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DESPERATE & TERRIFIED-Need BiPap or Cpap HELP
#11
Thank you everyone - I will get that data posted by Weds. and try to turn down the panic in the meantime.......
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#12
Ok I found the Sleep Studies - the first on 10/3 was a Split with 1/2 No Machine and 1/2 Autoset.  The second on 10/19 was a BiPap titration.  


https://imgur.com/RMJpyBu

https://imgur.com/udpWv8Q

The below is a Sleepyhead graph using the Resmed VAuto with a ResMed Nasal Mask:

(I don't know if I did this right - I always get confused about the last step - copy from the linked BBCode - thought it should transfer a file name and I'm supposed to add a .png somewhere, but it wouldn't transfer the file name.)


[Image: ojBy9Jrl.png]

This is a night using the S9 Autoset APap with the same ResMed Nasal Mask:

[Image: Y2rcOIql.png]


I saw a second Sleep Doctor on Thursday to get a second opinion and he reviewed the studies and the settings on the VAuto Bipap, and I explained that I was waking up with feelings of terror and doom that lasted for hours each day, even though it felt comfortable when I was falling asleep at night.

He talked to his Sleep Technician and came back and said they changed the settings to a High Pressure of 18 and a Low Pressure of 8 (from 20 and 12), and a Pressure Support of 10 (from 2) "because the Pressure Support must be the difference between high and low pressures".  I had seen this in a few articles, but that does not agree with what most people on the forum say.  I told him that when it was originally set on a 5 Pressure Support, it was hard to breathe and that I had lowered it to 2 and the AHIs improved and it felt better.  So he said "ok make it 2"??!!  I asked why he said it had to be the difference between high and low pressures and he said "it doesn't-whatever you want".....I am So Confused.... 

Then he said "Bipaps are very complicated machines and some people don't react to them very well"  I asked him what the other settings like trigger are, and he didn't know.....He said if I'm so afraid of it, just go back to an Auto machine and accept the AHIs of (usually) 5-9 or so.  The below Sleepyhead graph for the Autoset was a very unusually good night.

He said he wasn't really sure I had a great need for a Bipap based on the data and not having any major heart or lung problems, etc.

The last time I used the VAuto the settings were:

IPAP - 20
EPAP - 12
Pressure Support - 2
TI Max - 2.0s
TI Min - 0.3s
Trigger - Medium
Cycle - Medium

So....if you might have some suggestions on what settings might be realistic and might work, I surely would appreciate any help or thoughts.  The last 4 nights I have just been using my old S9 Autoset and waking up much calmer and not terrified. Obviously, the "numbers and results" on the BiPap don't seem to warrant me thinking the world is ending every morning, but something about it is affecting me in a very strange way.  I have not encountered this experience of doom after 3 years of CPAP and 8 years of APAP.  It's going to take some courage to try the BiPap again, but if it is best for me, and I can get the settings right, I will certainly try my best.

Thank you for your help with this!
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#13
Did you have a SD card in your autoset cpap? It would be really good to see the last week that you used it. the card would have the detailed data on it. just load to sleepyhead. There had to be a reason why they wanted to swap you to BPAP. Were you having these sleep issues on the cpap?
your second chart is also of the vauto and not the apap, going by sleepyhead left had column.

edit, I missed the stay at 2cm in your post and got it on a reread.
Just to make sure. they still have auto. the min 8 and max 18 is the auto epap. then they have the PS 10.
The reason I ask is because there is also a 10cm difference between the 8 and 18.

Did they want you to see them in a few days for a review? A PS of 10 is common when there are lung/respiration issues. It may have been as a diagnostic tool, to see if it resolved the issues you are having and go from there?

As just another cpap user, looking at your chart. I can't even see a reason to be on bpap. You seem to be getting enough air on PS 1.6 (which is less then epr or flex will give you) you're breathing a good amount of air each breath by your median tidal volume, you haven't got a fast breath rate and your minute vent would be in range for a female.
new http://www.apneaboard.com/wiki/index.php...re_success
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
From machine or charts for auto-cpap, set the min 1cm below median pressure, or 2cm below 90/95%. max at 20cm for now. Forum will help you fine tune settings
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#14
Have you ever tried fix pressures? The change in pressures can sometimes cause CA events to increase for some people.
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#15
I accidentally posted 2 VAuto days instead of 1 VAuto and 1 Auto

Below is the S9 Autoset day for comparison to the VAuto.

I also can't figure out why they decided I needed a BiPap.

[Image: FnZnhW7l.png]
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#16
I began years ago with a fixed pressure of 10, but much prefer the Auto - seems a lot more comfortable, and I have been on steroids for 6 years and have gained a lot of weight.  I need an Auto, just can't figure out whether a BiPap is even appropriate for me - maybe whatever all those other settings are doing is causing something to upset my brain at night?  I have never had really high centrals.  There's something going either with the settings on the BiPap or the Bipap functions in general that is "scaring" my brain?
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#17
Why not take a break from CPAP for a while (or go back to whatever you were doing before you got the new machine)??

I started CPAP back in October and struggled through much of November with nights were I woke up constantly.  I was feeling miserable during the day because of lack of sleep.  I finally decided on a simple rule:  The first time that I wake, up, I turn the machine off, go back to sleep without it, and try again the next day.  Doing that allowed me to determine that certain things were real problems, i.e. humidity makes my nasal passages swell, and so I turned the humidifier down to the lowest setting.  Still I was only getting about 1 to 1.5 hours uninterrupted sleep.

I took December off, and did not use the CPAP at all during that month.

I started again in January.  The first night I was shocked to find that I slept FIVE HOURS straight.  Still not perfect, but much better.
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#18
My apnea is too severe and after 11 years I can’t sleep without it. I have gone back to the Auto until I can get the issues worked out with the Bipap. If not I will just stay on the Auto forever.
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#19
The chart data looks ok. It's misleading, I'm one of the first ones to say to raise PS and have had debates about it. I missed it too. It shows how sleepyhead doesn't replace a sleep study.

after reading the sleep study. the bit I crossed out was right
"A PS of 10 is common when there are lung/respiration issues. It may have been as a diagnostic tool, to see if it resolved the issues you are having and go from there?"

It's a shame he didn't have more understanding with you. I honestly would follow the doctor and do what he wants you to do. The sleep report said you aren't getting enough o2. This is the reason they put you on bpap and now want you to try the PS 10, to see if it stops the waking up short of breath. The study had you on PS:5 with good o2 levels, this wasn't on your back though and they weren't sure if this setting was right for, when you got home with your machine.

I would use the bpap and raise the PS a bit at a time to get use to it. You said that PS:5 was too big of a shock. start off at PS:2 and raise it one cm every night until you start to feel uncomfortable going to sleep, then hold it there for 2-3 days before you start to increase it again.

You can also get a 24 hr recording o2 meter off of ebay for $50, that will also work with sleepyhead it's called the cms50f. Given your chart looks ok, perhaps the o2 meter may be of a help to see how your treatment is going.
new http://www.apneaboard.com/wiki/index.php...re_success
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
From machine or charts for auto-cpap, set the min 1cm below median pressure, or 2cm below 90/95%. max at 20cm for now. Forum will help you fine tune settings
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#20
(01-05-2018, 11:21 PM)bluemom51 Wrote: I began years ago with a fixed pressure of 10, but much prefer the Auto - seems a lot more comfortable, and I have been on steroids for 6 years and have gained a lot of weight.  I need an Auto, just can't figure out whether a BiPap is even appropriate for me - maybe whatever all those other settings are doing is causing something to upset my brain at night?  I have never had really high centrals.  There's something going either with the settings on the BiPap or the Bipap functions in general that is "scaring" my brain?

They are probably just pressure induced centrals and your brain is fine. It's just you body waiting for the co2 to build up to trigger a breath. You may get other side effects when you reduce your co2 load and increase your o2 too
You can look at how long the central lasts by looking at the left hand side bar and clicking on the 'events' tab if they are under 20-30 seconds, I wouldn't be concerned, you can also zoom in on them to see if there was a deep breath before hand, this applies to hypopnea too. You don't count these.

I would google 'obesity hypoventilation syndrome' that will help with understanding co2 and o2 stuff.
new http://www.apneaboard.com/wiki/index.php...re_success
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
From machine or charts for auto-cpap, set the min 1cm below median pressure, or 2cm below 90/95%. max at 20cm for now. Forum will help you fine tune settings
Post Reply Post Reply


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