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Advice needed.
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zonk Offline

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Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #11
RE: Advice needed.
Hi Realtor
In one of your earlier posts, you wrote "I do have a severe Insomnia problem"

Save your money on buying machines and deal with insomnia, AHI does not matter if you,re not getting good night sleep

RobySue wrote a blog titled "adventures-in-hosehead-land - A CPAP and insomnia blog by RobySue"
Go to her profile for the link and pay attention to what she say, she is the president of the insomnia club Coffee
07-16-2014 04:39 PM
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Realtor 1 Offline

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Posts: 48
Joined: Oct 2013

Machine: Resmed S9 Autoset
Mask Type: Full face mask
Mask Make & Model: Resmed F10
Humidifier: Built in
CPAP Pressure: 8-14
CPAP Software: ResScan SleepyHead

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Sex: Male
Location: Ontario, Canada

Post: #12
RE: Advice needed.
(07-16-2014 04:39 PM)zonk Wrote:  Hi Realtor
In one of your earlier posts, you wrote "I do have a severe Insomnia problem"

Save your money on buying machines and deal with insomnia, AHI does not matter if you,re not getting good night sleep

RobySue wrote a blog titled "adventures-in-hosehead-land - A CPAP and insomnia blog by RobySue"
Go to her profile for the link and pay attention to what she say, she is the president of the insomnia club Coffee
I have read Roby Sue's Blog and for last 13 month I have tried anything & everything humanly possible to get some sleep but nothing works. Have tried different diet, Lost 75 lbs, I eat very healthy, done moderate exercise, taking all types of herbs & herbal teas, Prescription Medicines but m stumped. Have worked with a shrink & taken depression medicine, Cat scans, 2 Mri's. all type of tests. Only 2 issues have been found one is sleep Apnea(I have been PAPing for 1 yr now) & H-pylori Bacteria (For that I have taken the anti-biotic tri-pac last yr and the Quadruple Therapy this yr but H-pylori is still there. A part from that no other physical Ailment has been diagnosed.
My family doctor has given up on me and I have not visited her office since early this year. I do have my follow up appointment with the sleep doctor in a few days and I can try to ask for the Provogil to work with the Fatigue.
07-16-2014 06:39 PM
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diamaunt Offline

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Posts: 436
Joined: May 2012

Machine: S9 VPAP Auto 36006
Mask Type: Full face mask
Mask Make & Model: mirage quattro/pilairo q
Humidifier: none
CPAP Pressure: 9-20ish
CPAP Software: SleepyHead

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Sex: Male
Location: texas

Post: #13
RE: Advice needed.
(07-16-2014 02:21 PM)archangle Wrote:  I believe the VPAP Adapt will do ASV modes and manual CPAP modes.

It will not do Auto CPAP or Auto bilevel/Auto VPAP modes. The ASV modes are "rougher" or "more controlling" to many people. If you don't actually need the special "central apnea" treatment the ASV gives, a normal APAP, bilevel, or auto bilevel machine will probably work better for you.

my favorite is the vpap auto, it can act like an elite, autoset, vpap s, and vpap auto, four machines in one Smile

you're right about the adapt, the old one does cpap and asv mode, the new adds autoasv to that mix.
07-16-2014 10:53 PM
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Sleepster Offline
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Posts: 4,988
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Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #14
RE: Advice needed.
(07-16-2014 10:53 PM)diamaunt Wrote:  my favorite is the vpap auto, it can act like an elite, autoset, vpap s, and vpap auto, four machines in one Smile

Five. You forgot to include the Escape. Dielaughing

Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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.
07-17-2014 06:36 PM
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diamaunt Offline

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Posts: 436
Joined: May 2012

Machine: S9 VPAP Auto 36006
Mask Type: Full face mask
Mask Make & Model: mirage quattro/pilairo q
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CPAP Pressure: 9-20ish
CPAP Software: SleepyHead

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Sex: Male
Location: texas

Post: #15
RE: Advice needed.
(07-17-2014 06:36 PM)Sleepster Wrote:  
(07-16-2014 10:53 PM)diamaunt Wrote:  my favorite is the vpap auto, it can act like an elite, autoset, vpap s, and vpap auto, four machines in one Smile
Five. You forgot to include the Escape. Dielaughing

I just checked, I don't see "brick" as one of the settings options. Tongue

and it can't imitate an escape auto, because it doesn't have 'apap' mode.
07-17-2014 07:36 PM
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robysue Online
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Posts: 1,222
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Machine: PR Dreamstation BiPAP Auto
Mask Type: Nasal pillows
Mask Make & Model: Swift FX
Humidifier: PR Dreamstation humidfier
CPAP Pressure: min EPAP = 4; max IPAP = 9;
CPAP Software: SleepyHead EncoreBasic EncorePro

Other Comments: Papping since September 2010

Sex: Female
Location: Buffalo, NY

Post: #16
RE: Advice needed.
(07-17-2014 07:36 PM)diamaunt Wrote:  
(07-17-2014 06:36 PM)Sleepster Wrote:  
(07-16-2014 10:53 PM)diamaunt Wrote:  my favorite is the vpap auto, it can act like an elite, autoset, vpap s, and vpap auto, four machines in one Smile
Five. You forgot to include the Escape. Dielaughing

I just checked, I don't see "brick" as one of the settings options. Tongue

and it can't imitate an escape auto, because it doesn't have 'apap' mode.
If PS can be set to 0, then the S9 VPAP Auto will act like the S9 AutoSet.

Questions about SleepyHead?
See my Guide to SleepyHead
07-18-2014 10:32 AM
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justMongo Offline

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Post: #17
RE: Advice needed.
(07-18-2014 10:32 AM)robysue Wrote:  If PS can be set to 0, then the S9 VPAP Auto will act like the S9 AutoSet.

S9 Autoset has a PS setting, does it not? It's limited to 3?
So, if the S9 VPAP Auto has the PS set 3 or less, then does it not act like the S9 AutoSet?

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.
07-18-2014 10:52 AM
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robysue Online
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Machine: PR Dreamstation BiPAP Auto
Mask Type: Nasal pillows
Mask Make & Model: Swift FX
Humidifier: PR Dreamstation humidfier
CPAP Pressure: min EPAP = 4; max IPAP = 9;
CPAP Software: SleepyHead EncoreBasic EncorePro

Other Comments: Papping since September 2010

Sex: Female
Location: Buffalo, NY

Post: #18
RE: Advice needed.
(07-16-2014 06:39 PM)Realtor 1 Wrote:  I have read Roby Sue's Blog and for last 13 month I have tried anything & everything humanly possible to get some sleep but nothing works.
I'm sorry that you are having so many on-going problems with insomnia and that nothing I've suggested seems to have helped.

Quote:Have tried different diet, Lost 75 lbs, I eat very healthy, done moderate exercise,
When do you exercise?

Quote:taking all types of herbs & herbal teas, Prescription Medicines but m stumped. Have worked with a shrink & taken depression medicine, Cat scans, 2 Mri's. all type of tests. Only 2 issues have been found one is sleep Apnea(I have been PAPing for 1 yr now) & H-pylori Bacteria (For that I have taken the anti-biotic tri-pac last yr and the Quadruple Therapy this yr but H-pylori is still there. A part from that no other physical Ailment has been diagnosed.
While you mention working with a shrink and herbs and prescription medication, you have NOT talked about any of the following things concerning your sleep problems. And they may be far more important than you think they are:

1) Sleep schedule. Do you have a regular wake up time and a regular bedtime that you attempt to stick with every day, including your days off? Or does your bedtime or wake up time vary dramatically on days off vs work days?

2) Caffeine and alcohol consumption. Both can pretty drastically affect the quality of sleep, and many people are very reluctant to admit that very moderate amounts of either might be aggravating their sleep problems.

3) Worrying too much about the sleep, particularly when in bed. Yeah, I know it's tough to try to "let go" of the worrying when the sleep is really bad. I've had my own real battles with "letting go" of the sleep log that I kept for 2 1/2 years. But eventually I got to the point where I realized that the log had become part of my problem, rather than part of the solution. It was very useful for the first 12-15 months. I'm not sure it continued to be of much use after that, and after most of my insomnia problems were addressed in some fashion, the sleep log did trigger more focus on my sleep than I really needed. I'm not saying that I don't still have insomnia problems (I do), but on most nights, the insomnia problems don't keep me from getting enough sleep to feel decent in the daytime.

4) A description of what kind of insomnia you're dealing with. Many (most) of the herbs & herbal teas and Prescription Medicines can work reasonably well to address sleep onset insomnia, but they're not particularly effective at tackling sleep maintenance insomnia problems. And they're even less effective in dealing with "wake too early for the morning" insomnia.

5) Possible circadian rhythm problems. Sometimes people mistake problems they're experiencing from delayed sleep phase issues or advanced sleep phase issues as insomnia. And most insomnia treatments won't do much to "fix" a circadian rhythm problem. Delayed sleep phase is when your body doesn't get sleepy enough by your desired bedtime: You want (or need) to go to bed by midnight, but the body is not sleepy enough to get and stay asleep until it's 3:00 AM. Advance sleep phase is the opposite. The body wants to wake up before your desired wake time: Your body is ready to WAKE UP (for the day) at 4:30AM regardless of when you went to bed because the body really wants to sleep from 8:30pm - 4:30am. Often times, people with an advanced sleep phase problem will say that they're very tired and sleepy in the evening, but they just gut it out until a more "reasonable" bedtime of 10:30 or 11:30, but once they wake up at 4:30, they just can't get back to sleep.


Quote:My family doctor has given up on me and I have not visited her office since early this year. I do have my follow up appointment with the sleep doctor in a few days
A good place to start the conversation about the insomnia with your sleep doc is with the following:

A) When do you want (or need) to be asleep? As in when do you think bedtime should be and when do you think wake up time should be? Are these times driven by the need to be up and functioning for a job?

B) An accurate description of the problem: Do you have trouble getting to sleep at your desired bedtime? Do you have multiple short wakes throughout the night? Do you have one or more very long wakes on most nights? Do you wake up too early and find yourself unable to get back to sleep?

C) A complete list of prescription sleeping medications that you have already tried: What medication? What dose? How long did you take it? Why did you discontinue it?

D) A complete list of herbs and supplements that you have already tried: Which herbs/supplements? What dose? How long did you take each herb/supplement? Why you discontinued each herb/supplement? Did you take combinations of herbs/supplements? If so, what combinations have you tried.

It may help your sleep doc provide better suggestions for treatment if you can drop the list of previously tried prescription medicine and herbs/supplements by his office and tell the receptionist that you'd like the list added to your medical records and that you'd like the sleep doc to review the previously tried medicines before your appointment.

Quote:and I can try to ask for the Provigil to work with the Fatigue.
Your sleep doc may be willing to prescribe the Provigil since you've been PAPing for a year without much improvement in terms of daytime fatigue. Whether your insurance will cover it is another issue altogether, and not all will.

But the sleep doc may very well want to focus on treating your insomnia/lack of sleep issues first before jumping to prescribing the Provigil: It is usually prescribed for a sleep apnea sufferer only when the OSA patient still has issues with daytime fatigue even though he/she is compliant with PAP therapy (you are) and is sleeping reasonably soundly with the PAP machine (you are not).

Questions about SleepyHead?
See my Guide to SleepyHead
07-18-2014 11:18 AM
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Sleepster Offline
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Posts: 4,988
Joined: Feb 2012

Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #19
RE: Advice needed.
(07-18-2014 10:52 AM)justMongo Wrote:  S9 Autoset has a PS setting, does it not? It's limited to 3?

It's EPR, and I don't if it does exactly the same thing as PS, but it's at least close.

Quote:So, if the S9 VPAP Auto has the PS set 3 or less, then does it not act like the S9 AutoSet?

Yes, I think it does. The VPAP also allows you to make adjustments to the shape and timing of the inspiration pressure. I don't know if the Autoset will let you do that.

Sleepster
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www.ApneaBoard.com


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.
07-18-2014 04:59 PM
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archangle Offline
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Machine: ResMed S9 AutoSet
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Post: #20
RE: Advice needed.
(07-16-2014 04:17 PM)Sleepster Wrote:  CPAP machines are not reliable discriminators between central and obstructive events. It's possible that they are just hypopneas, but as I said, if they're interfering with your sleep it's something to discuss with the doc.

My belief is that if an S9 or PRS1 says "clear airway" or "central," it probably IS a true central. However, if it says "obstructive," it may actually be central.

Apart from the question of reliably detecting a clear airway, I've read that sometimes the airway will collapse at the same time as there is no chest effort to breathe. In this case, the event meets the definition of a central apnea and needs central apnea techniques to eliminate or reduce.

I don't have a good idea of what percent of centrals occur without clear airways, but it's probably fairly small.

I'm a bit more skeptical about how often the machine is unable to detect the clearness of the airway by sensing pressure and airflow through a humidifier, 6 foot hose, CPAP mask of varying types, patient's nose and mouth, nasal passages, mask leaks, mouth leaks, etc. My gut feel is that they don't flag it as "clear airway" unless the indications are unambiguous. Detecting a clear airway seems to require a good deal of finesse.

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07-18-2014 05:09 PM
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