Frequently Asked Questions: (Last Update 9/18/07)
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Sent: Wednesday, May 16, 2007 7:48 AM
To: conjo@cpapman.com
Subject: Contact
RE: Synchrony S/T BiPap
Can only full face masks be used with this unit?
Thank you,
Al
Reply
Al:
Thanks for the inquiry.
You can use any nasal mask, full face mask or nasal interface with a bi-level
S/T unit. The primary difference between an S/T unit and a regular bi-level
unit is the back-up breathing rate.
The back-up breathing rate is a feature that reminds you to breathe when
you don't breathe such as in central apnea. The breathing rate can be set
so that if you do not breathe every so many seconds, the machine will automatically
kick up to the IPAP level and stimulate you to breathe. For example: If
you are to breathe 12 times per minute, if you do not start the inhale cycle
within 5 seconds of the exhale cycle, the machine will automatically switch
to the IPAP pressure.
As long as your mask or nasal interface fits properly and doesn't leak,
you can use any of them.
If you have other questions please feel free to ask them.
Thanks
--Joe--
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-----Original Message-----
Sent: Thursday, September 07, 2006 5:48 AM
To: joe@cpapman.com
Subject: no snoring
I have a question. If my CPAP pressure is high enough to prevent any and all snoring, does that mean that the pressure is high enough to prevent obstruction? From all the descriptions I've heard, snoring is the result of partial obstruction and apnea is the result of intermittent complete obstruction. Is this correct?
Thanks,
Jeff
Reply
Jeff:
Thanks for the inquiry.
In general, the answer to your question is yes. One thing to remember, a single pressure setting may not prevent partial closing or full closing of the airway in all stages of sleep, in all sleep positions or when in REM sleep. The pressure prescribed by the doctor is a calculated guess based on the polysomnogram and the capabilities of the sleep technician.
Snoring occurs when the soft pharyngeal tissue in the upper airway sags and begins to reduce the caliber of the airway. The same volume of air tries to come through the narrowed airway which means that it has to travel at a higher rate of speed thus causing the tissue to vibrate. Hence, the snoring sound.
When the airway is reduced so that on 50% or less air is getting through, lasting for 10 seconds or more, it is called a hypopnea.
An obstructive apnea is when the airway completely closes, the soft palate and uvula fall on the back of the throat and the tongue collapses on top of that and it all lasts for 10 or more seconds.
An apnea is the cessation of breathing for 10 or more seconds. A central apnea is caused by the brain stem not sending out a breathing signal.
I hope this answers your question. If not, I will try it again.
Thanks
--Joe--
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-----Original Message-----
Sent: Wednesday, August 09, 2006 8:33 AM
To: joe@cpapman.com
Subject: hints
Hello,
I have just started using a bipap machine the last 3 weeks, when I sleep
more than 4 hours with it I am great, the problem is tolerating it! I toss
and turn and many times rip it off after 2-3 hours? I am using nasal pillows
and have also tried the humidifier and ramp options. I know this thing works
when I can tolerate the use of it. Do you have any suggestions or hints
for me.
Thanks for any help,
Steve
Reply:
From: "The CPAP Store LLC" <joe@cpapman.com>
Subject: RE: hints
Date: Wed, 9 Aug 2006 12:11:34 -0700
Steve:
Thanks for the inquiry.
Which bi-level machine are you using?
What pressures are you set on?
Which nasal pillow interface are you using?
Answer to these questions will help me find a solution.
Thanks
--Joe--
Reply:
Sent: Wednesday, August 09, 2006 1:57 PM
To: joe@cpapman.com
Subject: RE: hints
Joe,
I am using the bipap plus, inspiration set on 12 and expiration on 8. The nasal system is puritan-bennet breeze.
Thanks,
Steve
Reply:
Steve:
It is always hard to say what causes a person to take their inter face off.
In your situation, there are a couple of things that may be causing the
problem.
First off, the Breeze SleepGear is not the best nasal interface in the world.
I do not recommend it for anyone. I think the Adams Circuit Nasal Pillows
with the CONJO Custom Headgear is probably the best nasal interface available.
It uses the same nasal pillows as the Breeze but has a very stable, comfortable
headgear that keeps everything in place. Another one that I think is just
about as good as the Adams Circuit is the AEIOMed Headrest. You can see
it at http://www.cpapman.com/AEIOMed.html. I used it for 5 weeks and it
is a good system. I have used the Adams Circuit with the CONJO Custom Headgear
for over 16 years.
Secondly, you are using the Respironics BiPAP Plus. That is a straight spontaneous
bi-level machine without Bi-Flex. The Bi-Flex feature would soften the effect
of the pressure, making it more tolerable. This is the lowest priced machine
on the Respironics Totem Pole of bi-level machines. The Bi-Flex feature
would help some.
Finally, a bi-level pressure of 12/8 cm H2O is not a real high pressure.
Most people usually acclimate to it over a period of time. Here is where
the pressure levels and the type of machine can make a difference to how
well people acclimate to it. The BiPAP Plus switches from inhalation (IPAP)
to exhalation (EPAP) in about 0.6 seconds or less. Going from IPAP to EPAP
doesn't jar the system. When you go from EPAP to IPAP, an increase for 4
cm H2O, it can jar a persons system and make it very uncomfortable. That
much change that fast can, in some people, cause them to wake up very rapidly,
causing them some anxiety. The Bi-Flex feature would soften that sudden
change, making it more tolerable for the user.
In my opinion, I think you would probably do much better if you were using
a BiPAP Pro 2 with Bi-Flex or a BiPAP Auto with Bi-Flex. Something else
that might be considered is having the pressure changed to 11/9 cm H2O and
sleep with it for a couple of weeks, then increase it to 12/8. That is something
that you would need to visit with your doctor about.
One other thing that could help you acclimate to the bi-level would be a
heated humidifier. Often time that will make the difference in how quickly
a user can acclimate to Bi-level therapy. Again, this is something you would
need to visit with your doctor about.
If you have other questions, please feel free to ask them.
Thanks
--Joe--
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-----Original Message-----
Sent: Sunday, May
21, 2006 10:28 AM
To: info@cpapman.com
Subject: Self retrofitting mask
Due to very minimal support from my sleep aptnea clinic
and apparently the unavailability of the extra small mask a year and a half
ago, I recently discovered that the main problem with the fit was that the
plastic unit fitting onto the face was a full one inch longer than the measurement
from under my eye socett to my upper lip.
I was given mis-information that my sleep position would not need to be
adjusted using this model, so my user expectations were poorly established.
Typically sleeping not only on my side but with my face practically into
the pillow, obviously was impossible. Hence, over the last 1.5 years I have
been trying to create a suitable mask to allow me full night's sleep.
First I used my dremmel to cut off the lower part of
the hard plastic triangle shape of the mask foundation. Then I used a soft
jersey sock (cut down of course) filled with batting and sewed it in such
a configuration to fit snuggly under the nasal passages and just beneath
the angle of the nose bridge. Next I hot glued full all
but the very most center of the vent holes (since the existing design does
indeed cause "back drafts" onto arms, cheeks and forehead). Then
comes the adjust-
ment to the head strap. Yours would have worked if I had been inclined to
shave my head to avoid always getting my hair to get caught up in the strapping
at one or more locations getting it on, adjusting it, during sleep and in
removing it...and that's only for ear length styles. For this task, from
my sewing supplies I
found a soft pajama type of elastic about 1" wide that I safety pinned
to each side of padding at about the mid-cheek level. No velcro to catch
on various other parts of the strapping and/or my hair while getting it
on. What a big relief from stuggle that was.
Finally I needed a way to reduce the air escaping through the fabric padding.
So I am now using a light weight medical paper tape to cover the top and
outer surfaces. But I think I will also try some liquid latex and see if
that works a bit better. Also, I got some very good information from your
customer services
that was very different from what the Respiratory Therapist gave me. IT
IS NOT ESSENTIAL to fill the water container. Only in very dry climates
is it necessary.
Also, that I needed to have a "cover" for the air hose (which
I created out of left over shoulder pads from the 80's).
So, I would suggest better training to your providers, and think about creating a really "adjustable" plastic mask foundation prototype that would account for the varying facial measurements that obviously exist---This is definitely not a one or two size fits all situation. Thank god I am finally over wanting to throw the machine out the window every night before I can get to sleep.
Charola
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Reply:
Charloa:
Thanks for the inquiry.
You went to a lot of trouble trying to make an interface. There are over
50 different interfaces and we have something that will fit and do the job.
We have to discern which interface is going to have the greatest chance
of working for the patient. Go to http://www.cpapman.com/masks.html and
you can see about 40 of them.
We are a provider and we work directly with the end user to determine their
need and what will work. We represent every CPAP and interface manufacture
that has products available for sale here in the US. We also manufacture
items that we can not find elsewhere, such as insulation sleeves for CPAP
tubing. We also manufacture insulated covers for nasal masks.
The problem with most providers is they represent perhaps two manufacturers
and then only certain items of the manufacturer's interfaces, not all of
them.
Visit my website at http://www.cpapman.com and look at the 60+ pages we
have up. We make everything available to you the user.
I have been doing CPAP setups for over 18 years and have used CPAP continuously
for more than 16 years. If you have a question please feel free to ask it.
You don't have to buy from us to get our help.
Thanks
--Joe--
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-----Original Message-----
Sent: Sunday, May 21, 2006
9:30 AM
To: joe@cpapman.com
Subject: Dear Joe...
Greetings..!!
I purchased my cpap machine from you years ago and I just want to thank
you for being so helpful to me over the years by offering your guidance
and support by reading, interpreting and sending back the smart card results
of my c-pap machine..
I wish I could say the same for all the so called doctors around this area..!!
They were not as helpful to me as you were over the years...!!
I do value you opinion and knowledge..
Bearing that in mind I have a question about the compatibility of my mask
and the c-pap machine
I have a RES-MED ULTRA MIRAGE II NASAL MASK ..
On page 2 of that manual it says..
"This mask IS NOT COMPATIBLE with those AUTO SET T flow generators
that have an INTERNAL SENSOR PRESSURE LINE" (end of quote)
What is that means to you..??
I have a REMstar AUTO c-pap from Respironics..
Are those two compatible..??
Please help..
Love,
LUIGI
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Reply:
Luigi:
Thanks for the inquiry.
There is only one machine that uses a pressure back line. The old AutoSet
T from ResMed did use a pressure back line and that is what it is talking
about. The only one today that use a pressure back line is the GoodKnight
420E from Puritan Bennett.
We have a number of customer that use the REMstar Auto with the ResMed Ultra
Mirage or Ultra Mirage II nasal mask. Their data look no different that
those using any other 22 mm nasal mask. The only thing I see different is
the leak factor. The Ultra Mirage and Ultra Mirage II has a larger leak
factor built into the mask than does most other nasal masks. This doesn't
hurt the performance of the machine it just makes the motor run more rpms
to compensate for the leak factor.
When I talk of leak factor, if you look on the literature that came with
the mask you will see a flow curve that indicates the liters per minute
flowing through the exhalation port at any given pressure.
If you have other questions please feel free to ask them.
Thanks
--Joe--
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-----Original Message-----
Sent: Saturday, May 20,
2006 4:06 PM
To: joe@cpapman.com
Subject:
Hi, I'm 29 years old and have been diagnosed with severe sleep apnea. I've been using a cpap machine with humidifier & swift nasal mask for almost 2 weeks now, but do not feel any better. Is this normal? When should I expect to feel better or at least start to notice some improvement? Is it possible there is something else wrong or the cpap machine is not working for me? Your answers and attention are greatly appreciated.
Thank you,
Cary
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Reply:
Cary:
Thanks for the inquiry.
There is no pat answer to your question. There are many factors that enter into what makes you feel better.
First off, if your apnea/hypopnea index (AHI) is in the mild range, 5 to 20 events per hour and the duration of each event is short, 10 to 20 seconds, then you will probably not feel much of a change in how you feel during the daytime. It may take two or three months before you feel the difference and most likely you will need to be off your CPAP for two or three days before you really feel how bad you were.
The higher the AHI and the longer the duration of your apneas the faster you will feel a difference.
There are some things you can do, if you are not already doing them, that will help you feel better during the daytime.
First, go to bed at the same time every night. Don't vary
more than 15 minutes from night to night. Try for 10:00 p.m. to 10:30 p.m.
Sleep a minimum of 7 hours.
Decrease your fluid intake from 6:00 p.m. on.
Do not ingest caffeine after about 10:00 a.m. This includes any food or
beverage that contains caffeine. This includes chocolate.
In fact, go to this link -- http://www.cpapman.com/hygiene.htm -- and read
it. I copied this out of one of my sleep medicine text books.
Stick with it. Even though we don't think CPAP is working, it probably is. Remember, it took 10 years or there about to get where you are. It may take 10 weeks or more to notice a difference. It will happen and I am ready to help you however I can.
If you have other questions please feel free to ask them.
Thanks
--Joe--
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-----Original Message-----
Sent: Saturday, May 20, 2006
6:22 AM
To: joe@cpapman.com
Subject: pressure of air flow
I currently have a resmed vpap machine. When I start it
the pressure is very strong so I use the ramp button allow the pressure
to build slowly, which it does. I often awake during the night and find
the pressure has dropped. It feels asthough the pressure is no longer trying
to force the airway open, due to lack of pressure. In fact, I have to inhale
placing a demand on the machine. My question is, shouldn't the flow pressure
remain continually the same, or is it variable. Any information you can
provide is greatly appreciated.
Russell
Reply - - - - - -
Russell:
Thanks for the inquiry.
The VPAP is a bi-level machine. There are two pressure settings, one for
inhaling and one for exhaling. Usually they will be about 4 cm H2O apart
with the inhale (IPAP) being the higher of the two pressures, the exhaling
(EPAP) the lower.
It sounds as though your machine is working properly. The VPAP machines
are a spontaneous machine, automatically changing from IPAP to EPAP when
you start to exhale then changing from EPAP to IPAP as you start to inhale.
If you have other questions please feel free to ask them.
Thanks
--Joe--
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Sent: Wednesday, February 01, 2006 7:30 PM
To: joe@cpapman.com
Subject: QUESTION
Thanks for information on my newly discovered disorder
of Sleep Apnea. I began using the CPAP machine about two weeks ago. I ordered
it with the humidifier and began having some palpitations during the day.
I stopped the humidifier and felt better. Now the palpitations began again.
I had an ECHO and it came out fine except for lung pressure. I still have
some palpitations. It was recommended that I do not stop using the CPAP
machine but why am I getting these palpitations, is that a normal side effect????
Thanks.
Naomi
-----------------------Reply------------------
From: The CPAP Store LLC [mailto:joe@cpapman.com]
Sent: Thursday, February 02, 2006 7:59 AM
Subject: RE: QUESTION
Naomi:
Thanks for the inquiry.
I am not a physician or a medical professional. I would strongly suggest that you pursue diagnosis farther. Talk to your sleep physician and a cardiologist very soon. This is something that you don't want to mess around with. You may have momentary arterial fibrillation that is going untreated. I can assure you that 'palpitations' or what ever they are, are not a normal side effect.
One of the things that might help is using a CPAP machine with C-Flex, SoftX or Expiatory Pressure Relief or an auto-titrator with C-Flex. An auto-titrating bi-level might also be considered. Any of those machine could provide the pressure to eliminate your apnea and lower the exhalation pressure. It is something that you need to visit with your physician about.
If you have other questions please feel free to ask them.
Thanks
--Joe--
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Sent: Wednesday, February 01, 2006 10:15 AM
To: info@cpapman.com
Subject: Questions
I've just been diagnosed with sleep apnea and hypopnea. I do not know
how severe it is. I'm waiting for a call from my insurance company's (BC/BS)
representative to talk about various cpap options. In looking into cpap
devices I have developed a couple of questions:
1. What are the advantages/disadvantages of full face v 'nosepillow' or
nose mask interfaces? Are they interchangeable so that I could alternate
usage?
2. I've heard a reference to 'dry steam' technology but I've not been able
to get any information about it. It is apparently a type of humidifier that
does not cause condensation.
3. I sleep on my side. Is there an interface that works better for 'side sleepers' ?
Thanks!
Dan
--------------Reply--------------
Dan:
Thanks for the inquiry.
The only time you use a full face mask is if you are a chronic mouth breather and can not breath through your nasal passage. If you can breath through your nasal passage then you can use a nasal mask or nasal pillows. The nasal mask or nasal pillows is much more comfortable than the full face mask.
I have been setting up CPAP for 18 years. I have never heard of 'dry steam' technology. I stay pretty well up on things. First off, steam is not what is used in CPAP systems. That would be far too dangerous. We use heated humidification and evaporation. We heat a body of water, pass an air stream over the water body and allow the evaporation to be absorbed into the air stream increasing the humidity to as near 100% relative humidity as possible. The warm moist air stream is what the nasal passage and lungs like. If fact, the body, via the nasal passage and upper airway, increased the temperature of the air stream to 98.6 degrees and 100% relative humidity before it enters the trachea and lungs.
Side sleepers should use a special type of pillow similar to the Theraputica. It has a square edge on it and is designed so that the mask or interface will hang over the edge of the pillow, thereby not putting pressure on the interface and causing it to dislodge and leak. Side sleepers should use as narrow an interface as possible, one that does not have hoses going up the side of the face. It is best if the hose comes overhead even if you have to support the hose off the wall or headboard of the bed.
I hope this answers your questions. If not, please feel free to ask them again.
Thanks
--Joe--
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Sent: Monday, July 11, 2005 1:30 AM
To: joe@cpapman.com
Subject: FAQ: tip for your readers
Hi. I've been using a CPAP for 5 years now, a Fisher/Paykel heated humidified
unit. I'd like to pass on a tip I found to help you get to sleep easier.
My unit starts off at a low pressure, then as the water temperature rises
it increases the pressure. I have found that if you start with refrigerated
water it takes longer to heat the water, thus the pressure is low for a
longer period of time, which gives you more time to fall asleep before the
full pressure surge. What I do is in the morning after cleaning the reservoir
bottle I refill it with distilled water and put it in the fridge. Then at
bedtime the bottle is cold and ready to go. I don't know if this will work
for other units but for my unit it really does work.
Thanks for providing your excellent service.
Vince
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-----Original Message-----
Sent: Tuesday, June 14, 2005 5:45 AM
To: joe@cpapman.com
Subject: Sleep Apnea
I have been diagnosed with sleep apnea and I do not adapt to the mask very well, so far I have not been able to sleep with the mask. This has been going on for almost a year and I have not had any problems. I get up two or three times during the night but most men my age (67) tell me they also get up. And until last week I have not had any problems. I am not taking any medication. I am about 70 pounds overweight and that coupled with being a smoker for many years (I quit in 2000) causes me to be short of breath. Blood pressure is 120/66, cholesterol is 195. Basically I have felt good until last week when my legs/feet started to swell, water retainage, I am told. And I started having shortness of breath sooner than before. Of course, we are having 98 degree weather.
The doctor is telling me this is from sleep apnea and I am having a difficult time with that diagnoses. I was told I had sleep apnea a year ago and it is just now causing problems.
Any thoughts/?
George
-----Reply-----
George:
Thanks for the inquiry.
Sleep Apnea is real. I am 67 and I don't get up during the night to go to
the bathroom. I believe what is happening is that, due to the sleep apnea,
you are not getting down into the stages of sleep where your body functions
slowdown and rest. Unless I drink a lot of fluids in the evening, I do not
get up to go to the bathroom in the middle of the night.
Your smoking for as many years as you did is a contributor to your shortness
of breath. It is made worse by the sleep apnea. Here is what happens with
sleep apnea: You stop breathing until your blood oxygen in your blood goes
low enough and the carbon dioxide in your blood gets high enough to cause
a response in your brain stem to wake you up. As your blood oxygen saturation
goes lower and lower, your heart starts to expand and push more blood so
that the brain gets the oxygen it is demanding. If the brain does not get
the oxygen it demands the it causes your heart to beat faster and faster.
If it still doesn't get the amount of oxygen it demands then the brain stem
starts to send out signals to move your body to wake you up and get you
to breathing again.
That sequence of event happens over and over during your sleep period. That
series of event increases your risk of heart attack by 23% and your risk
of stroke increase 3 to 10 times normal.
Obstructive sleep apnea is 100% controllable in 95% of the cases with CPAP.
You mentioned that you can not stand a mask. Well, welcome to my world.
I've been on CPAP for over 15 years. I do not use a mask. I use the Adams
Circuit Nasal Pillows with the CONJO Custom Headgear. Nasal Pillows are
small, oval shaped, silicone rubber, bellows shaped cushions that fit into
the opening of the nostril and seal against the outside edge of the nostril
opening. They are held in place with some hard frame and tubing that mounts
on a custom made headgear. You can see the system at http://www.cpapman.com/customhe.htm.
It takes about a week to get the system adjusted and fitting well. After
that, they are comfortable and effective. We guarantee them to comfortable
and effective or you get your money back.
I would strongly urge you to take care of your sleep apnea problem before
it takes care of you.
If you have other questions, please feel free to ask them.
Thanks
--Joe--
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-----Original Message-----
Sent: Friday, January 14, 2005 12:35 AM
To: joe@cpapman.com
Subject: GoodKnight 418 System
I'm a long time sufferer from sleep apnea. For years, I've geen using
the Good Knight 418 system. Lately however, I seem to be having problems
with it, as the mask has become quite derteriorated and it seems as
though the pressure is too high. causing severe burning and discomfort
in my throat and ears when I try to use it. Is there a way that I can
readjust the pressure on the system and also to see about perhaps
getting a replacement mask? Any help would be GREATLY appreciated.
Thanks in advance.
Robert
-----Reply-----
Robert:
Thanks for the inquiry.
Most likely you are suffering from nasal airway dryness and need a heated humidifier. What you describe is one of the main symptoms indicating the need for heated humidification. There is a 95% chance that will solve eliminate your symptoms and correct the situation.
Masks should be change about every year. They do tend to wear out and deteriorate with time. We have just about every mask available in stock and can ship immediately. My philosophy is that, "if it is work for you, don't change." If you will let me know which mask you are using then I can quote you a price. If you don't know, give me a call and I will figure out which one you have and go from there.
If you have other questions please feel free to ask them.
Thanks
--Joe--
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-----Original Message-----
Sent: Friday, January 07, 2005 8:51 AM
To: joe@cpapman.com
Subject: CPAP Info
Hi,
I read your description if how CPAP controls sleep apnea. Can you suggest a reference that explains more details, e.g., relationship of CPAP and breathing airflows, does CPAP just build up a pressure, but not move air after the pressure is initially built up, or is there always CPAP air flow?
Thanks,
Steve
----------
Steve:
Thanks for the inquiry.
A CPAP machine does two things creates pressure and airflow. The pressure
is to open the upper airway. The airflow is so that you have air to breathe.
By using a nasal interface, the entire airway, from the intake of the machine
to the exhalation port on the interface, is sealed so that we can regulate
the pressure. It is the pressure that moves the tissue and opens the airway.
It serves as a pneumatic splint. With the airway open you can breathe normally.
The CPAP unit is designed to produce pressure first, then airflow. The impellers
of the unit will always produce sufficient airflow for you to breathe normally.
If you have other questions please feel free to ask them.
Thanks
--Joe--
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-----Original Message-----
Sent: Sunday, December 26, 2004 12:05 PM
To: info@cpapman.com
Subject: looking for hose insulator
I'm a new CPAP user and have a couple of questions. I wonder if you have
thoughts on these, or can suggest where I might find information and advice.
I have been using 2 interfaces. One is a Resmed Mirage Activa nasal mask.
It is reasonably comfortable, but I awake four or five times a night to
scratch at an itch on my nose or cheek, or I pull it off in my sleep.
So, then I bought a Respironics complete seal nasal mask with the direct
seal cushion. I am experiencing moisture going up my nose, which I gather
comes from condensation. I'm not finding a hose insulator sleeve on your
website. Do you sell one? Can you send me the link for looking at it on
your website, and also how much it costs? I use a Respironics cflex cpap
machine, which has a heated humidifier. Is it possible that the heat is
not set to a high enough temparature?
I think all in all I'm happier with the Respironics complete seal nasal
mask.
I'm a new CPAP user and I really appreciate your thoughts. Thanks.
David
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David:
Thanks for the inquiry.
I think that if you use a double insulated sleeve on the tubing it will
take care of the condensation problem. It usually does. For a 6 foot hose
they are $18.99. It will work on and 22 mm tubing. We make them in just
about any length.
I generally recommend that you use the heat turned as high as possible.
That seems to do more good than low or moderate settings. You can find the
sleeves at http://www.cpapman.com/slv.html or, from our home page, click
on the link titled "Tubing Insulation Sleeves."
Regarding the itching and scratching: I would recommend either the ComfortLite,
which you have; the Adams Circuit Nasal pillows with the CONJO Custom Headgear,
which is superior to just about anything else; or one of the other nasal
pillow type interfaces. That way you can get to your nose to scratch it.
This sensation will subside after you acclimate to the system.
Some people go through a period when they take their interface off during
their sleep period. Not quite sure why but I think it is tied to the unusual
feeling for having something on your face that is not comfortable. Usually
this will stop after a few week or when you get the interface adjusted so
that it is comfortable or you get an interface that is comfortable.
If you have other questions please feel free to ask them.
Thanks
--Joe--
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-----Original Message-----
Sent: Wednesday, December 15, 2004 5:38 PM
To: joe@cpapman.com
Subject: FW: OSA
Hello Sir/Ma'am....
My question relates to Obstructive Sleep Apnea. With cases of Mild-Server
OSA, can a person's condition become worsened by their environment.
With my limited knowledge of OSA and what doctors have disclosed. Physicians
have stated, that there is no way to determine when a individual actually
developed the illness.
However, my question fall in the area which encompasses the whole subject.
One part which concerns me the most, which I have failed to find the answered
is:
Is there concert or any other information available to support environmental
effects, as they pertain to sleep deprivation/combat fatigue. Can a person's
environmental condition aggravate or exacerbated the disorder. "Example;
can a lack of sleep in a combat environment, which causes for a lack of
sleep... worsen this disorder?" Again....I.e.: Can more snoring than
usual relating to combat fatigue. Resulting in more stress on the muscles
in the throat, nose and mouth. Thus, Increase, aggravate or exacerbate the
sleep disorder.
Please advise or point me in an area that I might be able to obtain this
information.
Very Respectfully,
Concern patient....
-------------REPLY----------------
Nelson:
I don't know the answer to your question. All I can do is share with you my knowledge and experience.
First off, the body requires 8 hours of restful sleep every 24 hour period. Anything that interrupts or limits or fragments that restful sleep causes sleep depravation and the body reacts accordingly. It is not going to function to its fullest potential. Consequently, you are going to experience fatigue, excessive daytime sleepiness or any number of other abnormal events.
Certainly, some environmental conditions, such as combat, can cause fragmented sleep. Because of the effect on your body, you will not perform at as high a level. Your error rate will increase significantly. Even though you have been trained to react and respond in certain ways, your judgment will be impaired and your reaction time slowed, significantly.
OSA can not be pin-pointed to a start date. When you realize that you have a problem that need attention, you have probably been suffering for 20 years or more. OSA is not something that comes on suddenly.
Snoring is the prime symptom of OSA. It is caused by the narrowing of the upper airway wherein the soft pharyngeal tissue begins to sag, narrowing the caliber of the airway. The incoming air increases in velocity causing the tissue to ripple or vibrate, causing the snoring sound. It is amplified by the additional vibration of the uvula and soft palate.
Fatigue can cause your body to go into the deeper stages of sleep and REM sleep quicker. The deeper the stage of sleep, the narrower the upper airway gets. The narrower the upper airway get, the louder the snoring. At some point the smaller caliber of the upper airway limits the amount of air that you can get to your lungs. With the decreased volume of air in your lungs the less oxygen you have to exchange for the carbon dioxide in your blood stream. This leads to an increased blood pressure and higher heart rate to push more blood to the brain and body. This in turn can cause fatigue of the muscles and cause the brain cells to die off simply because the brain is not getting enough blood to function properly.
I think you can see the merry-go-round effect that snoring and OSA has on your system. The most immediate result is fatigue and excessive daytime sleepiness. The long term results can be heart attacks, strokes, diabetes, disorientation, forgetfulness, and the list goes on.
I would suggest that your go to http://aasmnet.org. This is the web site of the American Academy of Sleep Medicine. I think they can provide you with documentation or at least research studies that will back up what I have said.
If you have other questions please feel free to ask them.
Thanks
--Joe--
-------------------------------------
-----Original Message-----
Sent: Wednesday, December 01, 2004 12:54 PM
To: info@cpapman.com
Subject: CPAP recommendation
Hello CPAPMAN,
I am in the market for a new cpap, any recommendations? Know any websites
that have review and comparison charts? Too many to choose from. Could use
your advice.
thanks
frank
----------REPLY----------
Frank:
Before I can recommend a CPAP for you I need to know more information. Please
understand, you are not buying something like a car or vacuum cleaner. You
are purchasing a piece of equipment that is going to change your like. What
I look for is a machine that meets your therapy needs and well as your life
style needs. The features and the specifications of each machine is show
on our web site. The most important part of the system is the nasal interface,
not the machine.
Here are the questions I need answers to:
1. What pressure has your physician indicated that you need?
2. What is your apnea/hypopnea index (AHI or RDI) score?
3. Do you travel frequently? If so, how often?
4. When you travel is it by airplane, RV, Auto or some other mode of travel?
5. When you travel do you go to a lot of different elevations?
6. When you travel is it mostly domestic or international travel or both?
7. If you have a bed partner is that individual sound sensitive?
8. Are you allergic to vinyl, latex, silicone rubber or neoprene?
9. Is temperature in the room you sleep in below or above 65 degrees?
10. What state do you live in?
Answers to these questions will help me recommend a machine that will meet
your therapy needs as well as your life style needs.
Thanks
--Joe--
---------------------------------------------------------------
-----Original Message-----
Sent: Sunday, November 28, 2004 8:38 PM
To: info@cpapman.com
Subject: snoring problem
Hi,
I snore when I sleep, but I don't have sleep apnea. Can I use Puritan Bennett's Adams Circuit Chin Strap to help me close my mouth and hopefully stop the snoring?
Thanks!
Hong
----------REPLY----------
Hong:
Thanks for the inquiry.
That isn't going to stop you from snoring. It may stop the sound of snoring but the upper airway is still going to partially collapse and cause the tissue to vibrate, which is snoring in the medical sense.
When the upper airway partially collapses it limits the air flow into your lungs and you don't have the volume of air in your lungs to properly exchange the carbon dioxide in your blood stream for the oxygen in the air flow. That can cause a lowering of the oxygen saturation in the blood system which in turn causes your heart to beat faster and pump more blood. When that happens you increase the potential for a heart attack or stroke.
You would be best served to have a sleep study and take care of the problem properly.
Thanks
--Joe--
-----------------------------------------------------------------
-----Original Message-----
Sent: Sunday, November 28, 2004 8:25 PM
To: info@cpapman.com
Subject: Cleaning Instructions for Velocity Passover Humidifer
HI! I have been using your Velocity Passover Humidifier with my BiPap machine for over a year now. Lately I have noticed a mildew-type odor and small dark spots inside the unit. I have always used vinegar and water to clean it at least once a week. Is there something else I could try? Thank you in advance.
Francine
----------REPLY----------
Francine:
Thanks for the inquiry.
I would suggest a 10% chlorine bleach 90% water solution and soaking it for about 10 minutes. Follow that by thoroughly rinsing with one part vinegar and 3 parts waters solution. Follow that by thoroughly rinsing with luke warm water. When you think it is rinsed out as good as it can be, do it one more time. That should do the job.
If you have other questions please feel free to ask them.
Thanks
--Joe--
------------------------------------------------------------------
-----Original Message-----
Sent: Wednesday, November 24, 2004 5:40 PM
To: info@cpapman.com
Subject: chin straps etc.
Hi, I am supposed to use a cpap machine at a setting
of eight but I really don't. Do you have anything
that would help a bit, maybe a strap to prevent
snoring? If so, what is the best strap to prevent
mouth breathing? I am not going to also use machine.
Chin strips? What really works well?
Thanks
Ken
----------REPLY----------
Ken:
Thanks for the inquiry.
A chin strap probably won't do you any good. First off, it is not going to stop the snoring nor is it going to stop the loss of air flow to your lungs. Snoring is the primary symptom of Obstructive Sleep Apnea. By not using the machine you are setting your self up for a heart attack or a stroke or both.
I've been doing this for over 16 years. I have seen hundreds of people with your same attitude that ruined their life and their family's life because they didn't want to use the machine. I've been on a machine for over 14 years I feel very good that I know that I am doing all that I can to prevent a heart attack or be trapped in my body by a stroke. I'm 67 years old and I look forward to the next 20 years.
Put your pride and machoism behind you and protect the rest of your life.
Thanks
--Joe--
-------------------------------------------------------------------------------------------
----- Original Message -----
Sent: Tuesday, January 03, 2006 7:10 PM
To: CONJO@cpapman.com
Subject: Contact
Mr. CPAPMan,
How do I change the air pressure on my REMstar?
Thank you so much - the book walked somewhere...
Kathleen
------------------------------------
From: The CPAP Store LLC
Sent: Wednesday, January 04, 2006 10:41 AM
Subject: RE: Contact
Kathleen:
Thanks for the inquiry.
Which REMstar do you have?
I can fax you the instructions. What is your fax number.
Thanks
--Joe--
---------------------------------
Sent: Wednesday, January 04, 2006 4:31 PM
To: The CPAP Store LLC
Subject: Re: Contact
REMstar Plus
I'll hook up the FAX machine to our phone line in morning:
THANK YOU!
Kathleen
----------------------------------
From: The CPAP Store LLC
Sent: Wednesday, January 04, 2006 8:07 PM
Subject: RE: Contact
Do you have the REMstar Pro, the REMstar Plus, or the REMstar Auto?
--Joe--
---------------------------
Sent: Thursday, January 05, 2006 5:31 PM
To: The CPAP Store LLC
Subject: Re: Contact
REMstar Plus
I wish the Dr. had Rx'd a model which monitors oxygen level; my oxygen level
during sleep study was 30. My flow has been increased from 5 to 7. I thought
that I could adjust it between the lowest and highest level, but was told
that I couldn't. Seems to me that an intelligent person ought to be able
to adjust it without another Rx. I know it's programmed with the machine
unhooked from humidifier. I'm worried that I may not be getting enough oxygen;
am a mouth breather, but have the FlexiFit 407 (I believe); will try the
431 next. My main problem with the nasal mask is that I have upper denture,
which dentist and I want removed at night. Well, the mask will not seal
on my small face unless the gum are of mouth is "reinforced".
That may be something others would want to be aware.
Again, I'd like to be able to adjust the pressure myself, and am concerned
about NOT knowing my oxygen level.
Thank you in advance for your time, information, and assistance.
Kathleen
-------------------------
Kathleen:
I not sure exactly what you want to adjust. Are you wanting to adjust your
oxygen flow or the pressure on your CPAP machine?
One of the things you need to be aware of is that every nasal interface
has a leak factor. The higher the CPAP pressure, the higher the leak factor.
It can be as high as 100 liter per minute.
When you add oxygen to a CPAP system, the leak factor has to be taken into
account. For example, if the doctor decides that you need 2 liter per minute
(lpm) of oxygen without CPAP, on normal ambient air, and you are on 10 cm
H2O, depending on your mask leak factor you might be loosing 35 to 50 lpm
of air flow. If that is the case, based on your using 12 lpm of air to breath,
you would need to increase your oxygen by a factor of 3 to 4 or 6 to 8 lpm
if the oxygen is bleed in to the system before it gets to the mask. If the
oxygen is bleed directly into the mask, then you probably only need to increase
your oxygen by a factor of 1.5 or 3 lpm.
You would need to monitor your oxygen saturation with an oximeter until
you found the correct oxygen bleed-on level to bring your blood oxygen level
up to what the doctor wanted.
The second part of the question about raising the pressure on the CPAP machine.
Unless you are on an auto-titrator, I don't suggest that you change your
CPAP pressure from what your titrated pressure in the sleep lab was. The
first thing you want to get stabilized is your blood oxygen saturation.
Once you have that stabilized then you can begin to work on the pressure.
Understand, it takes a long time to find the best CPAP pressure unless you
have some means of monitoring it. The REMstar Plus is a good machine but
doesn't have the capabilities of monitoring your apnea/hypopnea
If you have other questions please feel free to ask them.
Thanks
--Joe--