Hello, I'm Dr. Worawat Suwanarak, a specialized plastic surgeon at Bangkok Hospital and Vichaiyut. I'm the CEO and CEO of NK Sleep Care Co., Ltd. Welcome everyone to visit our website.
If you have any questions Please leave a message below. Thank you.
I would like to ask for advice on procuring a ventilator for a patient with a tracheotomy.
Which type should be used? The patient was admitted for insertion of a feeding tube through the left nose and drain bile from the stomach through the right nose The doctor used a ventilator attached to a tube around his neck. and informed that the patient had to use a ventilator because his breathing was not good. Normally, the patient has a lot of mucus and saliva and must use a suction device frequently. But I can breathe on my own. When entering the hospital, the patient developed an infection and had a fever and low blood pressure. Therefore, he used a ventilator while receiving treatment for 15 days. The doctor informed his relatives to provide a ventilator. at home but did not inform the specifications of the machine that should be used Therefore, I would like to ask for advice on what type of machine I should look for and whether the company has it or not.
Hello, I apologize for the late reply. I would like to ask for your name and contact number to be sent to info@nksleepcare.co Or message LINE at @nksleepcare, I will have ventilator specialists come and give advice. Because I have to ask for some additional details.
Ask for more information, doctor.
In the case that we have been using the CPAP machine for 2 months, we would like to know how many months after using the machine we can undergo surgery to correct sleep apnea. And what is the chance of recovery?
Sorry for the late reply. Surgery can actually be done. But if the doctor uses the CPAP machine first, they might want to see how much the symptoms improve. You may consider using a CPAP machine along with surgery. Surgery may not need to be done as much because there is a machine to help with it. However, surgery does not guarantee complete cure or reduction of symptoms 100% and symptoms may return after 2-3 years, depending on the type and nature of the surgery.
Hello, I just bought a device and used it for a week. But aside from trying it on the first day, I haven't used it at all. Because of the mask problem Once covered, it becomes a vacuum. I didn't feel any wind at all. But if you pull it out, the wind blows normally. When I tried the machine it was normal. But at that time, a full-face mask was used. But this one was a miscommunication and it came as a nose cover. I'm not sure if it's because the mask size is too small. I've tried to adjust the strap hundreds of times. Or did you put it in the wrong way? In fact, I consulted with the nurse, but they said that we need to adjust the strap. I don't know if he doesn't understand my condition or not. It's not that the air is leaking, but there isn't any air, other than pulling it loose from the nose to feel the wind. Now if the cover has no wind Hammering from probably didn't help anything because there was no air rushing into the nose. If we fall asleep, will we die because we have no air to breathe? I'm afraid of this so I don't dare use it. If you use it, you have to pull it loosely or slide it down to cover your mouth, causing air to leak up into your nose. I don't know if anyone has a problem like this. After asking 2-3 times, it was recommended to buy a new mask. But we just bought the same mask machine and haven't used it a few times yet. And masks aren't cheap. I'm worried that if I use the method of buying a new one, what will I do if I encounter the same symptoms again? It's a little long. This week I slept very little because I was so busy adjusting my mask an hour before bed every day. Until I stopped using the device (temporarily) because I became unable to sleep instead. When trying to take the plane from sleep, the wind was so strong that I wasn't used to it, but after a while I was able to fall asleep. When I bought the machine to use myself, there was no wind. I'm very worried. Please answer.
Dear Momo, I apologize for the late reply 2-3 weeks ago. The doctor is very unwell. So I didn't answer many people's questions at all. I saw Mr. Momo post in another article with the same question. The doctor would like to collect the answers here in one place.
Coming back to the problem that was described. As far as I can tell, I understand that when I tried it, there was no problem. I used a full face mask, that is, covering both the mouth and nose. But there was a mistake and I got a mask that covers only the nose (model N20 Nasal), but when I use it I can't feel the air coming out. And solved the problem by sliding it down to cover the mouth, causing the air to leak up into the nose. First of all, we shouldn't solve problems this way. Because of the large amount of air leaking, the machine will not work well and make incorrect calculations. The second is that the air that is allowed to leak into the nose does not have enough pressure to heal the blockage in our throat. The results read that the AHI value was less than 5. It was probably due to the calculation machine being incorrect because there was a lot of air leaking. This can be seen from the machine showing red that the air is always leaking.
I assume this:
1) He is a person who sleeps with his mouth open. Because I saw that when I tried using the full face mask there was no such problem. When using a nasal mask, it may cause almost all air to leak out of the mouth. Therefore, it does not feel like there is air pressure in the nasal passages.
2) The machine pressure may be set too low. Especially during the beginning of bedtime. It may feel like there is no air pressure coming out.
It is recommended to contact the company from which the device was purchased or the hospital where we provide treatment. To request to test the full face mask to see if the problem has disappeared or not. If you try it and it doesn't work or you really can't find a full face mask to try. The next method is to have the company that sells the machine adjust the starting pressure (Ramp pressure) to be higher. If it still doesn't work, try adjusting the therapy pressure to be higher. In this case, adjusting the pressure must be consulted or Please notify the treating doctor first.
Please ask, in the case of the sleep test and the result was severe, the AHI value was 41.1 per hour, but the patient refused to use the CPAP machine due to the high price. What will be the effect?
I apologize for the late reply. In the past, the doctor was not well, so he did not answer many people's questions.
In the case of doing a sleep test, the AHI value was 41.1 times per hour. Considered to be at a severe level (severe), if the patient refuses to use the CPAP machine, it will have long-term negative effects on their health. Or there may be short-term dangers if there are congenital diseases such as heart disease, high blood pressure, or stroke. Therefore, the first step should be to try to get the patient to use the CPAP machine. Try checking to see what the reason is for refusing to use it because we may be able to modify it to make it usable, such as the mask being too uncomfortable. or the air pressure is too high Or the air pressure is not related to the rhythm of breathing. Or when exhaling and feeling uncomfortable, etc. These things, trained cpap company staff can adjust all settings appropriately. Later, if you try adjusting everything and the patient still refuses to use cpap, you need to consult with a sleep doctor about other treatment options, such as using a mouth guard. or surgery, which has many types Since the pain was minor, there was no need to go to the hospital. Until major surgery that requires a hospital stay.
Using a CPAP machine (not filled with water) will help you sleep comfortably for the first 2 hours. After that, your throat will be dry and your nose will hurt a lot. Until having to get up and expel phlegm There will be thick, sticky phlegm. I tried to put it on and then went to sleep. But it wasn't comfortable at all. Some nights I had to pull it out immediately. Because I feel like it's painful. How should something like this be fixed?
It is best to add a heated humidifier, as this will help keep your throat from drying out. Reduce nose pain and makes the phlegm not sticky But if it's not convenient, try consulting a doctor to try lowering the air pressure. It may help reduce dry throat and nose pain. But phlegm may not help much.
Want to know how to read CPAP results?
P90 and P95 values are between 7-10. Is this still normal?
And what should the Apnea value be?
The P90 (or P95) value in a CPAP machine is the pressure the machine calculates to treat sleep apnea (therapy pressure). Therefore, a P90/P95 value of 7-10 means that the therapy pressure is between 7. -10 cmH2O is considered to be at a moderate level. (If a person has severe sleep apnea, the P90/P95 numbers will be higher.) If the machine is set up properly and the mask is worn correctly. Apnea index value (Apnea-Hypopnea Index: AHI) while using the machine should be at a level lower than 5 times per hour.
Thank you very much, doctor.
I bought a machine from NK, model resmed 10. I would like to ask, how does the CPAP machine know that we have stopped breathing when the machine is always blowing air?
thank you
Inside the machine there is a sensor to measure the air flow rate and air pressure (Flow sensor & Pressure sensor). The air blown out will change the pattern of both flow and pressure according to our breathing all the time. The machine will record our breathing pattern (pattern) within a normal range. To compare with abnormal breathing patterns. This makes it possible to know when breathing stops and for how long.
If the user says Inconvenient when using the inhaler It's like you can't breathe completely into your lungs. Does that mean the starting pressure is too low or too high?
When using the breathing machine, it's uncomfortable, like you can't breathe completely into your lungs. Indicates that the pressure setting is too low. If it's the first time you turn on the machine, it means the starting pressure is set. (Initial/ramp pressure) is too low, but if symptoms occur all the time, it means the treatment pressure (therapy pressure) is set too low.
Dad has just been using a CPAP machine for about a month. He used it almost 10 years ago, but it didn't work. He stopped using it, and recently came back to try it again. Because the results of the sleep test showed that breathing stopped 30 times per hour. Lowest oxygen level 87% Pressure level is high at night. When do you sleep? The pressure began to climb. In the morning sometimes the pressure goes up to 200 and I start to feel confused. from poor capillary condition Not enough blood to flow to the brain Can't use strong blood pressure medicine. Because the diastolic blood pressure is not high and the heart rate is quite low (less than 50), the doctor told me to try using CPAP.
Currently trying out the Resmed AirSense 10 for Her machine, a Nasal mask (I've tried both the Full Face and Pillow as well). Father still wakes up not refreshed, sleepy, blood pressure is still quite high, and complains of discomfort and difficulty breathing when wearing the machine. Father lies with his mouth open. Can't wear a chin brace because of allergies. And it's even more uncomfortable. The machine pressure is set at a level of 6-12. The average pressure throughout the night has never used more than 8 air pressure. I don't know how to set the machine or how to use it so that Dad can use the machine more comfortably.
Hello, initially I would like to consult with the company that provided the device to try out first. Because they can download the results to view in detail. And we can adjust some settings to help us sleep more easily. In addition, because we just tried it for a few nights. You may need to give it some more time to adjust. Because in the beginning you may not be used to it and it may cause you to not sleep well.
But if you've used the device for more than 2-3 months and still don't wake up refreshed. You must consult with the officials of the company that purchased the device. In general, it is often recommended to adjust the resistance reduction (EPR) system down (as long as it is not too uncomfortable and you can sleep). If it still does not improve, you will consult a doctor to adjust the pressure to a lower level. or adjust the system from auto to constant pressure You must download the results of using the machine in detail to see.
Using a CPAP machine takes time to get used to. To be able to stay with the machine for at least 4 hours per night.
Ask the doctor. I was put on a CPAP machine and woke up with ringing in my ears. It's regular, but not very often. Is there a way to solve it? Thank you very much, doctor.
Some people who use a CPAP machine may experience tinnitus. This is normal. Because the machine has compressed air into our respiratory tract. The solution is to consult a doctor or representative who takes care of you to try lowering the air pressure, such as the initial pressure (ramp pressure) or the maximum pressure (max. pressure). This pressure reduction must not affect the overall treatment. Therefore, you should not do it yourself.
I have a question. I have been wearing the Resmed CPAP machine for 1 year. I feel like I feel sleepy after wearing it as usual.
Just like when I didn't wear it at all. The measurement on the machine came out good. The air is leaking a little. But when I wake up, I'm tired, my eyes are swollen, and my throat hurts.
-I have allergies at night. My nose tends to get stuffy because the inside is swollen. But I tried not turning on the air conditioner, just the fan, and put in the cpap machine and it was still the same.
Sorry for the late reply. Allergies to a blocked nose are usually a barrier to using a CPAP machine that uses a mask through the nose. This makes the machine not as effective in treating it as it should. A blocked nasal cavity while using the machine will result in the following: 1) The air pressure cannot be fully transmitted to the throat. This reduces the ability to treat sleep apnea that causes daytime sleepiness. 2) If it is an Auto CPAP machine, the machine will mistake it for a blockage in the throat. This causes the pressure to increase in an attempt to heal the blockage. As a result, the air will be released harder and make the user uncomfortable. or unable to sleep well 3) If using a mask to cover only the nose It will make us sleep with our mouths open and breathe automatically. causing air pressure to leak out through the mouth
It is recommended to consult a doctor to cure the symptoms of a blocked nose first. Then slowly come back to use the machine.
My father is a government official, can I reimburse the cost of a CPAP machine? Or is there a CPAP machine that is not expensive? I'm still young and don't have enough purchasing power.
1. Father can use the rights of the Comptroller General's Department to withdraw money. The maximum amount does not exceed 20,000 baht.
2. Father can use the right to withdraw equipment for his child. But the child must be under 20 years of age.
3. The price of the device now has a promotion starting at 35,000 baht and if you have an SCB KTC Krungsri Bangkok credit card, you can pay in installments 0% for 10 months.
Consult your doctor. I've been using the CPAP resmed machine for 1 year, but I feel like every time I wake up I'm not refreshed. Even though the mask didn't leak. The values coming from the machine are all OK. But when I woke up I felt tired and not refreshed. The mask I wear covers only the nose. Personally, I have allergies. At night the nasal cavity grows.
Hello, I would like to ask. I had a sleep test and the doctor recommended using a CPAP machine at a pressure of 6 and tried the resmed machine from the hospital. The machine I tried was the for her model. The officer informed me that it was an Auto machine. But the wind force was set to 6, not set to Auto. After testing, the AHI value = 3. I would like to ask, 1. Should I use a manual or automatic machine? The police recommend that using the manual is enough because it uses less wind power. There is no need to use the Auto type. 2. Tried using a mask that covers the nose but is allergic to silicone. It is very itchy in areas that come in contact with the face, especially the area between the nose and mouth. I'd like to know which mask I can use. From the trial, I like Resmed. It's not uncomfortable. I have a problem with being allergic to this mask. Thank you.
Hello, I would like to answer the following questions:
1. Because the air pressure was not high (6) and the result was an AHI=3 value, meaning the treatment was effective. Therefore, using a manual machine (constant pressure) is sufficient.
2. It is recommended that you try using a nasal pillow mask. There will be no part touching the facial skin around the nose.
Hello, I would like to ask High blood pressure, unable to breathe due to stress I would like to inquire if wearing a respirator while still unable to breathe will it have any effect?
It is not recommended to use a CPAP ventilator during this condition. because the cause is not caused by an obstructed airway It is advisable to consult a doctor on how to treat it when symptoms occur.
There is carbon dioxide I have to wear the BiPap device every day. (At normal times, sometimes there is a panic attack too.)
This requires consulting the doctor who treats you. because it depends on the level of symptoms of each person
Please allow me to ask the doctor. I have been using a cpap machine for 1 year now, the ahi sleep test is 15.1 (light breathing), the max pressure is set to 15, the ahi and cai are below 5. Every time I use it, I used to have only 0.1. I wake up every morning and I still feel dizzy every morning. Used to use an oring2 ring to measure oxygen in the blood, some nights it was as low as 86,%, even using a cpap machine, ahi 0.4, but still dizzy. I have angina. I don't know if angina can make it hard for me to breathe or if it doesn't allow my lungs to expand fully.
must try to send a report using the device to see details first If you look at the report and see that your CPAP machine is set up and working normally. It may be a result of the aforementioned heart conditions because the oxygen in the blood is lower than normal.
In case of difficulty falling asleep and insomnia Waking up often in the middle of the night can a CPAP machine help?
CPAP machines cannot help in cases of difficulty falling asleep or staying asleep. It is advisable to see a neurologist and sleep specialist. Because the cause can be caused by many reasons such as stress, anxiety, depression, insomnia, etc., which must be thoroughly tested and diagnosed by a doctor. Should not be left because it will destroy our health in the long run. Recommended doctor: Dr. Thapanee Somboon, Prasat Neurological Institute, Tel. One of them may be caused by sleep apnea, because lack of air during sleep can cause us to wake up frequently. If your doctor diagnoses your frequent nighttime awakenings as being caused by sleep apnea, your doctor may recommend treatment with a CPAP machine.
Ask about philips sound dampening foam.
Changing the foam will be safer, right? Does it need to be changed every year? Does Resmed's need to be changed? If you change, do you have to change every year as well?
โฟมตัวใหม่จะไม่มีปัญหาเดิมแล้วครับ ไม่จำเป็นต้องเปลี่ยนทุกปีแต่ควรนำเครื่องมาเข้าศูนย์ทุกๆ 1 ปี เพื่อให้ช่างตรวจเช็คสภาพโดยรวมให้ครับ ของ Resmed ไม่จำเป็นต้องเปลี่ยนโฟมครับ เพราะไม่ได้พบเจอปัญหาเหมือนของ Philips ครับ หากมีข้อสงสัยเพิ่มเติมสามารถสอบถามมาที่แผนกบริการหลังการขายได้ที่เบอร์ 02-460-9241 ขอบคุณครับ
Ask for permission to ask for self-assessment from the AHI value. We got from inserting the CPAP machine and having the machine read the value directly, right, doctor? We can evaluate the AHI value to see the severity of the disease. Is there any other way or not? Thank you, doctor.
If we read the AHI from the CPAP machine, it will be the value obtained "after" treatment with the CPAP machine, not the AHI from our normal sleep. The machine will get the correct value. As for the method of measuring the AHI, if accuracy is desired, it must be the value obtained from the sleep test (sleep test), which may be examined at the hospital or at home and has both detailed and limited results. But either way, the AHI is the same. There are also AHI calculations from smart watches. (May be called AHI differently) such as Apple Watch, Garmin, FitBit, but the values obtained from these devices are not as accurate as the values obtained from the sleep test.
Hello, I've been using a cpap machine for over two years. It's very good to wake up refreshed. during two years But recently, someone close to me said As if I came back to sleep like I didn't put on the cpap machine. I slept like I was in torture and struggled all the time, so I wanted to know Should I have to bring the device to the hospital staff after finishing it? I wondered if the reason might be because I was overweight. then have to do sleep Is it a new test again?
It is possible that our physical condition has changed from two years ago, such as increasing weight. making it possible to use more pressure It is recommended to bring the device to the staff at the hospital or doctor to set it up. You may not need to do a new sleep test.
Hello doctor, I have been using Auto CPAC for a long time. Pressure P95. At about 11 h2o, sometimes when exhaling, it feels uncomfortable because the flex system can only be set to 3
I bought a Bipap machine, set everything up like an old CPAP machine but with pressure support I set it to 4.5 exhaling was more comfortable but woke up in the morning my chest felt tight unlike when using cpap. My question is 1) If I don't have any serious illnesses, can I use a bipap device to make my breathing easier?
2) Why does my chest feel tight in the morning? I just tried it for 7 days.
My AHI is usually around 2 to 2.5 thank you.
In fact, P95 pressure at 11 is not considered high. You should be able to use a CPAP machine with Flex at 3. If you want to change to a 2-level pressure type machine or bipap, you should consult your doctor first because bipap machines have Many types if for people with OSA and need to use high pressure Doctors usually recommend an auto bipap or a basic version, i.e. with only spontaneous mode. Other types of bipaps are often used for patients with respiratory problems such as chronic obstructive pulmonary disease, emphysema. etc.
Right now the machine company is out of stock, right? must be pre-order I would like to know directly from the company as well.
Yes, now the products that are not in stock must be pre-ordered.
What is the cause of the bipap machine when patients can't sleep? Why does it look like a patient who uses it and looks so cruel?
The patient is suffering from a genetic type of muscle weakness.
The bipap or ventilator in this type of patient is primarily intended to help the patient breathe. Selection of the type and model (specification) of the bipap apparatus, and setting the apparatus to suit the patient's breathing condition and pattern. will make the patient less suffering or uncomfortable And will have the effect that the body is not tired and able to sleep well. Consult your attending physician. Have your doctor advise you to use the appropriate version. Or do you have to adjust the device settings to be more suitable or not?
Ask. I've done a sleep test and the air pressure value is constant. I'm wondering if I should buy an auto unit just in case. Or should I buy a fixed price?
From our past experience If the pressure to maintain is not very high, for example, not more than 8 cmH2O, most of them can use a constant pressure machine. Because the pressure is not very high, it will not feel uncomfortable. But if you need to use pressure in the range of 9-15 cmH2O, it is recommended to use it as a device that adjusts the pressure automatically (auto), because the device will only give a high pressure in the necessary range. This will help reduce discomfort during sleep. But if a treatment pressure of more than 15 cmH2O or more is required, this group is recommended to be used as a 2-level pressure-adjusting device (Bi-level).
Can I put my cpap machine on when I wake up in the middle of the night?
It can be put in. In fact, if it can be worn every time we sleep, it's even better. Whether it's a short sleep or long sleep