change with body position. Only auto cpaps should be prescribed. Teach us to self-titrate at home. Heck, if diabetics can determine how much insulin they need, there's no reason we can't dial in our own pressure regime.
Only auto? Absolutely not. In my experience most people don't even notice the difference between auto and a properly set fixed pressure machine. Fixed pressure can also resolve many of the issues caused by an auto machine. There is a use case for each of them and knowing the difference is important.
@@td6576 First, good data-capable auto machines help you dial in your data faster at titration than a single pressure machine. It's the best way. Why suffer over months of slow single-pressure self-titration when you can do it in weeks with a decent auto? Even if you do eventually end up with a single pressure, it's easy to make the auto emulate a single pressure machine. It's totally flexible. Second, I question the anecdotal suggestion that everyone does better on straight CPAP. I did terrible on a crappy Respironics for over a year before I switched to a Resmed auto. It was a gamechanger. My AHI plummeted. It's not like I have a drastic difference in my upper and lower pressures, but that slight difference accommodates me better at different positions. I suspect the only reason why some champion single pressure machines is because they're sold/rented cheaper. That way medical equipment suppliers (DME's) make a better return on investment because health insurance pays the same for a cpap as an apap, even though the apap is more expensive. The US system of healthcare is messed up, and sleep medicine is directly in the crosshairs of some vampiric DME's who want to make the fattest ROI, regardless of the needs of their patients. Same with cheap crummy nasal masks.
@@LaughterOnWater titration should be done on an automatic machine before a finalized prescription for ongoing therapy is signed. That would just be silly on a fixed pressure. Figure out your needs before commiting to purchase of a machine.
Reread my comment and you will see I never said "everyone" I said most. Meaning more than half. My anecdotal evidence is based on the hundreds, if not thousands of therapy titrations I've conducted.
In Canada, insurance companies usually set a limit which would cover an auto machine. Service providers make about $400 less profit selling a fixed pressure machine in order to save people money. Why pay extra for auto if it isn't something youre going to use. In many cases, auto can be problematic.
@@td6576 I suspect we mostly agree and that we're simply arguing semantics. Nick's video segment seems to suggest a prescription for pressure is less helpful than simply teaching users to self titrate. A single night of titration should be viewed more as a starting point than a "prescription". Also, losing weight, getting sinus or throat surgery, differences in diet... all of these things can affect required titration. Going to a sleep specialist for something like this is like a diabetic going to a specialist every time they dose. _Stuff changes._ CPAPers should be trained to determine their own titration to save headaches and stop the needless office visits. In this instance, I agree with Nick. Give us the tools to empower ourselves. The cpap should work for _us._ We shouldn't work for the cpap.
Thank you for all the great information. I've learned so much and improved my therapy thanks to you.
Hi Lynda, i'm certainly glad to hear it. You're very welcome. Best wishes. Nick
I had a lot of mask leaks on my nose mask and I found the flimsy straps were stretching. A new head strap cost $70 so I made my own out of leather with an easily adjustable bottom strap ( which I tighten after putting it on ) works really great. I have a S9 machine and bought a Air Sense 10 because the " motor has exceeded hours" came up on the screen. Since then , after watching all your videos I am confident that I understand these machines better and know what I need if I have to replace it again
They are excellent devices, I did my first test 2011and it was the first time I slept 8 hours straight (during the test), since I can remember. Had nose damage at about 5 years old and now at 71
Thanks for you great information
Most useful video on CPAP, explains why I was waking up tired for over 1 year with my previously set pressure setting. Luckily I replaced it with and auto setting machine without the sleep study. Thanks for the video.
I agree 1000%
They had my machine set at 6 - 15. 15 us insanely HIGH. and I have adjusted mine to 10 and I sleep well. Recently had an upgrade to airsense 11 and I tried to explain that 15 was too high, and she gave me some BS speech about what the prescription is. I'm sooo happy to find how to adjust my own settings.
I totally agree with you. I just had a titration study and it was terrible. I only had 2 hours of sleep. Thanks for the information when I go see my doctor. I really love your videos. Thank you for making them.
Thanks Ruth, glad you're enjoying the channel. Best wishes. Nick
Been on bipap 20 years the last 9 on auto. Big difference! I wish everyone had auto. But other than new patients the studies would be unnecessary. Right? My Dr told me that a few years back. Great info as usual. You're appreciated. Bless you and yours.
Hi Penny, great to hear my friend. Yeah PSG studies are fine for new patients but once you a CPAP i don't feel it's necessary to go back into the lab every year or so to get the pressure update. It's just a way the hospitals / labs / doctors keep clipping the ticket and making money. Cheers for the kind words. Nicko
I had a one set pressure at one point. Felt like I was starving for air after a few months. They reset my machine to a range now. I rarely get to the max unless a strap comes off, but I do use a range most every night. Everyone should be able to have the range. Blessings!
I agree %100. I purchase an APAP and the average pressure it delivers is about half of what my CPAP was prescribed. 4.5 rather than 9.
I did two sleep studies each about eighteen months apart. Reason I did two was I lost my job and could not afford the machine. The second time I bypassed the specialist as it was going to cost $385.00 for a fifteen consultation. So Rude. So both studies cost me over nine hundred dollars. Yes I know they saw me coming. But I did buy a machine, I took my results to where I bought it and they explained the results for FREE! Now I have found Nick, I am learning so much every single time MATE Thanks so much.
Thanks so much Nick. I started my therapy in August. Feeling so much better. Using ResMed Airsense 10 Elite. Thanks for your videos mate 🇦🇺
You're welcome mate, glad to hear it. Nicko
I only got one night of sleep test which I thought was not long enough, I was told I only had apnea when on my back but the machine tells a different story! As I have no contact with my sleep specialist your channel has been a God send for me, thanks Nick for all your help.😁
Greetings Nick, great information. It wasn't until I was put on a Auto CPAP machine and educating myself with SleepyHead, now OSCAR that my sleep apnea found a better equilibrium.
Glad to hear it brother. Appreciate the support. Nicko
This is true. When I went in for my setup at the sleep center they had my pressure cranked up to 18. I had a problem sleeping because the pressure was way too high. When they gave me an auto adjusting CPAP they set it between 12 and 18. After 1 year they looked at the data and found that the machine rarely went over 14. Now my machine is set between 10 ad 16 and it averages out around 11 or 12.
Is it Philips?
@@NoughtVun my first machine that I am referring to in this comment was a Respironics 'M' Series. This was back in 2007 so it may have been before Philips bought Respironics. I now on my second Resmed Airsense. I got the Airsense 10 in 2014 and I just got the Airsense 11 in February of this year.
I only went in to the VA once for the sleep study and they prescribed my max to 25. Way too high. All kinds of side affects. Thanks to your channel Nick, I’ve learned how to adjust my bipap machine to Max 19 and still keeping my AHI below 4. Thank you!
Omg...did you have to dislodge a sock from your airway?
That's epic man! 19 is still damn high, you sure you need that much still? Cheers
Great info! I use the Oscar program and I'm trying to get mine and my wife's machines tuned in. Mine was set on AUTO 5 to 20, but I remember seeing a printout on my machine a few years back showing my max pressure was hitting around 16. I turned mine down to 16.6 and after finding a good SD card I'm waiting on a week or so of good readings.
Nikko, I appreciate your help so much…. Thank you…. Btw, I hope your family is doing great!!
My experience is you have the study, it’s miserable, they start you out low to prove you still have sleep apnea, causing a lot of events, then they play with your pressure all night causing you to wake up a lot. First two studies I got a machine never heard from the doctor again, ever for years! Currently I’m looking at a third night because they say in two nights, they don’t have enough data. So I bought my own auto set and I’ve been able to tweak it enough to get a good nights sleep, following some of the suggestions in your videos, and am learning to use your software.
I had a set pressure of 14 initially - and was exhausted when I woke up. Another sleep doc (second opinion) asked if I'd tried auto CPAP? So she recalibrated my machine and EUREKA! Now I feel great when I wake up - just with that switch to auto CPAP made the difference! Experiment, my friends. Try different types of masks until you're happy, don't let a doctor tell you you're "fine" if your AHI is acceptable. How you feel is MORE IMPORTANT. I agree with Nick - be your own health advocate.
Hi there, great comment. I think what i liked most was 'experiment my friends'. That's the best thing about cpap therapy! It's very very easy to try different settings and then monitor the changes both with data and also how you feel too. Cheers
It sounds like I was lucky to have a good physician. When I got my machine I spent 1-2 months using it in auto mode, the top being something I was not expected to attain. When I had the longer time data they lowered my upper bound, but wanted to lower it to what had been seen as a max. I asked if they would leave a bit more room at the top while still using the slow ramp up and my physician quickly agreed!
When I first started using a CPAP I quickly worked out I could experiment with my pressures to make things work for me. I found I needed to modify my start pressures and the ramp and initial pressure I found was too low. Definitely learn how to use your machine.
I hv an BMC luna G2 auto cpap, I found that even with the auto mode on, it doesn't provide the best pressure for me. I hv to manually set the min and max pressure to my own preference.
Valuable information! I’m going on for a sleep study and trying to learn all I can! Thank you Nick!
Nice one! Good luck my friend. Nicko :)
Thank you Nick. We are being so messed over by bad business. Medical privacy laws have so many loop holes it is a joke too. Wait till you turn 65 and get all the sr cit mail bc they all have your birthday...makes me sick!
Thanks for the information. I learned from you how to change the pressures and wow I reduce my pressure and am getting longer better sleep than I ever got with the pressures the doctor set up. First night I tried to set my pressure I went up from 13 to 15. On a bi pap and 8 on the exhale. I started to skip breathing and ahi went to 19 in two hours of sleep. Having to much pressure really caused more problems for me. I reduce the pressure to 6 and 11 and have had the best sleep I have had since I went on the machine. Your information is priceless. Thanks.
I finally had a sleep center titration test. It was great! The at home test didn’t work, received the cpap machine after waiting 5 weeks and found it doesn’t work for me. They tested the bipap. Much better. Let’s see what happens once I am on my own with my new bipap!
With auto machines, we are doing the sleep study every night at home! This should be an over-the-counter product. I bet if the market was freed up that box stores could sell these things for $100 for the machine. Some plastic, a small air pump, a microchip board.
Hi Carl, i think you make a very valid point mate. Here in Australia they are over-the-counter however the prices are still very very high unfortunately. Cheers
After the 3rd Sleep study in 2 years, I figured this was just a upsell. I also knew that no useful info could be taken from such a poor untypical nights sleep (if you want to call it sleep!).
Hey brother, not an 'upsell' as much. More just an unnecessary test and profit making exercise. The lab get's a fee, the hospital get's a fee and the reporting doctor gets a reporting fee and normally a consultation fee to discuss those results. Cheers
@@CPAPReviews my sleep apnea dr has been useless. told her I never gave permission for text msgs on my phone telling me I had not used it enough in a night. I took spy chip out of machine. works just as well
Yes had that lab study about 5 times never again hard plastic pillows rock hard bed head full of glue and cold impossible to sleep when you do staff wake you to make some small adjustment best thing to do is learn how to operate every part of your machine and understand how to change settings my best find preheat the water to avoid a dry mouth using distilled water ,thanks for sharing 👍
Nice one Kerry, glad to hear it. You're welcome. Nick
My experience as well, you speak the truth. My titration study was completely wrong because it was based on minimal data points. Luckily I had self-diagnosed and started self-treating
8 years prior, so just adjusted my BiPAP to where it ought to be.
You are a genius. Wish we had met you years ago.
I really appreciate the way you explain all of it.
I only had a home sleep study and they set me 5-15. I didn't even last 10 minutes on that setting and changed it to 8-15. After a few months, I finally looked at my data on Oscar and my machine stayed around 15 most of the night so I raised it to 11-20 and have had no issues.
Excellent work Nick. I have been following your information as a subscriber
Ooops sent it too soon. I have found everything helpful even though many hints I have already arrived at through trial and trial and error. Please keep the hints coming mate.
Thank you Nick for the great video.
Thanks brother. Glad you liked it. Nick
I went in for my sleep study and was chatting with my tech who was wiring me up, a really nice older lady. Near the end we were talking about the people who work there and she mentioned a man who worked there who enjoyed watching women sleep and things he would say about them....and then Good Night me, enjoy your sleep. Needless to say I did not sleep and was told the next morning that I didn't have sleep apnea. I was like, I couldn't sleep for thinking about the pervert behind the cameras! She quietly told me she could fix my paperwork and to just get an auto CPAP, that should fix it. This was a few years ago and I am still paying off the thousands it cost me for that one night in hell. Sleep studies are full on BS. My health improved noticeably after a few months on my CPAP that was fixing my sleep apnea that I didn't have because I didn't fall asleep while being a pervert's personal cable channel.
When my dr pisses me off I fuck with them and play with the pressures 😂😂😂
Nick, thanks for another great video. I visited a new sleep doctor this week and learned more about CPAP & BIPAP in one visit than I have learned in eleven years, Your video really enhanced what I learned this week. I have an AirCurve BIPAP this is set on automatic, and I will review the data like you showed. I agree with you on a one-night test. I am a light sleeper and even with Ambien, barely made it through the six hours required by Medicare.
Is that program available to the public? Once upon a time I had a bootleg copy of the ResMed analysis program but lost it.
My auto system goes from about 9 to 12 depending. 12 If I have a few too many adult beverages or if I sleep mostly on my back. Makes sense because if I sleeped on my back before CPAP, I'd get an elbow in the ribs from the Misses. Since CPAP I have not snored once aparranly.
The other benefit for me. I never got diagnosed with sleep apnea but got machine for snoring, after using it, I'm 100% sure I have apnea. The reson for not getting sleep study is I'm now treated but I'm not getting monitored. Even though I have not failed to use the machine once I'd rather not be monitored.
Adjusted my own pressure from original pressure of 17-19 2 years ago. At a self adjusted pressure now at 9 my AHI over a two month period is 4.75. . (in fairness i must confess. I lost 80 pounds. At 18 my mask kept blowing up. The 18 was set from a one night in lab sleep study.
I just had a cpap titration at the end of last month and ended up with a pressure of 20 after having an in home study with an ahi of 114 and my blood oxygen level dropping to 57%. I actually just got my cpap today, the resmed airsense 11, so I'll have to see if it seems good over the long run but the morning after my titration I felt amazing.
Most folks, like me, don't know enough about it to fiddle around with pressure levels. I've struggled through years of aerophagia by adjusting my machine. I got sick many times as I couldn't figure out what was going on. I thought it was a cleanliness issue as I could clean my mask etc or change to my old machine and it would go away.
Hey mate, great point you make. "you don't know enough to fiddle around with pressure levels". That's why i made all the videos so you can know enough as many viewers will testify. It's not like trying to learn some crazy complex super computer. It's no different from learning how to adjust the humidifier up or down to increase or decrease the moisture. I'm sure if you took 30 minutes out of your day you could give it a go and i think you would be surprised. Cheers
@@CPAPReviews Thanks. I did enough research/youtubing to be dangerous to myself and I'm fairly competent on electronic gizmos. I was a electronic tech for 30 years :( . Apparently I had a blind spot when it comes to aerophagia!
I never heard of it till my ex looked up burping and cpap. What a relief! :)
Now I know!
Never in my 25ish years of wearing a cpap had I heard of it. Please tell me you've covered aerophagia and the causes in your youtubes and let me know where to find it. TY in advance!
Keep up the great work! Millions of us need more info.
Hi mate, sure here's a little info on Aerophagia and a few things you can try - czcams.com/video/3dBNUxeasTs/video.html but really most cpap side effects are the result of incorrect pressure settings (most of the time too high). Cheers
@@CPAPReviews Thanks. I've since lowered my pressure 6 or 8 months ago from 14ish to 10 or 11. I don't recall seeing AHI numbers but I've only seen resmed data. Where do I find that? Sorry for the annoyance but thanks again and I will be donating :)
Edit: I found what I needed I think. I'm in the middle of getting approved for an auto machine from resmed soon so I should be okay.
I tried to donate on paypal but not sure it went through. I'll verify and try again.
hi Nick, Great video, I would like to learn more about how to understand the readings to be able to adjust my pressure correctly. I am a paid member with special privileges. with a Lowenstein prisma smart max. I completed your academy. maybe i should do it again. Cheers
Of course my provider set the pressure at 15 and of course it was too high. First CPAP month I was miserable. Almost quit entirely but I did notice a marked difference in my wakefulness during the day so I kept on. Thanks to people like you on YT, I learned to access the clinical settings. I now set the pressure at 9 or 10. My AHI is less than 1 (usually .2 or .4) and I can actually sleep comfortably.
Bingo 😁 I've said this from day one but my doctor's call me nutz 🤪. So many variables considering sleep positions, stress, sickness and even if you took a shower prior or not. 👋😎👍
Nice vid Nicko! PAP forums and PAP vloggers such as your self do have a huge influence towards folks who are curious or yearn for improvement; I am both. Unfortunately the deluge of information out there compiled with key-board warriors and self proclaimed 'know-it-alls' add the to mass confusion. i.e. LeakyLefty (Jason) recommends a steady 'fix' approach to therapy vs. your video example; respects to Jason, but it creates confusion to most. For me, I experiment (but that's me). Some months I go Auto and some months I go fixed (influenced by Jason). There's benefits to both... and there's no 'one' correct or precise approach. The question is; am I getting optimal sleep? Answer: for the most part 'yes'. Has my sleep improved in the past several years? Absolutely. But thanks to diet, exercise, a keen 'frame of mind' and other factors... + PAP, my overall well being has indeed improved. PAPing is one part of a larger scheme to optimize sleep and life.
Great comment mate, i think it's good to have a number of opinions like all topics and the best thing about cpap therapy is it's so easy to try these options, look at your data, see how you feel and then keep working at it. All we can do is provide you with some techniques that have worked for us over the many years of working with patients but at the end of the day everyone is different and everyone has to find what works best for them. Mask, Pressure, Settings and like you said.... It's only one part of a larger scheme. Cheers
That's awesome advice, thanks, Nick! Thanks!
Every one you are right 😅
I've seen you reviewing the Z2. I have a Z2 CPAP, not an auto CPAP. That really doesn't make any difference I think as to what I am troubled by. When I check my sleep data in the morning, I never see any a h i readings. Now I know from past use of Auto machines and CPAP machines that my AHI, while low, is never absent. Can you please tell me what might be causing the lack of AHI data. I'm using Night Log to see my data. I 'd be very grateful for any help. I have contacted the manufacturer of the Z2 and the company that sold me the Z2. I haven't heard from the manufacturer and the company that sold me the Z2 doesn't even understand that there is software that is supposed to read AHI. And I totally agree with you that sleep studies are a farce. You didn't use the word farce, but I think they are bogus, at least. I have been on CPAP since I was 69, and I am now 85. When I first started using CPAP, I was given a constant pressure machine set at 6 çm. I did my own sleep study, varying the constant pressure over two or three days at a time and looking at it my ahi only encore software. I ultimately selected 9 cm. Later when I got an auto CPAP the software confirmed that 9 cm would be a good constant pressure. So, I am not new to this CPAP business and I just don't understand the Z2 data.
Hey Jerry, the nitelog app isn't the best. Have you tried using the PC data viewer? Cheers
Nick - I'm a fairly new subscriber from the US. I have received a lot of help (none from my sleep tech as they are focused on AHI and usage..). One person who helped me a lot is a fan of set pressure only. I tried this and kept changing it to try and optimize, but I could never make it work and went back to APAP with much better results. You may have already discussed this, but I would like your thoughts on APAP vs CPAP, pros and cons of each as I can't find the cons of APAP, but I am sure there must be some trade-offs.
Hey mate, that's a great idea! I will definitely do a video on this :-) All the best. Nick
Thats one thing I liked about the "machine we dont speak of"...my setting were 6-16...and never had an issue...Theres something different about the Resmed...I feel like its trying to blow the skin off my face...lol...Since your video on the settings Ive been "tweeking" my machine...I'll figure it out soon enough!
Hey Scott, it took me about a month for me to get used to the resmed, it felt like I was fighting machine to breath. But now all good. Had to fiddle with starting pressure and I start at 7 and have the auto set to full range 2-20 and I let machine figure settings out when i fall asleep.
@@bencahill3547 Thats usually when I have trouble...when I fall asleep...Im good until then...lol
Ben Cahill, I came from a Phillips Dream station that just worked great for me. I found that I was quite aware of working to breathing as I was falling asleep. I got my tech to turn off the ramp, and bump up the starting pressure. Much better now.
Haha " The machine that shall not be named " Glad to hear it Scott. Yeah they all have different algorithms that determine the pressure changes. With a bit of fine tuning though you can normally get the same results across the board. Cheers
Between you and Jason I think we will figure this out!
Thanks Steve
I highly suspected I had apnea after many years of symptoms. After my initial sleep doctor appointment, but before I had the home sleep study (thank you crap US health insurance), I was given an AirSense10 AutoSet by a family friend. They bought it and had barely used it before their supposedly unfixable underlying condition causing mixed apnea was fixed. It was set for APAP mode and I gave it a try.
After a few nights it was averaging a pressure of 11.8. My full overnight study and CPAP titration ended up coming back with a pressure of 12. If I hadn't already met my insurance deductible and had to pay the full ~$875 for the study I would have been pissed.
I did change the machine to CPAP mode at a pressure of 12 though to be a good patient. They want 6 weeks of data at that pressure for my followup appointment next week. I'm going to insist the prescription be updated to an APAP one though because I definitely slept better in APAP mode. I'll still switch it back to APAP even if they refuse. I don't plan to stay with this doctor anyway, and I can at least buy a replacement APAP with a CPAP prescription here should this one die on me.
Truth for the majority of OSA patients. However I think it would be good to clarify about complex sleep apnea and central sleep apnea. Those types of apneas can't be fixed with simple auto titrating CPAPs or even bi-level devices. A sleep lab titration would be the only way to fix patients with complex issues with servo ventilation. Most insurancees will require a titration study with the diagnosis of central sleep apnea and complex sleep apnea to do this.
Yes mate this is true. Useful for more complex cases 🍻
Makes total sense! Thanks
Glad you think so Rhonda. Have a great day. Nicko
I can call my doctor or machine provider and they can view my readings on a regular basis. My machine records all the time when I use it... so the air and other things can be adjusted as needed. So its not just based on the sleep study
That's kind of my point! Why would you need a study if your machine already records all the information required. Cheers
@@CPAPReviews well thats easier to answer. You need the study to prove to the insurance company that the machine is needed. I dont know about anyone else. But I didnt have a machine until i had the study show that i even needed one. Are you implying people have machines and then have a study?
To me, the stranger thing is that insurance programs, sleep physicians and respiratory therapists don't monitor changes over the years and adjust treatment accordingly.
I'm on a aircurve 10 ASV. It's a rare night when I get a good nights sleep. The machine will blast me awake with pressures of 17+ when all night it's been around 10. Not sure I can take this much longer. This BS that I'm going to get a great night's sleep seems to be a sales pitch from Resmed. I learned how to change the settings(no thanks to my gutless respiratory therapist) so I continue to make subtle changes. I go in for my 4th sleep study. They all agree I have central apnea but what to do with it. Thanks for the video, I'm going to make more changes tonight.
Hey mate, just drop your pressure max level. Bring it down to a level you're comfortable with. There's absolutely no point in using the machine if it's disturbing your sleep and quality of life. The RTs have no idea mate. They've never even spent a night using the machine. The whole industry is fucked. You gotta do what's right for you
@@CPAPReviews LOL...I couldn't agree more. After 3 sleep studies it's been more than difficult to find anyone who understands what's going on. Fortunately I'm going in for sleep study #4 and the PA seems to care if I sleep well. We'll see.
I wouldn't lie, I am bit cheapester.🤣🤣. After some studies instead of doing spending like $250 for therapy. I bought a used auto machine in really good condition and less clinical hrs for a good price. Coz what i found all those studies give you auto machines too to have ur data. Howz that different to doing urself when ResMed gives you same data through there app.
Well now thanks to Nick, your video's helpful in a way to adjust my pressure settings. Recently, bought pillow mask. Wished would have bought it a while ago,, i things it better than full mask for me. Thanks to BMC for reasonable prices for there mask and quality is as good. 🙂
By the way, what software you using there for full data analysis..☺️☺️
nothing wrong with getting a bargain mate. Cheers
I think I must have an auto because the pressure seems to vary during the night.
While I don't totally disagree with a lot of what you say, part of the reason I subscribe to your channel, I think calling over night titration somewhat of a scam can be dangerous. APAP's can be a good thing for many people but for obese people with obesity hyperventilation, people with neurological disorders like MS, Parkinson or Muscular Dystrophy, many pulmonary issues and CO2 retainers an Autoset can be severely compromised in it ability to accurately titration someone, pressure cycle or adjust to fast for their body to tolerate. I agree for completely health individuals not much of an issue and Oscar can be a great tool, but many don't know how to interpret the actual flow information and with out an effort channel hard to absolutely call central apnea central even with the fast fluctuations of pressure ResMed uses to try to gauge if an airway is open or not when it sees an apnea. That is why many of the above medical issues are currently not able to use Home Sleep Testing, at least here in the USA, at home along with Insomnia, Periodic or Restless Legs, Rem Behavior Disorder, Complex Sleep Apnea, Etc. Followed by Autoset. Unfortunately we see many Primary Care Doctors and some Insurance companies not understand this and many of the repeat testing and Titrations we see in lab here in the states are people put on Autoset with the above issues and either sleep extremely poorly due to the combination of these health issues, the Autoset and sometimesthe wrong mask for the patient.. I myself sleep much better on CPAP than when my Autoset is on Autoset but have found the combination of Oscar and the Autoset to find a good pressure after gathering information over several nights, generally a week, and then collecting information again for a week or better at different pressures. So I appreciate your view but with certain limitations with certain parts of the Sleep Apnea community with certain health issues or sleep issues that need to work closely with their Sleep Physician and Sleep Tech and even some normally healthy individuals if they are having issues that they have not been able to figure out on their own. Like I said I love your channel and look forward to your future posts but just thought that some might take this information and run with it when they need other modes like BiPAP, ASV or EERs to help them above and beyond CPAP or APAP.
Definitely a scam with insurance. I started out with bipap but kept having issues with centrals. In my case I was suprised the sleep lab titrated me correctly as a trial of lowering my pressures increased my ahi. My sleep doc just wanted to order me an asv and adjust based on what my machine reported. Unfortunately because ASV cost so much my insurance required a third sleep study. Kinda puzzled because it is actually going to cost more with the extra study. To make things even better insurance pre-authorized the study then rejected the claim afterwards.
Hi Shawn, yeah i'm still trying to figure out where insurance fit's into this equation. We have a different system here in Australia. I'm sure they're probably dodgy as well though. It's a little bit different when it's more complex OSA. Probably more need for lab testing etc. Cheers brother. Nicko
I don't know if this changed, but ResMed were totally against anyone messing around with the settings on their machines. (Once to the point of almost being abusive. Got told how they considered their machines like their children. I kid you not!)
My CPAP pressure was set perfectly.They just set it to TYPHOON.
Haha, thanks for the laugh John. Cheers
I didn’t know auto machines existed. I’m on a bipap which is part of the recall by the way. Are there auto bipap machines? If so, how do I get one?!
Hi there, yes there are Auto Bipap Machines also. You get one by buying it or if you are in the U.S you can probably get one through your insurance etc but you will need to speak with your doctor about it. Cheers
ive been fighting with my doctor on this he keeps trying to get me to come in to one night and
im thinking their going to get it wrong i don't need someone screwing with my airway . its maddening and sleazy messing with my lungs that way.
Thank you so much. I started my auto CPAP resmed but I can not get in to see my doctor for my “30 day follow up” for 3 months. I am getting no help at all. So frustrating. Your nasal pillow lesson helped too. I need to turn my pressures down!!
Hi Michelle, you're welcome! Here's a video you might also like to check out on pressure adjustments - czcams.com/video/pL4egwDrvbg/video.html . Best wishes. Nicko
I set my S10 to auto because the high pressure kept registering as high leaks every night. I too found that with auto, there were fewer events at a lower pressure. I always wondered if doing this was a mistake or not.
Nicko from CPAP Reviews did a video on this on youtube called: CPAP Pressure! Too Low, Too High, Just Right. How To Adjust Your CPAP Pressure Levels
Here is the thing,, I just figured out myself. Full face mask with high pressure will have more leak.. why? I believe coz when it starts leaking, machine thinks your not breathing, sends more pressure causing more leak. Also, if your EPR is not on, that means while exhaling, machines pressure is still pushing air. That causes more leak.
I just changed my mask to nasal one, changed my pressures as seen in Nickos one video. And having EPR settings on. Seen the difference with nasal pillow in 2 days. Which haven't seen in like a year.
@@humbalshah The machine can tell the difference between a mouth leak and an apnea event, Flow is not the same as pressure, If you turn off EPR, your machine will still monitor your breathing and will still not pump air while exhaling unless you have Cpap enabled. If you're having leaks with almost any kind of mask, it's a fit issue (or a mouth seal/chin fall issue) not a mask style issue. Some masks won't fit. That's just the way it is. Full face and hybrid masks are fine with high pressures. If you test your mask at whatever your max pressure is and have an appropriate fit before you go to sleep, you won't cause leaks when the pressure ramps.
Since auto machines seem to respond to flow limitations retroactively, and only increase the pressure after an event happens, is it therefore unrealistic to expect a 0 AHI while using auto? Or maybe there's some other factor I'm not considering. Obviously "don't let perfect be the enemy of good" and all that, more curious than anything.
Personally, I don't care for the auto titrating setting. I feel more well rested with constant pressure. For the past 15 yeas, I've been at 13 and it works great for me. Average AHI is now 1.41 when first diagnosed it was over 50.
Most dr set a range mine was 9-16 but working with lanky its now set to 11 steady. It's sad how terrible so many sleep dr are to just not care.
Nice one man! Glad to hear you're getting some great results with the help of old mate Lefty. He's a good egg that one. Cheers
I had one sleep study. i did not sleep well at all. i have often wondered whether i didn't actually need a machine. I can't sleep without it now, and i snore like a freight train without it. I bought my machine from someone other than my "specialist" so have not had someone analysis my data in over 3 years, i set my machine up to auto myself. I haven't tried going to another specialist.
thank you so much for this!
You're very welcome mate. All the best. Nicko
I always thought that the cpap pressure was set to a level so you don’t have an apnea episode.
How do you get that info? I have the Air Sense 11. Pressure is set at 11. I had 131 events at the study prior to the CPAP therapy part. My AHI is all over the place. Highs around 25s and lows of 3s. Id like to see what goes on through the night.
I am a new CPAP user and have the ResMed AirSense 10. Am getting great results but would love to be able to access the detailed charts that you show on this video. Are they available to users and how would I get them. Thanks again for all the terrific content helping me understand this new world.
Hi Rick, glad to hear it! This is open source software called OSCAR - cpap.review/oscar . Works well with the AS10. Cheers
And what is ramp-up all about? To lay there waiting for it to get from 4 to 7 is just wasting my time, as I could have fallen asleep in that time. I cannot fall asleep in that time, as I am waiting for the machine to reach a decent level. Probably in my mind, I am a new user? I probably have to watch the 3 part series again. I have turned ramp-up off, auto on, range of 7 minimum (Start at 7) to 16 and epr of 3. Mistake?
Moral of the story, buy an auto machine that works with Oscar so that you have access to the data if you ever need it.
I think that's a pretty fair summary ;-). Cheers
So should we all be on APAP ? I am on Bipap currently. Is APAP the way to go?
Can't you tell if your fixed pressure is right by reading the AHI's when you wake up? Lets say you get AHI's around 0.5 to 2 per day, wouldn't that indicate your fixed pressure is good?
When I did my titration in a private hospital overnight, I used a sleeping tablet to keep me knocked out. I looked the the charts on a couple of large screen computers and was amazed at the detail taken to tune your pressure in to suit. My sleep doctor told me that I responded better than most through CPAP for my sleep apnea use, the apnea count being quite high.
Thanks bro 😅very helpful information ℹ️ ❤❤❤
I love your videos as they are always really educational and empowering, but for me they are also incredibly frustrating to watch knowing all the data a cpap machine actually records and the functionality they have, and yet my sleep specialist has taken the decision to lock off everything on the airsense 10 auto so I can't see things like the AHI score or use a humidifier. I can't even turn the Wi-Fi on and off, FFS!
The Airsense 10 doesn't have a wifi card installed by default. That's something extra you need to buy separately and has nothing to do with your doctor or sleep specialist. If you flip your machine over, there's a square "battery cover" type thing on the bottom. That's where the Wifi card would go. Generally speaking, there is nothing that a medical supply or prescribing physician can do to "lock off" features of your device that you cannot undo. There is no "god code" menu that would allow you to enable disable features in the way you're describing. There's a theraputic menu, but that's pretty easy to access and is only meant to stop people who don't know what they're doing (children and children who shave) from messing with the settings. AHI score should be available under "reports."
Thanks mate. I've learned a lot about my machine since posting my earlier comment, and much of my frustration was due to not being told about how to access the data, something which I now know how to do. Thanks again for taking the time to reply.
i have been using a ResMed Escape S8 for 15 years which has ramp but only a constant air flow pressure. I really believe I could benefit using the auto pressure feature of the ResMed Auto CPAP you were utilizing in the Video and am now considering getting one. Are the Graphs you generated available for our consumer daily in home use as well via some obtainable software or is there some way the user can see how well the machine performed to build confidence that we are the right track? Appreciate the education and comments from others. Thanks All!
Food for thought, at the very least.
I got lucky that my ideal pressure was found with my titration study since I've tried higher and lower pressures to 12 cmH2O and both cause issues. Now I have an apap set from 10 to 13 and most of the night it hovers around 11-12 range rarely increasing to 13. But again I was lucky and I'm probably the exception.
Hi mate, i wouldn't call it 'Luck' although that's a very tight range for an auto but do whatever works for you and it sounds like you're doing well ;-). Cheers
@@CPAPReviews I know, it's tight as heck. Only reason it"s not broader is because I tried it at 8 and I feel like I can't breathe at that lower pressure. 10 felt like my comfort zone tbh. I may up it to 14 just so my machine has some wiggle room, doe. I've had days where 13 was hit once of twice in the night so it certainly wanted to go a bit higher.
@@NecroBanana It's 100% fine mate. Probably get better AHI results with a range like that. Cheers
Unfortunately a lot of sleep docs set up the machine with the default APAP setting, which is too low and too high.
This is very true! That works for some however for best results it's always a good idea to fine tune the min auto and max auto levels ;-). Good call
very good info. how can i find out if my machine is auto adjustable. i have a Air sense 10. last February 2021 is when i started using it. it is set to 9. i am located in the US.
Hi Ray, just check on the front. It should say 'Autoset' If it's an auto. Cheers
Hi Nick, Great Info
I'm looking for a new cpap tech.
Do you respond to emails?
Hi mate, check out @thelankylefty27 . He's your man! I try to reply to as many as i can but it's pretty overwhelming at times. Cheers. Nicko
Congratulations on the videos. I am learning a lot. I noticed that the pressure graph has only the line in black color and as an oscar user, I can say that you do not use expiratory pressure relief. What about that? I noticed that I have less apnea after I disabled relief in my airsense10 autoset.
Thanks mate, sorry what's your question?
What do you think about the use or not of exhalation pressure relief? Should it be used or not?
@@wxdrones EPR is a comfort setting not intended for therapy. You should use it, or not, depending on whatever your preference is, but you need to remember to increase the titration pressure appropriately, otherwise you'll be under-titrated for the pressure you should be recieving because EPR reduces your pressure.
In other words, if you've got a prescription that says 6/16 and you turn on EPR 3 you need to up the minimum pressure to 8/9 so that there's room for you to cut your pressure without being out of range. Also, if your pressure is at 4 with an EPR of 3, EPR isn't doing anything anyway.
If you can get away with Cpap 6, upping the pressure to 9 and then enabling EPR is probably not the preferred option from a therapy standpoint. On the other hand, if you're at a 16 and having problems like aerophagia or clostrophobia, enabing EPR is preferrable to dropping your pressure from 16 to 13 for comfort reasons, as the pressure you need is the pressure you need. If we were all robots, the ideal treatment would be the ideal treatment and we wouldn't use comfort settings at all. Every one of them sacrifices "ideal" therapy settings for intangible things like you not breaking your machine with a sledge hammer!
I go between 11 to 19
On the two occasions I had the sleep study, I hardly slept. So I have no idea what they managed to deduce , other than the huge cost to me!
I had the same.
Would have been lucky to get 2 hours real sleep.
Hey mate, you got any problem with using a vicks inhaler before I put my mask on.
Hello from Canada. I am a long time CPAP user and I have a question for you. Since your pressure requirements change on almost a daily basis, why don't the doctors automatically put their patients onto auto set machines instead of fixed pressure units. I have a ResMed Air Sense 10.
That's a great question. I personally believe that it's because if they put the patient on fixed pressure the patient then has to continuously come back to have the pressure checked which means more consultations, more reports and essentially more money for the doctor. Not all the time but for the vast majority of patients this is the reason. Cheers
@@CPAPReviews Thanks for taking the time to read and respond to my question: much appreciated.
@@CPAPReviews I don't know what the market is like in Australia, but in Canada I can say this is not generally the case. There are pros and cons to both fixed pressure and automatic CPAP. Many people do better with fixed pressure. A fixed pressure is generally set after a trial period of a couple weeks in auto so there are lots of nights of data to review and it is based on the average and 90th percentile of pressure, not the maximum. These pressures are much more regular than the nightly peak. Follow up is done to confirm that the AHI is still well treated with the fixed pressure and patient is comfortable. In many cases auto can work great, but in others, a rapid pressure changes can cause arousal from sleep, mask leak and in patients with heart condition lead to central apneas and CSR.
What machine was all of that data coming from and how do you get to it? We get limited info on our screens and be nice to see what’s happening throughout the night. I have an Airsense 10.
That was an AirSense 10 Autoset and i was using open source software called OSCAR - cpap.review/oscar