FlyerTalk Forums - View Single Post - Using cpap on-board flight
View Single Post
Old Apr 10, 2010, 3:38 pm
  #33  
Yaatri
Suspended
 
Join Date: Jan 2002
Posts: 22,778
Originally Posted by RFTraveler
Boy, do I feel like an idiot...

I looked really close at the display, and it's 10.5 cm H2O, not inches...

Sorry...

RFT
Don't feel bad. Anyone can make a mistake. NASA lost a $125 million mars orbiter due to the same issue of conversion between metric and English units. Traditionally scientists, especially physicists, use metric units while engineers, structural, mechanical etc. are more at home with feet pounds and seconds, along with BTu's. Lockheed provided data in English units, which NASA assumed was in metric units.

Originally Posted by RFTraveler
What I mean is that, according to my doctor, my sleep issues are fairly moderate, and that the setting of 10 in H2O was fairly conservative. And, I've had friends much higher... However, since you posted I've done a bit of web searching and see that at least one website describes the average pressure for CPAP therapy as 10 cm, or around 4 inches. Guess it's time to chat with my doctor again. Weird thing is, although the CPAP does test as accurate, 10" feels really low to me...not like when I started therapy, when 10 felt like it was popping my ears etc when it came on. As mentioned above, I've actually had it in to confirm the setting.

I use a full face mask, as I tend to have a lot of sinus issues. I might be able to use a nasal mask now, but when I started, I was having a lot of problems with open-mouth...

RFT
I chose a full face mask also primarily because even if my sinuses had some issue, I would still get appropriate therapy. My respiratory therapist had set my CPAP unit to not sound an alarm if it detected a leak. I found out after a week, that my usage was skewed with 50 hours of CPAP usage, I had received only 4.5 hours of therapy, which meant the mask was leaking 90% of the time.
I then set the unit to sound an alarm if it detected a (steady) leak. I was able to find ways to adjust the mask so that there was no leak. After a few months the straps had been tightened so much that the mask left a mark on face that lasted most of the day, my neck started to hurt and the mask would still leak. My beard did not help either. The mask had to be adjusted almost every day as the beard grew. I tried nasal pillow, I guess that's what you call nasal mask. I did not like that at all. I felt that the air was rushing too fast through my nostrils. I then found a mask made by Resmed, called Activa. The air pressure inside the mask creates a seal between the face and the mask. It worked perfectly, until I got the bipap/vpap. The two nights that I have used it so far there have been many leak alerts, on an average of about 3 per hour. Changing the orientation of the face usually eliminates the leak.
I take it we are in agreement that a pressure of 16 cm of water is not light?
So the question becomes, "who is a candidate for a BiPAP machine?". In general anyone with a relatively high CPAP pressure setting is a candidate for bilevel therapy. For example, if a CPAP user is prescribed a CPAP pressure setting of 16 cm H2O, then the maximum pressure support (or pressure relief) you could expect to experience with a technology like C-Flex is a drop of approximately 3 cm H2O, leaving you with the task of exhaling against a pressure of 13 cm H2O. For some CPAP users, an exhalation pressure of 13 cm H2O is uncomfortable. For others, it's simply just not possible.
A closer look at bipaps.
When I was first diagnosed with OSA, my biggest concern was whether I would be able to tolerate the pressure during exhalation. I asked the person who gave me the CPAP if I needed a bipap. She told me that the unit they gave me is what the doctor prescribed. I thought she, as well my doctor, both were a part of the sleep lab. This past week, I found out it wasn't so. The person, who I thought was my respiratory therapist, actually worked for a vendor that the sleep lap works with, and is an approved vendor for many insurance companies. The vendor sells a limited variety CPAP units. By limiting the number of types and manufacturers, the vendor presumptively gets a better deal and is also able to, at least, claim, that they can provided a better service at a lower cost. Having a vendor rep on site in the sleep lap helps patients as they get the therapy unit and service from the same place. I wanted to get a unit that has an integrated battery with the CPAP unit but I couldn't because the vendor did not supply or stock them.
On the other hand, whenever I have an issue with the mask, I go to the sleep lab and see the therapist/vendor rep. I get to try different masks without having to buy one.
I have not found a bipap/vpap that has an integrated battery. There is a cpap with a battery though. AEIOmed makes a CPAP Unit, Integrated Humidifier, Battery Pack and DC Power Adapter for just over $500, which would be ideal for travellers as some airlines allow you to use a CPAP with a battery only.

I have noticed that swallow some air during the night. Most mornings, I announce my arousal a big burp..
Yaatri is offline