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Apnaes: difference between Central / Obstructive ?
#81
RE: Apnaes: difference between Central / Obstructive ?
It would really help to have the settings from the left column that provides all the statistics. Please follow this tutorial to get the Daily Details screenshot with all the information http://www.apneaboard.com/wiki/index.php...ganization

From what I can see here, you are using a Resmed machine (unknown model, unknown settings), that during the apnea and hypopnea cluster from 2:30 to 3:30 is providing variable pressure between 8.0 and 10.5, with numerous CA and H events. This is classic central and complex apnea, and cannot be treated in this mode. You will need an ASV machine.
Sleeprider
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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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#82
RE: Apnaes: difference between Central / Obstructive ?
As Sleeprider says, it'd be very helpful to include the left panel. Sorry to hassle you with this; once you get the hang of it, it'll be simple.
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#83
RE: Apnaes: difference between Central / Obstructive ?
The doctor suspected bad handled hypopapnaes. 

The Loewenstein was suspected of not reacting sufficiently on half-open airway situation.

I did insist to get an ASV from Resmed, but they said that the Airflow 10S would be good enough :-(
Next week they will evaluate, for the time being, I am worse off than before.

If only I could get my parameters set up as before.
For me the parameters are different ..
Shall I go back down to 5 - 8,5 instead of 5 - 12 pressure settings?
In the COMFORT settings;
RESPONSE standard or soft?
Is it better not to useRAMP and EPR at all or can I set short RAMP and EPR during PARM?


I tend to agree that this is not the solution for me, I am considering calling the doctor again tomorrow.


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Don't forget the obvious.[Image: bigwink.gif]
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#84
RE: Apnaes: difference between Central / Obstructive ?
If your doctor was looking for a sufficient response to half-open airway, he is more clueless than I thought. First of all, your machine is a CPAP not an Aircurve 10 VPAP S but an Airsense 10 Autoset. CPAP. It is not setup for pressure support or EPR. It is made to simply provide pressure in a range from 5 to 12 cm H2O. Adding in EPR, while interesting wont' solve the problem. Using a minimum pressure of 7.0 and Maximum pressure of 12 with EPR on full-time at 2 will put you in the same area as your previous machine. Your statistics show your tidal volume is very good at a median of 540 mL but flow limitation is very high as indicated by the long inspiratory time and shorter expiratory time and the 95% flow limit index of 0.19. Adding EPR will help this, but may drive up central apnea.

Your AHI is 38 events per hour on average, but clustered so that in some hours, you are essentially not breathing. I think you should be using a pulse oximeter for your own safety and to evaluate just how serious this is. I consider events at this level an urgent indication of an need to go to ASV immediately. This is really serious stuff. You need to stop being so tolerant of your doctor's incompetence. He has diagnostic and therapeutic data that both point to the same result. This is simply negligence.
Sleeprider
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____________________________________________
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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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#85
RE: Apnaes: difference between Central / Obstructive ?
37.9 AHI! WOW what a trainwreck of therapy. I'd suggest calling Dr. McQuack or whatever his name is, tell him this machine's therapy is not helping. Tell him how badly you feel, do not mention any positive thing, supposing they even exist. Mention only negatives, very poor rest, extremely uncomfortable and such like. Call that doctor as soon as you can and say you will not accept this extreme failure of treatment. Then in a polite yet forceful fashion demand ResMed ASV. Also mention you are not trying this experiment any longer, ASV immediately.

Best wishes you succeed.
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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#86
RE: Apnaes: difference between Central / Obstructive ?
The doctor does not seem to trust the results as they are presented. I do not even know if he looks at the transmitted results in his backend system.
I agree, I do not feel well at all. My former machine was better.
Sleeprider, are you sure that the Aircurve 10S is only CPAP? I have it set to auto, which does adapt pressure as you can see on the chart.
It is just to optimize before I get a replacement.
I did drink some red wine, but that is part of our culture...
I had a nap this afternoon and had more than 20 apnaes!
Don't forget the obvious.[Image: bigwink.gif]
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#87
RE: Apnaes: difference between Central / Obstructive ?
The screenshot shows you were using a ResMed Airsense 10 Autoset. Look on the front of the machine to see what it says in the bottom right corner.

If you get a recording oximeter as Sleeprider suggests, the results may help you get immediate attention from your doctor. You might try using an oximeter that is compatible with Oscar; see the Oximetry Wizard page on the Welcome page.

If your O2 levels are below 90 for sustained periods of time and your doctor still won't pay attention, please get another doctor. This is a significant health issue.
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#88
RE: Apnaes: difference between Central / Obstructive ?
Using terminology like 10S is confusing. Correctly it is the successor to the S9 series and we would call it the S10, but without the model name Autoset, we don't know that it is the auto-adjusting CPAP. Resmed calls its CPAP line Airsense t0, and the models are CPAP, Elite and Autoset and Autoset for her. The bilevel models are Aircurve 10, and the models are VPAP S, Vauto and ASV.

There is a saying attributed to Einstein that continuing to do the same thing and expecting different results is the definition of insanity. Well, your doctor is insane, although I would argue incompetent is equally appropriate. I think you need to request a change.
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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#89
RE: Apnaes: difference between Central / Obstructive ?
My adjustments had some effect, as suspected Sleeprider. This brings me back to the old situation.
This morning I am expecting a call from the clinic.
What do you all think better but not enough? Shall I still insist on an ASV?
Sleep well in the other time zone  Smile


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Don't forget the obvious.[Image: bigwink.gif]
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#90
RE: Apnaes: difference between Central / Obstructive ?
Me, I'd say things don't look acceptable if these were my results. I'd replace the PAP machine and probably the dimwit doc just to be sure I began to get proper treatment.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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