1 month review please?!

[FrankNichols]

Hi Frank,
I notice you don't have Periodic Breathing listed in your events graph. Be sure it's checked on the drop down box at bottom right of page.
It's possible you didn't experience PP, but would be good to see along with the Clear Airways.

Thanks for the reply, I don't see Periodic Breathing listed anywhere except in the preferences under events. I checked all the drop downs and pop ups and everywhere I could look and the option is not available - maybe it is a ResMed thing that they aren't available?

As to 11 vs 10 pressure, I also had days at 11 that looked exactly like the 10's. I think the increase in events on the mouth breathing example was a result of all the leaks, but I could be wrong. It is on my list of "to bring up with the doctor".

I have heard that I would need to have the CA's appear to be mostly untreated to qualify for an ASV machine? While they do exceed my OAs normally, they are only in the 2 to 3 per hour range when things are all "working". Personally I don't care which machine I use, as long as it works and I start feeling better - I will definitely be talking with the doc about that. (I did have an echocardiogram recently that showed my heart is in good condition and no left ventricle reduction, so ASV would be safe/okay for me if I need it.)

[shewhorn]

Hi Frank,
I notice you don't have Periodic Breathing listed in your events graph. Be sure it's checked on the drop down box at bottom right of page.

Can you elaborate on this? I just looked for an option with that name and didn't see anything. Maybe it's not on the Mac version (I'm using OS X as well), or perhaps only specific machine models report that (my current machine is an Aircurve ASV, previous was an Airsense 10 Autoset).

[OpalRose]

I was wrong.....in Sleepyhead, go to the Daily Page, bottom left and click on PB arrow. It will be a Grn/Blk box. If Red/Blk, then it is turned off.

[FrankNichols]

Hi Frank,
I notice you don't have Periodic Breathing listed in your events graph. Be sure it's checked on the drop down box at bottom right of page.

Can you elaborate on this? I just looked for an option with that name and didn't see anything. Maybe it's not on the Mac version (I'm using OS X as well), or perhaps only specific machine models report that (my current machine is an Aircurve ASV, previous was an Airsense 10 Autoset).

I have an AirSense 10 AutoSet. I can see the "Event" enable in the preferences in Sleepyhead under Events. But I can't see anyway to have it displayed. I expect that means ResMed does not report it.

[Sleeprider]

Frank, you are using a fixed pressure of 10 and no EPR. Could you review what settings you have tried as an alternative to fixed CPAP at 10 cm?

[FrankNichols]

Frank, you are using a fixed pressure of 10 and no EPR. Could you review what settings you have tried as an alternative to fixed CPAP at 10 cm?

I tried a few days of APAP at the second week or so just to see what it thought would work. It ran around 13 or 14. However, there was so much new going on it is hard to draw any conclusions during that time. So, I went back to the 10 (I tried an 11 for a couple days after things settled down) to try to get the leaks and AHI under somewhat of control before starting a more rigorous experimenting routine.

I did start off with all the comfort settings on (Ramp, EPR, etc) and after a few days I shut them all off, to "simplify" the treatment and try to get it under control. I am running really simple straight CPAP at the moment.

[FrankNichols]

I was wrong.....in Sleepyhead, go to the Daily Page, bottom left and click on PB arrow. It will be a Grn/Blk box. If Red/Blk, then it is turned off.

Nope, sorry, I am running beta 2.2 on OS-X and there is nothing about PB there on either the right or left bottom corners of the Daily. There is a PB enable on the Overview page, which I never look at. But, while it is in the drop down menu, and is a "green" switch looking thing, there are no PB values on any of the charts on the Overview page.

[Sleeprider]

Frank, you are using a fixed pressure of 10 and no EPR. Could you review what settings you have tried as an alternative to fixed CPAP at 10 cm?

I tried a few days of APAP at the second week or so just to see what it thought would work. It ran around 13 or 14. However, there was so much new going on it is hard to draw any conclusions during that time. So, I went back to the 10 (I tried an 11 for a couple days after things settled down) to try to get the leaks and AHI under somewhat of control before starting a more rigorous experimenting routine.

I did start off with all the comfort settings on (Ramp, EPR, etc) and after a few days I shut them all off, to "simplify" the treatment and try to get it under control. I am running really simple straight CPAP at the moment.

That makes sense. You've tried a variety of settings and settled on simple CPAP. I recall experiencing higher leak rates without exhale pressure relief, but I agree with the idea of keeping it simple to limit the variables you're trying to address. You are still seeing obstructive events, and I continue to think that resolving that should come ahead of any consideration of CA showing up. I would continue to elevate pressure to try to reduce OA and H, and perhaps gradually add in EPR to keep it comfortable and minimize leaks. If reducing OA/H elevates CA, then you have the foundation of an argument for bilevel ASV. Otherwise, I hope you get the best sleep possible. So much of this is in finding the mask solution; and that varies by individual.

[FrankNichols]

Thanks, that is I think the basis for my talks with the Doctor Friday. To see what he feels will address the events best and put that into practice. Since I have passed the compliance test requirements, I will also be letting him know it is my intent to slowly be adjusting things based on what I see in Sleepyhead, and based on the direction he suggests going. Hopefully he will give me some kind of goal to reach where we can say, this is no longer working, what is plan B, with plan B being a different therapy or a different machine or something. It's not that I am in a hurry, a few months is reasonable to me, but I am the type that likes to have a goal and measurable progress, not just "try this and see what happens".

As far as the EPR I have not felt any issue with the pressure so far, of course I am not up the the higher teens yet either. But, within a few minutes of turning on the machine at night, I don't notice the pressure at all - it feels completely natural breathing at 10 with no relief.

Any questions I should add to my list for the Doctor?

[robysue]

I was wrong.....in Sleepyhead, go to the Daily Page, bottom left and click on PB arrow. It will be a Grn/Blk box. If Red/Blk, then it is turned off.

Nope, sorry, I am running beta 2.2 on OS-X and there is nothing about PB there on either the right or left bottom corners of the Daily. There is a PB enable on the Overview page, which I never look at. But, while it is in the drop down menu, and is a "green" switch looking thing, there are no PB values on any of the charts on the Overview page.

OpalRose has a PR machine and those machines do flag periodic breathing.

FrankNichols is using a Resmed machine and to the best of my knowledge they do not flag periodic breathing. SleepyHead can't show data the machine does not record, but the stuff shows up in the SH options.