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There have been a LOT of debates spanning many years about that “AHI of 5” standard for treatment. It’s a complicated and important issue and I will shortly start a new thread elsewhere on this on that subject. To some extent, it is a matter of what the insurers are willing to reimburse. But there are those who will tell you that a single apnea, if it lasts long enough, can do a lot of damage, especially if you are someone who desaturates badly.
I had the aerophagia problem early in the history of my APAP treatment. Also, one night I awoke trying to exhale against a hurricane of 18cm! The problem was I had sustained a large leak which was driving up the automatic pressure response on the APAP.
But there WAS an easy fix: my sleep tech set the pressures for a narrower range than the machine is capable of—-so they couldn't go so high. My average current pressure requirement is about 12 and I think the machines is set for something like 9 to 15- so it can’t go TOO crazy. I think this was before the advent of expiratory assist availability, too. Using that might also help.
The other approach, of course, is to attack the source of the leak. I did that by adding a chin strap to my nasal mask gear until such time I as learned to keep my mouth shut. (I was assured by the other patents in my patient support group that even a recovering lawyer would eventually learn to do that—and, fortunately, they were right!)
If you live in an area subject to frequent power outages, you’ve probably had to deal with the issue of how to run your PAP machine during an outage. The first line of defense, of course, is to have either a generator, a whole house battery, or deep cycle (usually marine) battery backup.
But it is also frequently the case that if you are dependent on oxygen, PAP, or other electrical medical equipment, your local electrical utility will prioritize outages affecting you. However, they can do that, ONLY if they are aware of your medical needs.
So, be sure to contact your local utility to see if they offer this service. If so, register with them. If not, encourage them to do so, and stress the medical necessity.
I found that the single most important factor in feeling better was to eliminate apneas as much as possible. That was critical. That meant that I used PAP all night, every night. I did whatever was necessary to minimize leaks and optimize treatment. I don’t leave home without my machine. I don’t nap, even on planes, without using the machine. I have backup power in my home and places I visit frequently, in case of a power outage. For me, since I desaturated badly ( less than 60 percent, regularly, without treatment) it is not a question of getting adequate restful, restorative sleep. It is, first and foremost, about eliminating apneas and the associated hypoxia damage to the maximum degree possible. Only when you stop the ongoing hypoxia damage, can you and your brain begin to recover......
