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BIPAP machine stops blowing when I stop breathing
#31
RE: BIPAP machine stops blowing when I stop breathing
Without trying to appear to harsh or skeptical, I will posit that insurance has made doctors their agents to obstruct getting any appropriate therapy above CPAP. The burdens of proving medical necessity above the level of CPAP are ridiculous and considerably above the cost of providing the therapy. A sleep test costs at least twice the cost of even an ASV bilevel machine, and the conditions described for qualification are so profoundly debilitating that they are more appropriate for someone hospitalized on invasive mechanical ventilation. Sleep medicine is for people with simple obstructive sleep apnea. I have paid for both of my bilevel machines and anticipate I will buy the third out of pocket rather than submit to Medicare and DME requirements for sleep tests and various physician evaluations, insurance submittals, denials and appeals. This is is what the state of insurance and the medical practice are. Your problems are entirely mild to moderate CSA and you can't tolerate CPAP or Bilevel therapy. You will find efficacy and comfort with ASV. If you want to screw around with the medical mafia, be prepared for the frustration that goes with it, or as your awareness increases of other possibilities, you will eventually become more like me and many others that just circumvent the intentional malpractice. At the very least, you can later go to your doctor with the results from your personally acquired ASV and show him that the therapy works and is the most effective solution. Not everyone has the financial resources or awareness of alternatives to pursue this on their own.
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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#32
RE: BIPAP machine stops blowing when I stop breathing
I appreciate this response very much and feel vindicated and supported for how I am feeling at this point. 

I went ahead and ordered that new, out-of-box Res Med Air Curve 10 ASV from "Second Wind CPAP', a company that buys and sells both new and reconditioned units for $2599. I saw new units starting at $3500 and one company even quoted me $6500. Wow! 

A problem is that, like many companies, "Second Hand CPAP requires a copy of my doctor's prescription with settings and that prescription recommends the Res Med BiPAP 10 ("or similar") with settings of 12/4. But my doctor did allow me to have those settings changed to 8 or 10/4. I don't know if they will accept this prescription for a ASV unit based on the "or similar" addition to the prescription. I'll soon find out. I'm waiting for a copy of his settings change prescription from my doctor. 

Tonight I will try out your suggestion of setting the Trigger Sensitivity to "Very High."

I saw one of your posts from 2-19 where you advised another member on appropriate settings for the ASV. Perhaps, when/if I get mine, I will tap your expertise.
Thanks!
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#33
RE: BIPAP machine stops blowing when I stop breathing
The default settings for the Resmed Aircurve 10 ASV are in the titration guide I linked earlier. Basically for ASV auto it is EPAP min 4.0, EPAP max 15.0, PS min 3.0, PS max 15.0. We usually observe the results from a single night of these settings, then fine-tune for comfort. SecondWindCPAP has been a long-time provider to many of our members. They used to sell "gently used" machines for well under $1000 and a fair price on new ones. Prices have gone up nearly $1000 in the past few years, and there is nothing we can really do about it. Be assured they are a very capable vendor and my even use your sleep test results to help you out where they show CSA as the primary problem. They will however work with your doctor and you to get what you need. Expect a short period to adapt to the therapy, but most members with your issues have very easily found immediate relief.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
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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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#34
RE: BIPAP machine stops blowing when I stop breathing
Thank you, Sleep Rider. I didn't think of sending the sleep study too. 
Also thanks for these settings. Yes, I do remember seeing that post.
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#35
RE: BIPAP machine stops blowing when I stop breathing
I would like to see your daily charts and a 15 minute view of your central apneas.

A bit confused, something that can be cleared up by posting your charts. On sleep Studies I like to see the full study, though you appear to copied the narrative fairly well. Why? Because often info about CSA is buried for one reason and both SR and I have seen tests showing 99.9% central events with 1 single obstructive event being diagnosed as severe OSA.

On review of this thread I'm not necessarily seeing the need for an ASV. On review of this thread I have the impression that your centrals are on the low end of mild. As such you should Tre trigger on High/Very High and see how your centrals respond. Then and only then should ASV be considered.

That said Sleeprider is 100% correct on what it takes to get an ASV.
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#36
RE: BIPAP machine stops blowing when I stop breathing
Thanks for your message.
I have changed the Trigger to Very High and will provide the results/charts tomorrow.
Here are the first 3 pages of my sleep study of 7/23/22. I will send the final 4th page in the next message.
I appreciate your attention to my case.

Here is the 4th and final page of my sleep study.


Attached Files Thumbnail(s)
               
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#37
RE: BIPAP machine stops blowing when I stop breathing
Good call Gideon. We have not had much data, and the only Oscar graph is a brief 1 hour period with highly variable respiration and a cluster of CA using 4-10 pressure with PS 4. This is of course insufficient to judge efficacy of bilevel and the likely reason the doctor is unwilling to consider more advanced therapy without seeing a serious effort at compliance. It will be interesting to see the titration results from the test narrative just published.
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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#38
RE: BIPAP machine stops blowing when I stop breathing
       

Last night I was able to stay on the BiPAP for 3.26 hours with only 10.4 AHI events per hour. My sleep study and previous AHI rates were 27.7 per hour. I was better able to fall asleep with the 8/4 Inhalation/Exhalation settings which is what was used in my sleep study.

I am working hard on compliance, even though there are doubts about the appropriateness of the machine I have. I guess if I slept for over 3 hours and didn't suffocate, I could do 3 more. 

However, after 3.26 hours, the same issue that I initially posted here became a problem. After not breathing, when trying to inhale, there is nothing there. My body has to actively stimulate the air flow to restart. 

I sent my sleep study yesterday. Here are the reports from last night's session. 

Thank you.
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#39
RE: BIPAP machine stops blowing when I stop breathing
What is your trigger setting? You have to tell us. It is important.

Also Set IPAP to 7 to reduce PS and hopefully CAI
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#40
RE: BIPAP machine stops blowing when I stop breathing
At Sleeprider's suggestion, I set the Trigger at "Very High" last night which gave me my best experience so far. 

The machine started at "Medium." I'd tried "High" once which didn't help.

I will try the "7" Inhalation setting tonight. 

Again, I seem to hum along fine until I have a hypopnea or whatever you call stopping breathing for relatively long periods of time and then starting back up again. That's where I gasp for air and try to prod the machine to start up blowing air again. Being "responsive" to my breathing, it seems to stop or ramp down when I stop. 

Thanks again.
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