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Can’t get to sleep with the BiPAP machine.
#21
(09-16-2016, 04:04 PM)Sleeprider Wrote: It would be interesting to see what would happen to your sleep, and event count if you maintained EPAP at 12 and tried 16 for IPAP. I think you'd find it much more comfortable, and at worst, you'd possibly see an increase in CA events, which I think your machine is labeling UA. If you zoom in on the flow rate line during the UA events, we could probably tell what they are. It would also be interesting to see what the flow rate looks like during a period of sleep. It's your choice, but if I was in an experimenting mood over the weekend, I'd try a night with lower IPAP.

I tried over the weekend IPAP of 16. My AHI went up to average 30 and a max of 43. The second half of the night I went back to 18 and the AHI dropped back to average 5-10. It was definitely easier to fall asleep at 16 but my events went way up. See attached.
My two biggest issue now are falling asleep with all the pressure and the fisher mask leaked really bad last night. I'm wondering if it can handle the pressure.    
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#22
Well that certainly makes the case for maintaining your pressure support at 6.0. Have you checked what modes are available on the machine?
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#23
Crazy last 3 days. Day 1. able to use BiPAP and fall asleep. 7 hours of sleep. AHI 4.62. Wake up rested with energy for the first time in maybe years. Day 2. Unable to fall asleep with the mask on/off all night. Had to call off work. Day 3. Unable to fall asleep. Wore mask for 3 hours and gave up. Sleep without the mask for 5 hours woke up exhausted.

So I just go off the phone with my doctor and they are going to try me on the ASV. She said it's a last resort. That's not very encouraging. First I have to get another sleep study (My 3rd. CPAP, BiPAP, now ASV). Will probable be 2-3 weeks before I can get the study and then the machine. Dr. wants me to keep going with the BiPAP in the mean time.

How long should I wear it and not sleep? Not wearing it with 40 AHI seems better than wearing it and getting 0 sleep.
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#24
Sleeprider,
I finally got them to switch me to a ASV machine. After one night AHI of 2.6 and I was actually able to fall asleep. I uploaded my graphs in case you have any more insight.

Thanks for your help last month. It's been difficult but I think I'm finally on the right path.


Attached Files Thumbnail(s)
   
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#25
I'm impressed! Congrats on the new ASV, and it sure looks like you're taking to it well. Time will tell. Would you mind transcribing the settings for the forum? I think it helps others to see the setups being used on the ASV machines. The low EPAP of 8.0 and variable PS for IPAP seem to be working.

How did you work it out with your doctor that he got the original machine Rx wrong? You clearly didn't belong on a ST.
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#26
(10-19-2016, 10:17 AM)Sleeprider Wrote: I'm impressed! Congrats on the new ASV, and it sure looks like you're taking to it well. Time will tell. Would you mind transcribing the settings for the forum? I think it helps others to see the setups being used on the ASV machines. The low EPAP of 8.0 and variable PS for IPAP seem to be working.

How did you work it out with your doctor that he got the original machine Rx wrong? You clearly didn't belong on a ST.

Here's the set up.
Mode: ASV
EPAP 8
Min PS 3
Max PS 11
Mask Pillows
Ramp Time 20 min.
Start EPAP 4

Doctor never said the BiPAP was wrong. They said it was just a process that I had to go through.

PS last night wasn't quite as good as the first night but this way better than the BiPAP. 6.5 hours of sleep with 4.66 AHI. The first two hours wasn't sleep in reality. Seems it's still going to take some getting use to.
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#27
ASV is a different animal for getting comfortable. Obviously, when you don't intiate breaths, it does. Eventually some images may help. I typically see low EPAP with minimum PS of 2, and max PS of 8-10, max IPAP of 20-25. How does your tidal volume compare? About the same?
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