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Bipap bloating stomach questions
#11
RE: Bipap bloating stomach questions
The choice of even lower pressure numbers is really up to you. I think I'd rather you use it on some low number than not use it at all.

The doctor part can and will get sticky and a bit difficult. First thing is to get doc to actually recognize your CA tendency. Second is to get him to answer if he's considering ASV or if he refuses ASV for some reason. If this happens, ask why you can't get the ASV, why he doesn't recommend it. Then at that point, if he will not issue an ASV if it is clearly necessary, it may be time to switch docs in-network or ask if another doc in that office will review the data. Insurance may have some answers, but they will probably defer to docs insistence on ST over ASV if that becomes true. Unfortunate, it may come down to replace doc with one that will treat CA properly. First things first, see what the report says and then question doc about getting ASV.
Dave

OSCAR
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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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#12
RE: Bipap bloating stomach questions
(11-07-2020, 10:06 PM)SarcasticDave94 Wrote: The choice of even lower pressure numbers is really up to you. I think I'd rather you use it on some low number than not use it at all.

The doctor part can and will get sticky and a bit difficult. First thing is to get doc to actually recognize your CA tendency. Second is to get him to answer if he's considering ASV or if he refuses ASV for some reason. If this happens, ask why you can't get the ASV, why he doesn't recommend it. Then at that point, if he will not issue an ASV if it is clearly necessary, it may be time to switch docs in-network or ask if another doc in that office will review the data. Insurance may have some answers, but they will probably defer to docs insistence on ST over ASV if that becomes true. Unfortunate, it may come down to replace doc with one that will treat CA properly. First things first, see what the report says and then question doc about getting ASV.

Thanks for being reasonable and logical about this, that helps! I will do as you say and report back. Appreciate it so much Dave
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#13
RE: Bipap bloating stomach questions
(11-07-2020, 10:06 PM)SarcasticDave94 Wrote: The choice of even lower pressure numbers is really up to you. I think I'd rather you use it on some low number than not use it at all.

The doctor part can and will get sticky and a bit difficult. First thing is to get doc to actually recognize your CA tendency. Second is to get him to answer if he's considering ASV or if he refuses ASV for some reason. If this happens, ask why you can't get the ASV, why he doesn't recommend it. Then at that point, if he will not issue an ASV if it is clearly necessary, it may be time to switch docs in-network or ask if another doc in that office will review the data. Insurance may have some answers, but they will probably defer to docs insistence on ST over ASV if that becomes true. Unfortunate, it may come down to replace doc with one that will treat CA properly. First things first, see what the report says and then question doc about getting ASV.

Hi Dave i am uploading my most recent data and may create a thread as well not to confuse this issue with other issues.

I contacted my doctor and he basically told me "That it's great i read up, but this info takes years to know. They are trying this and if needed will do another sleep study with ASV" I am confused as I thought they should have done everything in that study. I am still requesting the documents. But basically looks like i am stuck with it now. He asked me to schedule a follow up to briefly explain why he went this way. Is there anything i can do in follow up ( 2 weeks from now ) to switch to ASV, do i have to do yet another sleep study?

Also uploading my charts after changing the settings to something reasonable 10/5 (I am surprised at no snore and low AHI) which makes me wonder why do i still feel like it is not so different than cpap, is it just me? I woke up feeling okay (Mouth dry despite humidity being 81 in machine) 

Thanks again


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#14
RE: Bipap bloating stomach questions
Years!? NOPE. I didn't take years to decide I needed ASV. I was on a BPAP that was a disaster. I made an urgent pulmonary office visit, and pointed to the sleep study/titration where it says 124 CA 24 OA. I then said "Should we consider ASV due to the CA?" The nurse said she was surprised the doc didn't just go from sleep study/titration report to getting me an ASV. Now, assuming we have conclusive evidence you need ASV, it does not take years. Months maybe, years no way.

Don't take this as if I doubt your need, but we have to cover all bases and get the report in hand. Let's see it or at least tell us the stats that says OA was x, Mixed was x, CA was x, Hypopnea was x. If you see 50% or more as CA, light the fire under doc or fire him and get a doc that knows how to treat CA with an ASV.
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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#15
RE: Bipap bloating stomach questions
The machine you need for comfort is the Aircurve 10 Vauto. The ST is used to treat a number of pulmonary conditions including COPD, neuromuscular disorders and obesity related hypoventilation. It provides a square-wave pressure support and backup rate. Pressure are fixed. The Vauto provides a very smooth inhale/exhale transition using Easybreath™ that is very comfortable and easy to tolerate, along with auto adjusting pressure to prevent obstructive events. In the absence of pulmonary disease or central apnea you have been prescribed the wrong machine. I will give you a link to the Resmed Sleep Lab Titration Guide that describes the different machine and the conditions they are intended to treat, as well as the approach to titrate pressure. Read about the Vauto and the ST and you will see you have the wrong machine. You need to find a way to tell your doctor you want the Resmed Aircurve 10 Vauto. https://www.resmed.com/us/dam/documents/...er_eng.pdf
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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#16
RE: Bipap bloating stomach questions
(11-09-2020, 07:01 PM)Sleeprider Wrote: The machine you need for comfort is the Aircurve 10 Vauto.  The ST is used to treat a number of pulmonary conditions including COPD, neuromuscular disorders and obesity  related  hypoventilation. It provides a square-wave pressure support  and backup rate. Pressure are fixed. The Vauto provides a very smooth inhale/exhale transition using Easybreath™ that is very comfortable and easy to tolerate, along with auto adjusting pressure to prevent obstructive events.  In the absence of pulmonary disease or central apnea you have been prescribed the wrong machine.  I will give you a link to the Resmed Sleep Lab Titration Guide that describes the different machine and the conditions they are intended to treat, as well as the approach to titrate pressure.  Read about the Vauto and the ST and you will see you have the wrong machine.  You need to find a way to tell your doctor you want the Resmed Aircurve 10 Vauto.  https://www.resmed.com/us/dam/documents/...er_eng.pdf

Hi Sleeprider,

So are you saying ST is or not for Central apnea, I have requested my sleep study which they mentioned centrals went to 0 with ST. I assume VAuto is a step less than ASV so should be fine to be prescribed? and does it treat central as well? Based on my charts above anything out of ordinary?

Thanks,
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#17
RE: Bipap bloating stomach questions
The ST is for pulmonary disease and hypoventilation. The ASV is for central and complex apnea. Read the difference on pages 28 and 34 of the link I provided above. ST is a mostly obsolete technology that uses fixed pressure. Its replacement is the ST-A with iVAPS, but many doctors still prescribe the old ST. All you get is fixed pressure and a timed backup rate. With ASV you get automatic backup rate that matches your natural breath rate, an adaptive pressure support that gives you as much or as little pressure support as you need to maintain minute vent (tidal volume x breaths/minute) and it does this in a way that is very comfortable and natural. READ THE LINK and note the table on Page 5. This is what they treat...what are your needs?

ST: COPD, NMD, OHS and other respiratory conditions
ASV: Central or mixed apneas, complex sleep apnea, Periodic Breathing (PB)
Vauto: OSA, non-compliant OSA
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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#18
RE: Bipap bloating stomach questions
Yes the info is correct that Sleeprider provided. Bilevel machines like the ST is for COPD or some other lung conditions, ASV for CA, VAuto for apnea that's not CA or Mixed. ST has been surpassed by newer technology such as ST-A, but only for those that need it.

The bottom line is somewhere back near the beginning of the thread I made mention of ASV instead of VAuto. So strike out the areas when I said ASV. It should have been VAuto. My fault.
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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#19
RE: Bipap bloating stomach questions
Well, the Aircurve 10 Vauto is simply the best machine on the market for resolving obstructive sleep apnea and upper airway resistance with comfort and effectiveness. It has a very comfortable pressure support transition and can accomplish resolution of obstructive events at lower pressures than any CPAP. With the results I have seen in this thread so far, we could significantly reduce your pressure and resolve the residual hypopnea pretty easily. The auto pressure lets you stay at lower pressure when that is possible. Based on what I'm seeing here, I'd probably set your EPAP min to 5.0, PS 4.0 and max pressure to 14.0. That would give you a range of 9/5 to 14/10 (IPAP/EPAP) and the machine could just take care of business. The big difference is the pressure transition, which on the ST is a square wave, vs a natural wave on the Vauto. Again, there are images in the Titration Guide that can help you visualize what I mean.

I guarantee you don't need the ST backup rate of 10 BPM. You are on the wrong machine.
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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