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Cutting off inhale breath
#11
RE: Cutting off inhale breath
Goldchair, if you have the ability to download OSCAR and install to a PC where you can get data from your new ST, we can give you detailed rationale to discuss a machine change with your doctor. You happen to live somewhere close to me, and it would be pretty easy to help you out if you don't have this capability, but my beverage of choice is on you, so be forewarned. Seriously, the justification of ASV is not that difficult, and most doctors will quickly come around once you point out they are doing it wrong, and it is hurting your health. If not, there might be a doctor out here in Monroeville that is a bit more informed.
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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#12
RE: Cutting off inhale breath
See attached

See attached 2 image


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#13
RE: Cutting off inhale breath
Well that's pretty damn awful! You have AHI at 13 to 17 per hour which was defined as efficacy by nobody ever. Your leak rate is off the charts and those black marks above the flow rate chart are an indication that you are not spontaneously breathing so the machine is applying a timed breath or at least switching to IPAP. Your pressure appears fixed at IPAP 9.0 and EPAP 7.0, so you're gettng less than 2.0 cm PS. Either the settings you described in post #1 are incorrect or OSCAR is not properly reading your settings.
Mode;ST
IPAP: 19.0
EPAP: 9.0
BPM: 12
Ti: 1.0

I think you should first verify the settings on your machine, and if they are as described in Post 1, we need to get you on an updated beta version of OSCAR. I think that might be the case as the older version of the software did very poorly with Philips machines, however, the events are likely real. You have an abundance of CA and hypopnea events. You must call your doctor and complain that you can't function like this. If he is no help, it's time to change doctors to someone that can treat central apnea. The machine you need is call a Resmed Aircurve 10 ASV.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
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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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#14
RE: Cutting off inhale breath
Setting


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#15
RE: Cutting off inhale breath
To resolve the breath being cut-off lets change Ti to 1.3. That will give you longer IPAP support, and we can increase from there. Your seetings of 15/9.0 provides 6.0 cm of pressure support. That is providing some inspiratory volume in cases where you formerly had CA events, but you're left with hypopnea. You can raise the pressure support in 0.5 cm increments to see if we can reduce hypopnea. In addition to increasing Ti time also increase IPAP to 15.5. This may help.

You are on the wrong machine. This document describes the intended use of each machine from CPAP, bilevel (VPAP or BiPAP), ST, VAPS and ASV. Read about the ST and ASV and you will see the manufacturer does not recommend the ST for your conditions. Please persist in complaining to the doctor, or change to a competent doctor.
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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#16
RE: Cutting off inhale breath
I talked to my RT and doctor today. They both agreed that ASV is the next step, so I'm going back for a sleep study with ASV. Unfortunately when I do get an ASV it will be manufacturer by Philips. Is there anything wrong with the Philips revision of the ASV?
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#17
RE: Cutting off inhale breath
My research and feedback from other users was that most felt the Respironics machine breathing pattern was less than natural feeling, and that it didn't respond as quick as a ResMed. Either ASV will be better than what you've got now, but it's possible the ResMed is still the best choice. If it were myself, I'd swing for the fences to get the home run ResMed unit.

I chose a local in-network DME that issued ResMed only for the ASV and therefore I directed getting a ResMed ASV that way.
Dave

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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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#18
RE: Cutting off inhale breath
The simple truth is, you may have to change suppliers. Your doctor should not have bias as long as the therapy is provided. You should know that Philips pays for exclusive access or influence, and one way to find out is "Ducks for Dollars https://projects.propublica.org/docdollars/ With rare exceptions, the Resmed works better and ASV was invented by Resmed. We have many members here on ASV and it's painful to watch the Respironics users struggle. It should be your choice as long as the supplier is in-network for your insurance. Get a list of DME providers from your insurance company and find one that deals Resmed, then have the prescription sent there. It is a conflict of interest for your doctor and medical team to have a financial interest in your equipment. Kind of like getting an emissions inspection for your car, and the inspector would have exclusive rights to sell service and parts.
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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#19
RE: Cutting off inhale breath
Just one thing to note is that OSCAR was also reporting EPAP as larger than IPAP, another sign the reported pressures may not be correct.

Your reported respiratory rate is high, likely due to premature cycling because of the low inspiration time. Add in backup rate too and it is pretty easy to see why you probably can't sleep.

Ti recommendation in PR's titration protocol is 1.5, should probably educate your RT on this and then shop for a different provider to get access to Resmed machines and knowledgeable RT's...
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