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I am currently using a responics one bipap auto with settings 8-twenty something. My ahi's are dropping but not by much, 34 to 20, since april. What happens if pap therapy doesn't work. I use a quattro fx mask, which fits really well. I tried quite a few masks but this is the one for me. What's the next step to pap?

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What does your hospital say about this Carolyn?  It seems your pressures may need adjusting before you think of giving up.
HI Kath. I am not thinking of giving up, yet. I don't like being defeated and I'm sure if I keep plodding away with it, it will come right in the end. Some people adjust their own machines, but I'm not doing that, as this is still quite new to me. I made some cotton mask liners today and I am hoping this will help with seal issue.

Settings 8 to 20 pretty much guarantee problems, maybe not so much if your 90% is 9.

If you are not prepared to adjust your machine yourself, you have to badger your clinic. Question is - do they know how to adjust an APAP optimally for you? You need an adjustment every four days while you chase the "correct" settings - which change according to you, the weather, de dah. de dah.

My advice? Learn to adjust for yourself - it really is very easy. You can get from AHI 20 to <5 in a few days, no problem.

Tigers Fan, would you mind telling me how to do changes, every four days. I have to collect a new cuchion, for my mask, next week and I could have a word with the nurse. If I show that I know what to do, they might listen to me.

Tigers Fan said:

Settings 8 to 20 pretty much guarantee problems, maybe not so much if your 90% is 9.

If you are not prepared to adjust your machine yourself, you have to badger your clinic. Question is - do they know how to adjust an APAP optimally for you? You need an adjustment every four days while you chase the "correct" settings - which change according to you, the weather, de dah. de dah.

My advice? Learn to adjust for yourself - it really is very easy. You can get from AHI 20 to <5 in a few days, no problem.

Here's the legal bit - if I tell you how to make adjustments then I am liable in law; if you know how to make adjustments I can discuss with you "what I would do in that situation" adjustments I would make. It's also about you doing some of the work, taking ownership of your therapy. I am not a doctor.

That said, if you were to Google "name/model of your machine Clinicians' Menu" it should not take long for you to discover the "how to" of making adjustments - it's just button pushing. If that doesn't work, go to most any American CPAP retail site and nose around your machine and pretty soon it will reveal the "how to".

Once you know "how to", I'll be happy to discuss what I would do to improve my AHI if I were in your position.

Something else that would hugely help in the adjustment stage is knowing what your 90% pressure is - or 95% in some makes. It's one of the readings recorded by the machine in the Clinicians' Menu if not the Patients' Menu as well.

Thanks Tigers Fan. I will have a look at Google. What does the 90/95% mean? I have seen this while looking through the menu.

Tigers Fan said:

Here's the legal bit - if I tell you how to make adjustments then I am liable in law; if you know how to make adjustments I can discuss with you "what I would do in that situation" adjustments I would make. It's also about you doing some of the work, taking ownership of your therapy. I am not a doctor.

That said, if you were to Google "name/model of your machine Clinicians' Menu" it should not take long for you to discover the "how to" of making adjustments - it's just button pushing. If that doesn't work, go to most any American CPAP retail site and nose around your machine and pretty soon it will reveal the "how to".

Once you know "how to", I'll be happy to discuss what I would do to improve my AHI if I were in your position.

Something else that would hugely help in the adjustment stage is knowing what your 90% pressure is - or 95% in some makes. It's one of the readings recorded by the machine in the Clinicians' Menu if not the Patients' Menu as well.

You spend 90/95% of your sleeping time at or above this pressure. To begin with, I had to think hard as to the relevence of that figure but soon saw that it is key to knowing the pressure settings needed and more importantly, it is an index of the efficiency of your therapy.

If you are at AHI <1 and 90% 15cm and then we tweak and adjust and achieve an AHI <1 and a 90% 12cm, have we improved or worsened your therapy? Also think of comfort at lower pressures.

What is your 90% at the moment?

Thanks to all of you for not posting the secret handshake in an open discussion. It could one day prevent me from participation.

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