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2 days in with AirCurve 10 AVAP
#21
This is the SleepyHead data from last night.  I'm thinking leave it alone for a couple of nights and see how the new settings work and give me time to settle in to the machine.  Is there any do to lower the clear airways?  they seen to be my biggest hurdle. 

[Image: 1xtGajPl.png]
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#22
You still have good TV at PS=4. You could consider lowering PS to 3. Of course then you essentially have an Autoset machine with EPR=3.

Question, since you said you have lung cancer: Are you on any pain meds? Pain meds, especially opiates can cause CAs.
Your median respiratory rate is a bit slow at 10. Suggests pain meds?

Your final solution may come down to getting an ASV machine since it treats central and mixed apneas.
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#23
I am on pain meds and still taking chemo 5 days a week, chemo this week and one more week 21 days from yesterday. Didn't start back on pain med till yesterday and took one dilaudid yesterday about 10 am, one last night about 9pm and one this morning at 8 am. That's the only 3 I've taken since mid January. I only take pain meds when i need to, but then again my wife and nurses tell me I'm sturborn and should take then when pain starts not wait till it's unbearable.Even with the setting of EPR 3 and min 10-max 20 with the autoset i was still getting high numbers. That is why I was moved up to the bi-level machine. Does the ResMed VAUTO have the auto function to run variable pressure as needed, for example, my max is 15 as now but if my breathing requires more pressure will it do this? Thanks for you help JustMongo.
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#24
Dilaudid can certainly cause CAs. If you need it, you need it.

Your machine is running Auto within preset limits. You can see it in your pressure graph.
With the settings in your last Sleepyhead graph: EPAPmin=9, IPAPmax=15 and PS=4.
The machine will run in auto: holding the relationship of IPAP - EPAP = PS.

So, the IPAP, EPAP will auto adjust to Hypos and OAs like this:

IPAP EPAP
9 13
<------ and points in between
10 14
<------ and points in between
11 15

Your OAs and Hypos are in good control. I see no reason to increase IPAPmax from 15.
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#25
These results are an improvement so far. You can try PS at 3.0 which is what I use because at higher PS I had more centrals. I am not familiar with the drug interactions, but certainly possible they are affecting things. Your obstructive and hypopnea index are very good, and if your sleep is restless, that alone can explain some centrals. I'll offer that your current AHI is acceptable, especially if these events are short duration. A decrease to PS3 may bring events down to less than 5.0.
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#26
Thanks JustMongo and Sleeprider for the responses and help.  I'll lower the PS to 3 for tonight and see it it goes.  Can't hurt to try.  I-love-Apnea-Board
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