I've noticed that several enterprising individuals have taken it upon themselves to sell the Provider Manauls that come with CPAP and Bipap machines. This is different from the User Manuals that ARE given to the patient. The Provider Manuals give information about how to access the Clinical Menu and change pressure settings and other parameters.

These manufacturer states that the Provider's Manual is NOT to be given to patients. This is because some people may attempt to change their settings away from the setting that was determined at a titration study at a sleep lab. The reasons are varied. Perhaps some people want to lower the pressure to make it more comfortable, others may want to raise it. I think that it is fair to inform people that lowering or raising the pressure on your own can have suboptimal effects to your therapy. If you lower it too much, you're possibly not providing enough pressure to fix apneic episodes and you may have a few apneas or hypopneas sneak through. If you raise it too high, you run a risk of having pressure-induced central apneas (particularly if you are at risk for this phenomon) PLUS having an adverse effect on intrathoracic pressure and venous blood return. It's not that the information is protected by some secret society, ala The DaVinci Code, it's that willfully providing this info can easily be made a legal issue as far as liability of the DME for example. With people wanting to sue everyone at the drop of a hat, I could imagine the lawsuits that could possibly spring up.

Also, legally, a DME cannot make a pressure adjustment without a physician order.

I feel that people have the free will to do whatever they please, that's why I sell Provider Manuals, but I feel an obligation to educate so that their choices can be informed decisions and what risks CAN be associated with pressure adjustments. I am a Respiratory Therapist who specializes in Sleep Medicine and PAP applications so hopefully you can feel confident about what I'm saying.

If you are looking for an answer to your CPAP problems, please let me say that adjusting your pressure setting probably isn't the best way to start about it. Mask fit and humidification should be addressed first. Ramp time may need to be tweaked. Pressure adjustment should be one of the last things to consider. If you feel like your pressure setting IS wrong (and it does happen), perhaps you could consider a trial on an auto-titrating PAP for a month or two to see what pressure it is averaging out to. Some of the more decent DMEs out there can provide an APAP machine for a loaner.

I will be soon completing an ebook which I feel will be of good value to CPAP users and people with other forms of sleep apnea. Written from my perspective as an RT, I hope to help educate and hopefully increase people's compliance and comfort.

I hope you have found something of value in my guide. If you have, please vote!

Thank you!