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CPAP, Bipap or Bipap ASV?
#1
I was diagnosed with OSA about 10 years ago and used a ResMed Autoset. My Min. Pressure Setting was 4 and Max. Pressure Settings was 10. My recent home sleep study shows, I also developed Central Sleep Apnea(CSA) in addition to OSA. Here is some information from the home Sleep Study:

AHI: 54
Respiratory Effort Index (REI) : 57
Central Apnea Index: 6

I am in the process of getting a new machine. Which make and model would be appropriate for me? Is it CPAP Auto, BiPAP auto or BiPAP ASV? Which machine records detailed data for tracking?
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#2
A central index of 6 is very borderline. You would need the advice of a doctor trained in sleep apnea treatment to prescribe the correct machine for you.
Sleepster
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#3
Hi thasan26,
WELCOME! to the forum.!
Hang in there for more answers to your question and much success to you as you continue your CPAP therapy.
trish6hundred
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#4
One thing you want to be sure of is that your new machine is data capable so that you can be aware of your therapy progress.

Rich
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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#5
(05-01-2016, 10:26 PM)thasan26 Wrote: Is it CPAP Auto, BiPAP auto or BiPAP ASV? Which machine records detailed data for tracking?
All of these should provide detailed data for tracking as long as you don't wind up with a Resmed S9 Auto Escape, which has been discontinued.

The bigger question of which machine is appropriate is something that I think you will need to discuss with a sleep doctor. The CAI is barely above 5 on a home study, whereas the untreated AHI is well into the severe range.

My guess is that one question the sleep doc may have for you is: How do you feel using your Resmed AutoSet Spirit in its current range?

By the way, does that AutoSet Spirit show any data at all? If so, what's the treated AHI?

Chances are your doc is only going to switch you to a BiPAP or an BiPAP ASV if there's some evidence that the APAP is not doing the job.






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#6
   
(05-02-2016, 08:59 AM)robysue Wrote:
(05-01-2016, 10:26 PM)thasan26 Wrote: Is it CPAP Auto, BiPAP auto or BiPAP ASV? Which machine records detailed data for tracking?
All of these should provide detailed data for tracking as long as you don't wind up with a Resmed S9 Auto Escape, which has been discontinued.

The bigger question of which machine is appropriate is something that I think you will need to discuss with a sleep doctor. The CAI is barely above 5 on a home study, whereas the untreated AHI is well into the severe range.

My guess is that one question the sleep doc may have for you is: How do you feel using your Resmed AutoSet Spirit in its current range?

By the way, does that AutoSet Spirit show any data at all? If so, what's the treated AHI?

Chances are your doc is only going to switch you to a BiPAP or an BiPAP ASV if there's some evidence that the APAP is not doing the job.

Thanks for the quick response. ResMed Autoset Sprit only records summary data. Please view the attached file for 30 day summary data.
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#7
Thanks for giving us the 30-day summary data.

The S8 AutoSet program was often suspected of over scoring Hs and my guess is that your sleep doc might not be too concerned with the treated AHI being at 8.8 given the fact that the HI = 6.7.

But your leak data is alarming. Your median (excess) leak rate is 22.8, and that means that you are leaking AT or ABOVE 22.8 L/min for 50% of the night. And Resmed defines a Large Leak as 24 L/min. So you may be spending significant portions of the night in Large Leak territory. And that may mean the AHI data is off. But just as important, spending that much time in Large Leak territory may also disrupt your sleep enough so that you might not feel at your best. Has anybody pointed out that your leak numbers are way to high before?

My guess is that a sleep doc is likely to tell you to start with an APAP and only move you to a BiPAP or a BiPAP ASV if your treated AHI remains high on nights where the leaks are under control. Some people find it more difficult to keep the leaks under control with BiPAPs and BiPAP ASVs.
Questions about SleepyHead?
See my Guide to SleepyHead
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#8
(05-02-2016, 10:52 AM)robysue Wrote: Thanks for giving us the 30-day summary data.

The S8 AutoSet program was often suspected of over scoring Hs and my guess is that your sleep doc might not be too concerned with the treated AHI being at 8.8 given the fact that the HI = 6.7.

But your leak data is alarming. Your median (excess) leak rate is 22.8, and that means that you are leaking AT or ABOVE 22.8 L/min for 50% of the night. And Resmed defines a Large Leak as 24 L/min. So you may be spending significant portions of the night in Large Leak territory. And that may mean the AHI data is off. But just as important, spending that much time in Large Leak territory may also disrupt your sleep enough so that you might not feel at your best. Has anybody pointed out that your leak numbers are way to high before?

My guess is that a sleep doc is likely to tell you to start with an APAP and only move you to a BiPAP or a BiPAP ASV if your treated AHI remains high on nights where the leaks are under control. Some people find it more difficult to keep the leaks under control with BiPAPs and BiPAP ASVs.

I also noticed that my leak data is high. I don’t notice any significant leak when I use it and my wife also confirmed that she did not hear any hissing noise at night while I am sleeping. ResMed AutoSet Sprit has some recommended masks (ULTRA MIRAGE MASK, MIRAGE FULL FACE MASK, FULL FACE MASK SERIES 2, MIRAGE MASK and MODULAR MASK). Clinician's manual also says, "For therapy in AutoSet mode, use one of the recommended ResMed masks. The AutoSet algorithm has appropriate parameters for these masks." but I am using a ResMed Swift Pillow Mask which is not in the list. I also selected “Standard” mask type in the CPAP settings menu. I don’t know, if different vent rate of my current mask is causing this high leak data problem.
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#9
I found that I had difficulty controlling leaks when using nasal pillows. I also tried the new Dreamwear mask and couldn’t control leaks at all. I am currently using the ResMed Mirage FX mask and am having a better time with leaks.

Rich
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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#10
(05-02-2016, 03:44 PM)thasan26 Wrote: I also noticed that my leak data is high. I don’t notice any significant leak when I use it and my wife also confirmed that she did not hear any hissing noise at night while I am sleeping.
Unless your wife is awake all night long, that's not compelling evidence that you are not leaking. And not all leaks sound like hisses.

Quote:ResMed AutoSet Sprit has some recommended masks (ULTRA MIRAGE MASK, MIRAGE FULL FACE MASK, FULL FACE MASK SERIES 2, MIRAGE MASK and MODULAR MASK). Clinician's manual also says, "For therapy in AutoSet mode, use one of the recommended ResMed masks. The AutoSet algorithm has appropriate parameters for these masks." but I am using a ResMed Swift Pillow Mask which is not in the list. I also selected “Standard” mask type in the CPAP settings menu. I don’t know, if different vent rate of my current mask is causing this high leak data problem.
Which nasal pillows mask are you using? Most CPAP masks of a given type have roughly the same leak rate---as in one mask's intentional leak rate at your pressure might be 30 L/min and another of the same type might be 35 L/min. But it would be very unusual for a nasal pillows mask to have a leak rate that is 20 L/min above the leak rates of most nasal masks.

Does your Spirit allow you to choose "Swift" for the mask type? If so, that's what you should be using for nasal pillows masks. (The on-line version of your user manual seems to indicate that Swift should be one of the choices for mask type.

Questions about SleepyHead?
See my Guide to SleepyHead
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