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Anyone else experience this?
#41
What is your minimum EPAP set at? It looks like the machine's rapid response to OAs is what triggered the 2 clusters of CAs in this data. If your min EPAP is 4 or 5 and if it were me, I would raise the min EPAP by 1 and reduce the Pressure Support by 1 and see if it helps.

I think that you should talk to your sleep doc and present some of this data to him/her as soon as possible. I think that it is ultimately going to require a bilevel machine with a back-up rate to get your CAs down to a good level but that is just my opinion.

Question: Is your Pressure Support currently set at 4?

Good luck with whatever you decide to do.

Question for others: What would cause Sleepyhead to have only one pressure trace for a VPAP? PS set to 0? VPAP in CPAP mode? Anything else?

Best Regards,

PaytonA
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#42
(07-20-2015, 10:15 AM)Sleeprider Wrote: Rich, that's interesting, particularly that you have essentially zero OA and H. On the theory that pressure support may aggravate CA, what is the minimum CPAP pressure you can tolerate before those begin to reappear?

I tried straight 9 CPAP and 5 9 Bipap with similar results. I have only had 4 nights with AHI below 20 in the past 6 weeks. I am thinking of trying straight 5 this week.
Apnea Board Member RobySue has posted a Beginners Guide to Sleepyhead Software here:  http://www.apneaboard.com/wiki/index.php...SleepyHead

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#43
[attachment=1615]
(07-20-2015, 10:15 AM)Sleeprider Wrote: Rich, that's interesting, particularly that you have essentially zero OA and H. On the theory that pressure support may aggravate CA, what is the minimum CPAP pressure you can tolerate before those begin to reappear?

Here is a snippet at CPAP 9. The HAs have returned big time. I am going to try a straight CPAP 5 which is probably the lowest pressure I can tolerate. I am pretty sure that I have lots of Periodic Breathing without the machine.
Apnea Board Member RobySue has posted a Beginners Guide to Sleepyhead Software here:  http://www.apneaboard.com/wiki/index.php...SleepyHead

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#44
(07-20-2015, 10:33 AM)PaytonA Wrote: What is your minimum EPAP set at? It looks like the machine's rapid response to OAs is what triggered the 2 clusters of CAs in this data. If your min EPAP is 4 or 5 and if it were me, I would raise the min EPAP by 1 and reduce the Pressure Support by 1 and see if it helps.

I think that you should talk to your sleep doc and present some of this data to him/her as soon as possible. I think that it is ultimately going to require a bilevel machine with a back-up rate to get your CAs down to a good level but that is just my opinion.

Question: Is your Pressure Support currently set at 4?

Good luck with whatever you decide to do.

Question for others: What would cause Sleepyhead to have only one pressure trace for a VPAP? PS set to 0? VPAP in CPAP mode? Anything else?

Best Regards,

PaytonA

Not really sure who this is directed at since it seems both Rich and I are posting our Sleepyhead data looking for answers. If directed at me, prior to last night my min EPAP was currently set to while my Pressure Support was also set to 4.

Last night I lowered my Pressure Support to 3.0 (min EPAP is still 4.0) to see what that would do for me. Attached is my Sleepyhead report;

[Image: du5rX74l.png]

Once again I had a AHI spike early in my sleep, but for well over 2 hours I had an AHI of 1.0 or less. It's this early spike of 35 that is making my AHI avg out at over 9 for the night. Wish I knew what I was doing when I got the lower AHI so I could do that all night. Any ideas?
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#45
(07-21-2015, 04:37 AM)wxmcpo Wrote:
(07-20-2015, 10:33 AM)PaytonA Wrote: What is your minimum EPAP set at? It looks like the machine's rapid response to OAs is what triggered the 2 clusters of CAs in this data. If your min EPAP is 4 or 5 and if it were me, I would raise the min EPAP by 1 and reduce the Pressure Support by 1 and see if it helps.

I think that you should talk to your sleep doc and present some of this data to him/her as soon as possible. I think that it is ultimately going to require a bilevel machine with a back-up rate to get your CAs down to a good level but that is just my opinion.

Question: Is your Pressure Support currently set at 4?

Good luck with whatever you decide to do.

Question for others: What would cause Sleepyhead to have only one pressure trace for a VPAP? PS set to 0? VPAP in CPAP mode? Anything else?

Best Regards,

PaytonA

Not really sure who this is directed at since it seems both Rich and I are posting our Sleepyhead data looking for answers. If directed at me, prior to last night my min EPAP was currently set to while my Pressure Support was also set to 4.

Last night I lowered my Pressure Support to 3.0 (min EPAP is still 4.0) to see what that would do for me. Attached is my Sleepyhead report;

[Image: du5rX74l.png]

Once again I had a AHI spike early in my sleep, but for well over 2 hours I had an AHI of 1.0 or less. It's this early spike of 35 that is making my AHI avg out at over 9 for the night. Wish I knew what I was doing when I got the lower AHI so I could do that all night. Any ideas?

Hi wxmcpo,

Take a closer look at your data. There is a section between 20:00 and 21:00 that looks suspicious. Highlight 5 or 10 minute sections of your flow rate graph to see how you are breathing breath to breath. I suspect that your are experiencing periodic breathing in that section as well as many other sections.

richb
Apnea Board Member RobySue has posted a Beginners Guide to Sleepyhead Software here:  http://www.apneaboard.com/wiki/index.php...SleepyHead

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Organize your Sleepyhead Charts
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#46
I have had a lot of trouble with my machine since it was re-programed with a new prescription by my provider. I checked my settings and found the machine was set for Vauto min 4 and max 15. The big problem is the PS was set for 8. Previous setting was Vauto min 5 max 16 PS 4. I was unable to get to sleep and so I checked the setting and re adjusted the PS to 4. Slept better but got an AHI of 20. My settings were supposed to be Bi-pap 11 15. This setting produced lower AHI during my 2nd titration. I am going to try that setting tonight and then try CPAP straight 5 the next night. PaytonA suggested I look for a low setting where the events minimize. I think I will see more Hypos at the lowest setting just as I did when I went to straight CPAP 9.
Apnea Board Member RobySue has posted a Beginners Guide to Sleepyhead Software here:  http://www.apneaboard.com/wiki/index.php...SleepyHead

Download Sleepyhead
Organize your Sleepyhead Charts
Post from Imgur


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#47
Rich, I've been watching this thread without intervening until now. However I agree with paytonA that you should be looking at a bilevel with backup. Putting it bluntly, you are on the wrong machine and all the experimenting with pressure modes and settings is wasting time. You need an ASV machine, which will suppress periodic breathing and central apneas. I'm convinced you will see an immediate and dramatic improvement with an ASV.

The only caveat on that is that there have been some adverse outcomes for patients with a narrowly defined congestive heart condition - you need to talk to your doctor if that affects you. See this: http://www.resmed.com/us/en/consumer/new...erapy.html
and this: http://www.sleep.org.au/documents/item/1759
DeepBreathing
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#48
(07-21-2015, 07:00 AM)DeepBreathing Wrote: Rich, I've been watching this thread without intervening until now. However I agree with paytonA that you should be looking at a bilevel with backup. Putting it bluntly, you are on the wrong machine and all the experimenting with pressure modes and settings is wasting time. You need an ASV machine, which will suppress periodic breathing and central apneas. I'm convinced you will see an immediate and dramatic improvement with an ASV.

The only caveat on that is that there have been some adverse outcomes for patients with a narrowly defined congestive heart condition - you need to talk to your doctor if that affects you. See this: http://www.resmed.com/us/en/consumer/new...erapy.html
and this: http://www.sleep.org.au/documents/item/1759

I need 2 more days of data to bring to my sleep doc to show that the machine is actually bad for my health. My BP is elevated above that when I am not on a machine. My sleep is horrible. I have been saying that I need an ASV machine, medication or both for a while now.

richb
Apnea Board Member RobySue has posted a Beginners Guide to Sleepyhead Software here:  http://www.apneaboard.com/wiki/index.php...SleepyHead

Download Sleepyhead
Organize your Sleepyhead Charts
Post from Imgur


Post Reply Post Reply
#49
(07-21-2015, 06:48 AM)richb Wrote: Hi wxmcpo,

Take a closer look at your data. There is a section between 20:00 and 21:00 that looks suspicious. Highlight 5 or 10 minute sections of your flow rate graph to see how you are breathing breath to breath. I suspect that your are experiencing periodic breathing in that section as well as many other sections.

richb

Richb,

So I took a look at the section you were mentioning. Below is 5 minute sections starting at 2100 and going for almost 24 minutes. I will admit I am not 100% sure what I am looking at there, but I can see signs of where it looks like my breathing may have slowed or stop at times. Is that what you were looking for?

[Image: kpDRLYgl.png]

Quote:I have had a lot of trouble with my machine since it was re-programed with a new prescription by my provider. I checked my settings and found the machine was set for Vauto min 4 and max 15. The big problem is the PS was set for 8. Previous setting was Vauto min 5 max 16 PS 4. I was unable to get to sleep and so I checked the setting and re adjusted the PS to 4. Slept better but got an AHI of 20. My settings were supposed to be Bi-pap 11 15. This setting produced lower AHI during my 2nd titration. I am going to try that setting tonight and then try CPAP straight 5 the next night. PaytonA suggested I look for a low setting where the events minimize. I think I will see more Hypos at the lowest setting just as I did when I went to straight CPAP 9.

So my machine is also set to VAuto but with min 4 and max 25. A couple of nights ago I turned my PS down from 4 to 3 and my AHI went from 20+ to 9. So last night I left PS at 3, but turned my TiMax down from 3 to 2 and my AHI dropped to 3.2. This is one of my best numbers ever. Here's a screenshot of last nights data;

[Image: zpcio9Cl.png]

I am going to leave settings where they are for now and see how that does me over the next couple of nights. One big difference I noticed from previous nights is I didn't have an AHI spike early in my sleep, but rather late in my sleep.
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#50
(07-20-2015, 10:33 AM)PaytonA Wrote: Question for others: What would cause Sleepyhead to have only one pressure trace for a VPAP? PS set to 0? VPAP in CPAP mode? Anything else?

Hi PaytonA -- This question came up on another forum. Apparently SleepyHead is only showing the IPAP trace (though you might be able to see both IPAP and EPAP lines in the Mask Pressure graph). Just a little bug -- SH hasn't caught all the way up with the AirCurve machines yet.
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