Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

[Diagnosis] I am commited to make it work - Need Help and guidance
#11
RE: I am commited to make it work - Need Help and guidance
My apologies. I meant to say, "use the mask attached to the CPAP and operating". You aren't going to get use to anything trying to suck air through a straw. . . as it were.
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
___________________________________
Useful Links -or- When All Else Fails:
The Guide to Understanding OSCAR
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Apnea Helpful Tips

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.
Post Reply Post Reply
#12
RE: I am commited to make it work - Need Help and guidance
About trying another type of mask. How can one try different masks? The insurance is paying for a new mask only once in 3 months. If I chose the wrong mask, I won't have a replacement for that period. I asked the store providing me the masks, and they said they don't have masks tryout, they actually need to pay for any mask they provide.
Post Reply Post Reply
#13
RE: I am commited to make it work - Need Help and guidance
I would look into finding another DME.   I'm on a Medicare Advantage plan. Because of the "stuff" that DME's make you go through, I just buy my own masks outright. I've actually purchased masks cheaper than what my copay would have been.  As far as mask sizing, several suppliers have the manufacturer's sizing guide for download.  They are in a PDF format.  If you decide to use these guides, be sure to set you print options to "Actual Size".  By default, the print option is set to "Fit to Page" and will skew the size chart. Use the Supplier List link at the top of the page to check some of them out.
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
___________________________________
Useful Links -or- When All Else Fails:
The Guide to Understanding OSCAR
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Apnea Helpful Tips

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.
Post Reply Post Reply
#14
RE: I am commited to make it work - Need Help and guidance
Hi.
after The first study I got a CPAP after not being compliant and suggestion of some mixed apnea doctor sent me to an ASV test. after two years not being able to get compliant I went to a third doctor that was surprised I had S9 VPAP adapt and sent me to Bipap test which is where I am.
The ti parameters I have are default, so I'll definitly take a look. I do not think any of the tests even took a look at those parameters. How can a lab technician decide if I need iNav ,ST, ASV?
Reading it make me feel that modern machines have a lot to offer to get better compliance.
Would anyone on this forum is able to look at these study sleep reports and maybe suggest their opinion? I can post those as well.

Thanks you everybody for your help. I am feeling it was a good idea to post it, and shouldnt have waited 5 years.

Thanks again
Post Reply Post Reply
#15
RE: I am commited to make it work - Need Help and guidance
The sizing guides for many masks are available in the Mask Primer, see my sig.
Supplier #1 has return insurance, free on some masks.

I've also heard that some sleep labs will help with fitting masks. The most that can happen is they say no.
Post Reply Post Reply
#16
RE: I am commited to make it work - Need Help and guidance
Hello everybody. I added the resemd SPO2 device and unfortunatly I used the machine only 2 hours last night (4.5 hours sleeping in total) .  I did not play with the settings yet nor I was able to get a new mask. The level of oxygen seemed to go multiple times below 90 and once went down to 84. I did wake up with a headache but that could be due to lack of sleep. One observation I had was that the machine started inhaling process before I finished exhaling. I looked at the manual and Ti could be something to tweak to solve this. Could the oxygen level still be an issue of the leak which seems to be a bit less than yesterday?

Attached are the three screenshots including the oxygen and pulse levels. (Third snapshots is with SpO2)


[Image: hNBYRAMl.png]

[Image: oldYAuHl.png]

[Image: 5kyIOX1l.png]

Thanks again for all the help.
Post Reply Post Reply
#17
RE: I am commited to make it work - Need Help and guidance
The previous S9 VPAP Adapt should have been able to perform much better than the ST and it's too bad we don't have the features of the ASV to help out here. It seems you are using a VPAP ST in fixed bilevel mode (S) with pressure support of 4 cm. This is a very simple bilevel. The correct response to the hypopnea and UA is to raise EPAP, and probably go ahead and maintain the pressure support for now. This was suggested on the previous page by dmeRT, and I agree EPAP 8 and IPAP 12 may show some improvement. In any event it's worth a look.

You are not using the "timed" mode for the ST machine, and I would suggest adding a backup rate of 10. That means if you don't maintain a breathing rate of 10/minute, the machine will automatically switch to IPAP. This may reduce the UA, but the ASV is far better at this. Your current respiration rate is over 21, so a higher backup rate maybe needed, but 10/min is a conservative start. I suspect your ASV was simply setup wrong. In ASVauto mode, the machine could have provided a variable EPAP and variable PS that should have resolved hypopnea and centrals much more effectively than ST. I just can't comprehend the rationale to convert you to essentially BiPAP S.

If possible, you should obtain copies of all sleep studies and titration tests. These are important to have in your records, and there may be some information there that would help us.
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.
Post Reply Post Reply
#18
RE: I am commited to make it work - Need Help and guidance
Unfortunately you will probably not get the best fit or what you want solely with the insurance.
It is also often cheaper than copays to simply buy on Amazon or Ebay. Some DME providers do have a 30 day return deal if they are doing all your supplies, mine does. It is still cheaper for me to buy on Amazon but I can try the first one at no cost if I don't want it. There are also some internet vendors that will give a mask guarantee for returns.
It took me about 5 masks to find what worked the best and easiest and that was Dreamwear.

Once you settle into one, you can stock up on sales and when good deals turn up.
Post Reply Post Reply
#19
RE: I am commited to make it work - Need Help and guidance
I still have my s9 Vpap Adapt at home which is older than the new Resmed Aircurve 10 ST.
The Settings on the machine is not S mode but rather ST mode.
Other params:
IPAP: 10.0
EPAP: 6.0
Resp. Rate: 20.0
Ti Max: 2.0s
Ti Min:  0.3s (should have this been "MIN"?)
Rise Time:  Min
Trigger: Med
Cycle: Med
Mask: Pillows
Ramp Time: Off
Climate Ctrl: Auto

The new doctor who gave me ST, said she does not understand why I got s9 VPAP adapter as there was no indication I need it.

In my first study My BMI was 37.3 while today my BMI is 31.9 still obese but a bit less.
Attached are my 4 studies, I hope anyone can make sense out of it, and maybe can tell me why first doctur wanted to try ASV, why the second one was not a fan, and whether ASV could help anyway or just mess up things and get it worse.

First Document with first  three studies (initial without cpap, cpap and asv):
https://drive.google.com/file/d/0B4VmClE...sp=sharing

Second document is the last sleep study (BiPap):
https://drive.google.com/file/d/0B4VmClE...sp=sharing
Post Reply Post Reply
#20
RE: I am commited to make it work - Need Help and guidance
let me say right off, you have been working at this trying everything you can, throughout the various tests.  it is obvious by your responsiveness to the doctors and technicians, and clearly seen by your drive to reduce BMI from 37.3 to 31.9 (that is wicked awesome, and kudos for you!).

the answer to my question about the dry mouth kind of rules out mouth breathing for most of the night.

your sleep studies do not point to PLM as being an issue, but spontaneous waking is, thus far not attributed to the actual respiratory stress.

your sleep studies also seem to suggest more % of sleep at lower pressures, and more REM at lower to moderate pressures.  N3 seems to extra low, and I am at a loss on how to boost that, except to [contrary to normal forum antics] lower your pressure somewhat to increase your length and % of sleep.

I think I would try a setting of 5/9 and backup rate of 10, but would be interested in Sleeprider's ideas on using the s9 VPAP Adapt to accomplish similar reduction with perhaps even better comfort and longer sleep.

QAL
Dedicated to QALity sleep.
Post Reply Post Reply


Possibly Related Threads...
Thread Author Replies Views Last Post
  please help me make sense of my central apneas p4ncaketim 27 595 3 hours ago
Last Post: Sleeprider
  New to CPAP, looking for guidance and advice iamJB 16 298 7 hours ago
Last Post: Expat31
  Tech Nerds-think this battery setup will work for Transcend Micro? johnbrain 7 107 8 hours ago
Last Post: johnbrain
  [Pressure] Looking for some pressure guidance lavenderlate 1 135 03-11-2024, 07:50 PM
Last Post: staceyburke
  Not sure what to make of my OSCAR data Machinist 3 214 03-10-2024, 09:14 PM
Last Post: Machinist
  Another new user needing guidance Unathletico 1 167 02-26-2024, 07:08 AM
Last Post: grubsztyl
  Can someone help me make sense of my Therapy Numbers? kc90 6 353 02-21-2024, 08:58 PM
Last Post: kc90


New Posts   Today's Posts


About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.