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[Diagnosis] I am commited to make it work - Need Help and guidance
#21
RE: I am commited to make it work - Need Help and guidance
Thanks. Since I do still have the s9 vpap adapt, I don't mind trying it back, but I am really curious, does ST has a mechanism that the ASV could not perform as one is for OSA and the other is from what I uNderstand is to treat central and mixed apnea?
Last. What do you mean by backup rate set to 10. Is this the same parameter as reps rate which is now set to 20.0?

This is very helpful.  I should get the full face mask tomorrow and will try that as well.

Cheers
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#22
RE: I am commited to make it work - Need Help and guidance
Going by your chart, I question whether a backup breathing rate of 20 would be needed and may be causing you trouble. Given you still have the adapt, that is the one I'd use till you can sort this out. It will give you an auto adjust function and do all that a ST can do. I'd change sleep labs and doctors if needed. they need to set your BPAP ST up for you,

just to remind you of the initial settings, page 41. and then adjust as needed (I would change the min epap to 6 and keep the other settings)
https://www.resmed.com/us/dam/documents/...lo_eng.pdf
ASVAuto default settings
Only four therapy parameters to set
Min EPAP 4 cm H2O
Max EPAP 15 cm H2O
Min PS 3 cm H2O
Max PS 15 cm H2

the titration manual also talks about the ST, it doesn't adjust tidal volume breath by breath and works by pressure and a forced breath if the set BPM/breathing rate isn't met.
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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#23
RE: I am commited to make it work - Need Help and guidance
(06-09-2017, 07:55 PM)ebitansky Wrote: What do you mean by backup rate set to 10. Is this the same parameter as reps rate which is now set to 20.0?
yes. generally stated, most people are disturbed by the machine initiating breathing, instead of having spontaneous breathing.  unless your spontaneous rate of breathing is higher than 20 breaths per minute, the machine keeps jumping the gun.  some of your past posts indicate you thought the machine was unduly initiating breaths.  lowering the backup rate allows you (and us) to see what your spontaneous rate really is.  and, now that you have the SP02 device, you can see if the spontaneous rate and depth of breath (tidal volume and minute volume) stabilize to keep your oxygen level up.  that will give us more to base any new setting of backup resp rate.

by the way, one publication I read does state that longer and better quality sleep was seen in patients subject to lower backup rates vs. higher backup rates during a very short term study.

QAL
Dedicated to QALity sleep.
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#24
RE: I am commited to make it work - Need Help and guidance
Hello everybody.
Most of you recommended I'll try use a full mask. I had at home the old Resmed Mirage Quattro Full Face Mask and I got a new replacement to the cushion. I think that the theory of being "Mouth Breathing" was correct.
My observation using the Full mask in comparison to the P10 Nasal Pillows
AHI went below 5.0 and is mostly Hypopnea (With the P10 it was getting to 20 and above)
Usage: 40 minutes, lots of anxiety (With the P10 I had nights with 5 hours usage)
Leaks: Minimal (P10 had major leaks)

If the theory of mouth breathing is correct and the P10 is useless as it harms more then help with lowering the oxygen level below 80% then I can think only of two options:
1. Stay with the P10 and Give the Cervical Collar a try
2. Try different ResMed Full Face Mask like the Airfit or Airtouch F20 (Any advice on those, as I was told the AirTouch F20 gets the face quite hot)
3. Suck it up and force to stay with the Resmed Mirage Quatro until I somehow can stay longer with therapy.

Attached are the results using the Full Mask. It would be great if you could confirm my assumption and perhaps provide additional advice.

Thanks you all again for all the help so far.
[Image: uDioHQil.png]
[Image: fcIPGHtl.png]
[Image: xOqFAEFl.png]
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#25
RE: I am commited to make it work - Need Help and guidance
I would stay with the full face mask till it's sorted out, keep the variables to the minimum. it has improved your AHI
Are you working with a doctor or working it out yourself? If you are under doctors care, that is where I would go.
My best advice is to see your doctor about your respiration rate, I think you are still breathing too fast. I think you may need more of a gap between your high and low pressure. 4cm gap/pressure support does not seem enough to give you decent tidal volume.
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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#26
RE: I am commited to make it work - Need Help and guidance
did you adjust your backup rate (resp rate), and if so, what is it set at?  Are you willing to drop your pressure to 5 and 9?

Are you able to spread out your sleep, taking naps, etc. to increase sleep length per day?

Are you still sleeping some hours without the CPAP machine, and are you keeping a log of how much?

QAL
Dedicated to QALity sleep.
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#27
RE: I am commited to make it work - Need Help and guidance
I think the backup rate is turned off. The min resp. rate is zero.
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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#28
RE: I am commited to make it work - Need Help and guidance
good point
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