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[Equipment] Longtime BiPAP w/ centrals needs new machine advice
#11
RE: Longtime BiPAP w/ centrals needs new machine advice
(07-30-2020, 11:59 AM)jaswilliams Wrote: My suggestion is a Resmed ASV look at Supplier #2 if out of pocket. A VAuto won’t do what you need

(08-01-2020, 04:54 PM)Sleeprider Wrote: Resmed is much easier to adjust and more quickly responds to events which is very important with ASV. The specific model is the Resmed Aircurve 10 ASV.

Meanwhile I want you to try some new settings in auto SV mode:
EPAP min 6.0
EPAP max 12.0
PSMin 3.0
PSmax 15.0
Breath rate auto

This should help wit the hypopnea and unresolved CA.
Oh wow! Was not expecting this level of help and kindness. I am really moved honestly. This is just awesome. Thank you so much Sleeprider.
I will get into the settings and try them out.
Again - really really a big thank you.
Thanks Thanks Thanks Thanks
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#12
RE: Longtime BiPAP w/ centrals needs new machine advice
(08-01-2020, 04:54 PM)Sleeprider Wrote: Resmed is much easier to adjust and more quickly responds to events which is very important with ASV. The specific model is the Resmed Aircurve 10 ASV.

Meanwhile I want you to try some new settings in auto SV mode:
EPAP min 6.0
EPAP max 12.0
PSMin 3.0
PSmax 15.0
Breath rate auto

This should help wit the hypopnea and unresolved CA.

Good morning and thank you in advance for all your expertise and passion to help people get the best out of their units. I know there are lots of people on here who are extremely grateful 
Thanks

I have 2 questions I am hoping I can get some help with:
1. I changed the settings to what was recommended by Sleeprider. I have attached the Oscar charts after carefully following the Wiki on what to display. How many days should I post for pre vs post to see if the change if beneficial? I've posted a few as samples.

2. My DME only sold Dreamstations. So no go there after a while back and forth with the manager not getting the message of the unit I wanted. Other 3 DMEs in my area will only rent and not permit outright purchase. So I followed Jaswilliams advice and went to Supplier #2. My question is should I buy used or new?
I asked the agent specifically how many blower hours the gently used unit had been run for and was quoted 2000 hrs. For me, that works out about 307 days use. That's almost 20% of the expected life of the unit (5 yrs). Does this seem reasonable? I don't know the answer. Is it worth trying to come up with the extra $830 to get a new unit from them?
Would I have to go back to my sleep doc and have him program it or would that be up to me?
Thank you friends.
I am so grateful.


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#13
RE: Longtime BiPAP w/ centrals needs new machine advice
No problem helping you to setup a new (to you) machine. With any used machine I suggest a Factory reset to reset all settings to their default settings, just to be sure. Then set the remaining parameters.

On your PR machine change your min PS from 0 to 3. That should help with your hypopneas.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

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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: Longtime BiPAP w/ centrals needs new machine advice
I got mine used through supplier 2 it was an excellent machine with 250 hours.  I would suggest you call back after a couple of days, they get other machines in daily.  Set a number of hours you would be ok with and ask if they have any with less than that number.  I would think you should be able to get one with only a month or 2 use.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed 
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#15
RE: Longtime BiPAP w/ centrals needs new machine advice
Good advice by both Fred and Stacey above. I think 2000 hours is the cutoff where Supplier #2 will not accept a machine. I would call back and get some one actually pull the machine and tell you the actual run hours. The customer service is usually more helpful than what you got. I’m absolutely certain a Resmed ASV will be a much better experience for you. Your DME has an exclusive marketing agreement with Philips which increases their margin and reduces consumer choice. I’m not a fan.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
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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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#16
RE: Longtime BiPAP w/ centrals needs new machine advice
(08-13-2020, 09:54 AM)bonjour Wrote: No problem helping you to setup a new (to you) machine.  With any used machine I suggest a Factory reset to reset all settings to their default settings, just to be sure.  Then set the remaining parameters.

On your PR machine change your min PS from 0 to 3.  That should help with your hypopneas.

Hi bonjour,
Thanks for taking the time to look at my OSCAR outputs. I did follow the advice from Sleeprider about 2 weeks ago. The 1st uploaded images shows where I was on the settings from my sleep study and the next 2 images are with the altered settings.
I am trying to determine if it has made much of a difference.
I still see hypopneas occurring but I don't know if that is "as good as it gets" for me or if I need to try something different.
I do appreciate you taking the time to help me.
Any advice is greatly appreciated.

Thanks for the advice. I will definitely do that. I did the online chat and that's how I found out about the 2000 hrs. I will make a call and see if I can get a unit with less mileage. Would be awesome to save $800.

Any advice on the OSCAR outputs now I adjusted to the PSMin of 3?
Image 1 is pre adjustment and images 2 & 3 are post adjustment

I am actually hopeful about getting a newer unit and things in general. Been a rough couple of years.
Thanks guys/
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#17
RE: Longtime BiPAP w/ centrals needs new machine advice
Would some kind and knowledgeable person have a spare minute to look at the 3 images (http://www.apneaboard.com/forums/Thread-...#pid362204) of my pre- changes recommended and the second and third images that show after updating to:
EPAP min 6.0
EPAP max 12.0
PSMin 3.0
PSmax 15.0
Breath rate auto
Does it show any improvement?
I'm going to call Supplier 2 and see if they have lower use units for the Resmed.
Thanks guys.
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#18
RE: Longtime BiPAP w/ centrals needs new machine advice
If the screenshots 2 and 3 were after adjustments, it got worse not better than image 1.
Dave

OSCAR
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Mask Primer
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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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#19
RE: Longtime BiPAP w/ centrals needs new machine advice
I have never seen anyone on a Resmed ASV do this poorly. If the airway is open, the pressure support should be able to result in a breath that maintains minute vent and tidal volume, yet your Dreamstation is flagging all kinds of hypopnea and central events. With your current machine, the EPAP is moving up from 6.0 and often reaches 9.0 at the 95% pressure. I think we should start titrating EPAP min upward to see if we get a better response. Take EPAP min to 7.0 and we will see if we need to move to 8.0. The biggest problem for Philips machines is increasing and maintaining a pressure that provides efficacy, when the minimum is too low.
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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#20
RE: Longtime BiPAP w/ centrals needs new machine advice
I think I could create a chart that looks something similar to that on a DreamStation BPAP.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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