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Breathing synchronization problems
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DeepBreathing Offline
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Posts: 2,293
Joined: Sep 2013

Machine: Resmed S9 VPAP Adapt
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: Resmed H5i
CPAP Pressure: EPAP: 9 - 15 PS: 3 - 10
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Perth, Western Australia

Post: #11
RE: Breathing synchronization problems
The machine will deliver air all the time it's switched on, and should be synchronising with your own breathing. If you breathe very slowly or irregularly when first lying down, it might try to force the pace. I find the best way is to just breathe slowly but fairly deep. If the machine tries to go faster, just blow back at it (ie exhale strongly) when it is trying to give you an inhale. It seems smart enough to recognise that you want it to go slower and will reduce its speed accordingly.

DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


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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.
12-13-2014 10:42 PM
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vsheline Offline

Advisory Members

Posts: 1,907
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #12
RE: Breathing synchronization problems
(12-13-2014 07:06 PM)mergx Wrote:  
(12-13-2014 03:37 AM)vsheline Wrote:  Yes. As you have found, there is no way to manually control the backup respiration rate, but the machine usually will synchronize itself to our recent natural breathing rate.

It seems to not be synchronizing. If I let my breathing just do it's own thing, then it's not long before the S9 is delivering air to me even though I'm still breathing and definitely not having an apnea (I'm awake, after all). If I try to keep breathing naturally in hopes of getting it to fall into line with me, it never does, and the increased pressure keeps me awake. I can keep it from increasing the pressure by breathing faster, trying to keep ahead of the device, and then it never delivers me extra pressure, but doing that also keeps me awake.

I had the impression that the ASV part would have the machine sync to me unless I actually stopped breathing for a while, though I don't know how long that is, but it doesn't seem to be syncing. I also seem to be swallowing enough air to keep me belching and farting and to give me cramps occasionally. Eventually I give up and take it off, which at least lets me get some sleep even though I may be having apneas.

Any thoughts you might have on its failure to sync with me would be appreciated.

Hi mergx,

For what reason did you decide to shorten the Ramp time?

Did it feel like the pressure was too low during the Ramp period, so you wanted to shorten it?

During the Ramp period, does it feel like the machine is hurrying you to breathe?

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 12-14-2014 11:48 AM by vsheline.)
12-14-2014 05:05 AM
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mergx Offline

Members

Posts: 5
Joined: Dec 2014

Machine: ResMed S9 VPAP Adapt Model 36037A
Mask Type: Full face mask
Mask Make & Model: Quattro FX
Humidifier: ResMed H5i
CPAP Pressure: EPAP 6, PS 3-10
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: New Mexico, USA

Post: #13
RE: Breathing synchronization problems
(12-14-2014 05:05 AM)vsheline Wrote:  Hi mergx,

For what reason did you decide to shorten the Ramp time?

Did it feel like the pressure was too low during the Ramp period, so you wanted to shorten it?

During the Ramp period, does it feel like the machine is hurrying you to breathe?

D'oh! I just noticed that this had moved on to a second page.

I shortened the ramp time as a result of a suggestion I saw on another thread. I've got it back at 30 now and while I can sort of feel the machine doing little things to the air pressure while I'm breathing slowly, it's not bothersome and doesn't feel like it's "pressuring" me. Even after the ramp the pressure changes don't seem too bad now, either because it's adjusted to me or vice versa.

I seem to be initially falling asleep ok, and most nights I can sleep for about an hour or so and then wake up with a belly full of air. If I can belch it out and am not cramping too badly then I'll usually get back to sleep for another hour or so and wake up again the same way. Third time's not the charm, however, as after that I end up lying awake until I give up and take the mask off, after which I can usually get back to sleep. I also changed masks, from the Mirage Quattro to the Quattro FX, which doesn't push against my forehead and cause a headache from that, but which feels a little more claustrophobic at times.

I guess there's a four-hour line that's important to the insurance company, so I try to make that, but, man, it's just really unpleasant. I feel like I'm getting less and worse sleep than I was before I started using the thing and feeling bloated and uncomfortable a lot of the time to boot. More morning headaches recently, too.
12-24-2014 12:01 AM
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vsheline Offline

Advisory Members

Posts: 1,907
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #14
RE: Breathing synchronization problems
Redundant post deleted by author.
--- Vaughn

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 12-25-2014 04:12 AM by vsheline.)
12-24-2014 03:52 AM
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vsheline Offline

Advisory Members

Posts: 1,907
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #15
RE: Breathing synchronization problems
Redundant post deleted by author.
--- Vaughn

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 12-25-2014 04:15 AM by vsheline.)
12-24-2014 03:55 AM
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vsheline Offline

Advisory Members

Posts: 1,907
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #16
RE: Breathing synchronization problems
(12-24-2014 12:01 AM)mergx Wrote:  I shortened the ramp time as a result of a suggestion I saw on another thread. I've got it back at 30 now and while I can sort of feel the machine doing little things to the air pressure while I'm breathing slowly, it's not bothersome and doesn't feel like it's "pressuring" me. Even after the ramp the pressure changes don't seem too bad now, either because it's adjusted to me or vice versa.

I seem to be initially falling asleep ok, and most nights I can sleep for about an hour or so and then wake up with a belly full of air. If I can belch it out and am not cramping too badly then I'll usually get back to sleep for another hour or so and wake up again the same way. Third time's not the charm, however, as after that I end up lying awake until I give up and take the mask off, after which I can usually get back to sleep. I also changed masks, from the Mirage Quattro to the Quattro FX, which doesn't push against my forehead and cause a headache from that, but which feels a little more claustrophobic at times.

I guess there's a four-hour line that's important to the insurance company, so I try to make that, but, man, it's just really unpleasant. I feel like I'm getting less and worse sleep than I was before I started using the thing and feeling bloated and uncomfortable a lot of the time to boot. More morning headaches recently, too.

Hi mergx,

Sounds like the machine must be increasing Pressure Support too high for you to tolerate yet, causing excessive air-swallowing. So much so, that the therapy is not really being successful.

I suggest you and your doctor consider temporarily lowering the Max PS to 8, in order to reduce the amount of air being swallowed. The insurance company does not care what exact settings are being used, it cares only whether the machine is needed and is being used.

The trade off accepted when lowering Max PS to 8 would be that the machine might not be able to eliminate as many apneas, might only be able to eliminate some and change the others into hypopneas. But that would be an improvement to the present situation if it allows you to use the machine all night, which I think is essential.

You may find that slight changes in sleep position, or how close your chin is to your chest, or the angle of your head and neck, may reduce the amount of aerophagia.

If after another week or longer there has been insufficient improvement, I would suggest temporarily lowering Max PS again, to 7 or 6. Min PS must be at least 5 lower than Max PS, so Min PS would need to be lowered to 2 or 1.

I recommend not lowering Min PS below 1 or 2, because using at least a small amount for Min PS makes it more comfortable, easier to inhale, which tends to keep us more adequately ventilated than if PS were zero, which also tends to help keep the machine's calculated ventilation target (which is 90% of our usual "Minute Ventilation") from drifting too low.

In the meanwhile, it would be helpful if you can post reports showing waveforms of the Flow, High Rate Pressure, and Leak, so we could better see what's going on.

Take care,
--- Vaughn

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 12-24-2014 10:31 AM by vsheline.)
12-24-2014 10:00 AM
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trish6hundred Offline

Advisory Members

Posts: 6,430
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #17
RE: Breathing synchronization problems
Hi mergx,
WELCOME! to the forum.!
Much success to you as you continue and finetune your CPAP therapy.

trish6hundred
12-24-2014 11:57 PM
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