[Diagnosis] Frustrated

[Sleeprider]

There is a distinct signature for this in the flow rate. It's covered in the Beginners Guide to Sleepyhead wiki, but not a trace of it in your flow rate or leak charts. I'm skeptical to say the least. You need to contact the clinics or doctors that conducted/ordered sleep studies and get your own personal copies of the study results. You want the detailed study reports, not just the summary or recommendations. These records will be valuable to you in the future, and would give you the reasons you are using bilevel therapy.

Most people are "diagnosed" with obstructive apnea, but those that have issues with therapy, especially CA have shown a tendency for central apnea all along. This is especially true for those eventually prescribed bilevel machines. So many members have come here with your pattern and complaints, and ended up needing ASV or a similar alternative. I think your case deserves a reading of Spy Car's excellent adventure. http://www.apneaboard.com/forums/Thread-...-Adventure It was a happy ending, but this is someone who was rendered dysfunctional by therapy like yours, and found his own path to "getting his life back".

Get your study results, and don't assume the therapy you have been prescribed is either correct nor ideal for you, or that you have even been given a correct diagnosis. Most of all, problems with therapy are probably not your fault, or what you think may be the root cause. I see a tendency for complex apnea, not mask leaks or mouth breathing. It might be constructive to look at why CPAP therapy was discontinued in favor of bilevel.

[joesetx]

I am also interested in EERS or Enhanced Expiratory Rebreathing Space and have been reading a few journal articles.
I have ordered a whisper II Exhalation Port and some Corr-A-Flex tubing.

Are there any current Full Face CPAP masks that are best for a trial. I'm using an Amara View for now. can I just tape the exhalation holes?

How dangerous is this anyway?

[Gary K]

Thanks, I will attempt to contact my original doctor in Florida and see if I can obtain the original sleep study results. I would think my Kaiser doctor would have gotten this information but apparently not. I have an appointment with a specialist on December 11 because I was recently diagnosed with ILD this may also be why I am having this trouble. I do not seem to have breathing issues while awake, only when attempting sleep.

[Sleeprider]

If you want to post a closeup of your normal flow rate chart we might see if ILD is influencing inspiratory flow limitation. As far as the existing CA events go, you might try slowly backing off on pressure support. Your graphs did not include any of the respiratory statistics on the left column of Sleepyhead, and that data is important to evaluating tidal volume, minute vent and respiratory rate as you make changes, especially if ILD is a concern. My signature ha a tutorial on organizing charts, and the closer you get to that content, the better.

[Gary K]

If you want to post a closeup of your normal flow rate chart we might see if ILD is influencing inspiratory flow limitation.  As far as the existing CA events go, you might try slowly backing off on pressure support.  Your graphs did not include any of the respiratory statistics on the left column of Sleepyhead, and that data is important to evaluating tidal volume, minute vent and respiratory rate as you make changes, especially if ILD is a concern.  My signature ha a tutorial on organizing charts, and the closer you get to that content, the better.

Here it is, thanks for your help

[Sleeprider]

Gary, you need to zoom in on the graph to about a 2-minute segment. This will make the individual breaths I. the flow rate visible. Just click repeatedly and the chart will zoom. Instructions are also in the Organizing Charts wiki in my signature.
tom

[Gary K]

Gary, you need to zoom in on the graph to about a 2-minute segment.  This will make the individual breaths I. the flow rate visible.  Just click repeatedly and the chart will zoom.  Instructions are also in the Organizing Charts wiki in my signature.
tom

Hope this is what you need....

[Gary K]

Or do you need a view that includes a CA or OA event?

[Sleeprider]

This is fine.  The graph here shows normal floe morphology and no indication of inspiratory weakness.  The abundance of central events points to a need for ASV, or possibly just cutting back on pressure support. EERS may be helpful, but is an unconventional approach.  

[Gary K]

This is fine.  The graph here shows normal floe morphology and no indication of inspiratory weakness.  The abundance of central events points to a need for ASV, or possibly just cutting back on pressure support. EERS may be helpful, but is an unconventional approach.  

Thanks Sleeprider, I have cut the PS back from 4 to 3.4 for tonight. What to you think of partially blocking the exhalation port on my nasal mask?