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1st Night Bi-Pap, high pressures = terrible
#41
RE: 1st Night Bi-Pap, high pressures = terrible
I appreciate those inputs, that helped.  The reason my minute ventilation got screwed up was that in the learning mode I was taking big breaths so it kept those settings. Ironically it wasn’t as uncomfortable as 22/17. Obviously I take full responsibility for that. 

The pulm Dr I saw today was great, presented her with my info and they recommended an ASV so we’re gonna try that. 

Going forward I’m going to go back to ivaps close to the settings from Wednesday night as they were the most comfortable. My question is that if I pick a low target minute ventilation will it try and prevent me from going over that? So instead of trying to nail a number can I undershoot it and then take whatever I need over it? Or does it shoot for that target high and low?  We’ll see, I could just go back to ST also but I’ll try this first, it’s a lot more intelligent mode. 

Again I appreciate everything.
Brando
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#42
RE: 1st Night Bi-Pap, high pressures = terrible
That is something I was wondering about and hesitated on recommending as I do not know how iVAPS works in that regard.

With ASV it targets 90% of your previous minute ventilation and provides pressure support to maintain this current target. This allows the machine to fluctuate with your breathing requirements which does vary a bit in different stages of sleep etc. The minute vent is determined by your effort and the machine just works to supplement any bad breaths/apneas.

That is not possible on iVAPS which is one reason I would be hesitant to use it. Either you set a realistic target and the machine provides ventilation at times or you set a low target and run the risk of it under treating your apnea as you are handcuffing its pressure support/algorithm by doing so(breathing has to drop below that low target before machine will try to help you).

Your doctor is on board with the ASV, how long will it take to swap machines? Seems like you should be able to get that to happen sooner than later if the decision has already been made.
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#43
RE: 1st Night Bi-Pap, high pressures = terrible
I did an experiment and turned the minute ventilation way down to 3L/min, it didn't restrict breathing so I think it's just a floor that it tries to meet and if you go over it allows you to pull whatever you want. but if you fall below it it brings you up. So I'm just going to put it a 7L/min and try again tonight and see what the AHI's are. Thats pretty close to what it was on Wednesday night when I had the most comfort and felt the best. The Dr said their regular nurse was out today so they would call Monday. I'm working 13hr shifts the next 4 days so just trying to be conservative and get some sleep. They also want to do an echo of my heart since ASV isn't good if you have heart failure which I don't suspect to have anything, also getting an MRI brain just to make sure there's no underlying etiology for the centrals although we don't expect anything. Thanks again, fingers crossed.

I've been so busy with this machine thing I haven't time to look around at other topics yet. Hopefully with lower pressures I can try a nasal mask again. I'll look around and see what people prefer.

Brando
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#44
RE: 1st Night Bi-Pap, high pressures = terrible
Brando, thanks for bringing the results of your experimental trials with vent rate to the forum. You can be assured these insights will be passed along to others as we start to see more of these machines in use. I would be concerned that a Va of 3 L/min would not be supportive enough of someone with restrictive respiratory conditions that merit the use of this machine, but it's useful to know that it does not interfere with spontaneous respiratory rates. The 7.0 L/min sounds like a more appropriate target even for your CA events and chronic hypopnea. Please keep us informed.
Sleeprider
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#45
RE: 1st Night Bi-Pap, high pressures = terrible
Brando, would you be interested in helping with the new OSCAR beta release? The new version in testing now should read your therapy mode and other data on your ST-A more accurately. If you'd be willing to try the new version and evaluate for bugs or QA issues, please send a PM to Bonjour and request admission to the Beta Test Group. The new beta version is available for download from that location and should improve your experience with OSCAR. Equally important, we don't have a lot of ST-A users, and your input would be appreciated.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#46
RE: 1st Night Bi-Pap, high pressures = terrible
Absolutely, I’m working a lot over the next few days but I’ll get to it.
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#47
RE: 1st Night Bi-Pap, high pressures = terrible
Brando80,

Continued best of luck in succeeding when dealing with the Ducks and DMEs.
Dave

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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