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[Equipment] Machine with fixed EPAP/IPAP
#11
(08-22-2015, 09:41 AM)quiescence at last Wrote: Are you in ASVAuto mode? See if your machine will let you set the following parameters:

EPAPmin=8 EPAPmax=8 PSmin=3 PSmax=8

and can you set the maximum pressure? If so, and you set maximum pressure of 14, this will limit the PSmax attainable to 6 even though it is set to 8.

That combination should give you what in bi-Level would be 11/8 until central events are sensed, and then auto adjusts as needed.

and re-read http://www.apneaboard.com/forums/Thread-...VPAP-Adapt i don't know if that helps some.

QAL

My machine is not an AutoASV, it is the older Adapt #36007, very basic, just EPAP, Min/Max PS...that's all...
At EPAP 8 I have a hard time breathing out, not going there..as I said earlier, I have tried a lot of settings...

S

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#12
(08-20-2015, 04:44 PM)storywizard Wrote:
(08-20-2015, 04:33 PM)Sleeprider Wrote: You have a lot of choices. Fixed bilevel is what is provided by the Resmed VPAP S or the PRS1 BiPAP model 660. Moving up from there is the VPAP Auto or PRS1 BiPAP Auto model 760. The Resmed works like an auto CPAP with a fixed pressure support of 4-8. EPAP and IPAP move up and down together in response to apnea precursors. The PRS1 Auto works with a pressure support range of 4-8, and the EPAP and IPAP can move independently with PS changing.

None of the above machines has an ASV function, so no spikes of PS.

Thanks for the info Sleeprider...I am torn these days...
I feel lousy, getting through my days on coffee, until noon, tea in the afternoon...
but really not doing well...

I am seeing another sleep tech on Saturday, will take original sleepstudy, Sleepyhead screenshots...I have no expectations of learning anything, but need to find a way out of this fatigue.

I was going over the pressure graph of my BiPAP week, it was pretty smooth, but I felt worse than the ASV...I am starting to think that xPAP may not be for me...

I will keep going a little longer...

Storywizard
Sounds like we have similar sleep problems. All Hypopnea and periodic breathing at low pressure and nearly all Centrals at higher pressure. I am currently on a ResMed S9 ST machine. My current settings are EPAP 11 IPAP 15 and a backup rate of 8. The backup rate of 8 BPM is at the same pressure as the normal settings. Last night I had an AHI of 9 and felt terrible when I got up this AM. I looked at my waveform and found erratic breathing for most of the night. ( The machine doesn't score a Hypopnea when it is providing backup breaths). I only had about 1 hour of smooth waveform indicating some level of sleep. I am trying to get an ASV machine but am worried that might not work either. I have an appointment with a new sleep center in a month.
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#13
Last kick at the CPAP can, part one.
Met with a new RT yesterday, to say it was a revelatory experience would be an understatement, this guy not only wanted to see all my data, yes Sleepyhead, he loves working on complex problems...
Apparently the two docs I have seen so far have terrible reputations as hard to communicate with, and showing no interest if you have anything other than OA...

Anyway, long story short I am now on this:
Philips Respironics System One (60 Series)
RemStar BiPAP Auto with Bi-FlexModel 761CA - P13845704FDA6
PAP Mode: Fixed Bi-Level
EPAP 6.0 IPAP 10.0 (cmH2O)

We are going to see what happens over the next week or so, and take it from there...

He has given me the name of a sleep doc who actually takes the time to help complicated patients,
and if the tech cannot help me I will go and see her.

Last night was the first time for a long time I had almost no leaks, had a great first three hours after waking, then my energy went.
It will be interesting to see if the events calm down, I will not post a screen shot yet, as it would not be pretty, lol.

It was amazing to have pressures that matched how I actually breathe, it was super comfortable.
Whether I get restorative sleep, that is a question yet to be answered.

Next up is a session with a hypnotherapist, and then I am done...:-) well maybe...

thanks again for all the support...

Storywizard
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#14
How nice that you got with a good, caring RT. Whatever happens, you can say that you did everything you could. I'm really hoping the new machine marks a positive turning point for you.

S, I've been on PAP for three years -- from the start I've had stellar SleepyHead reports. I've had maybe a dozen obstructive apneas -- total -- in these three years. And a few dozen hypopneas -- total. My AHI has consistently been below .5 consisting of a few 'centrals' flagged by my machine -- maybe real, maybe SWJ. Yet like you I've had little if any improvement in the quality of my sleep.

All this just to say that I empathize with your plight. I plod on with my machine because I was desatting in my sleep study and fear is a good motivator, but if I was in your situation with events continuing and/or increasing despite treatment, and not feeling any better, I'd be exactly where you are with it.

Thinking good thoughts for you.Smile

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#15
(08-23-2015, 07:10 PM)kaiasgram Wrote: How nice that you got with a good, caring RT. Whatever happens, you can say that you did everything you could. I'm really hoping the new machine marks a positive turning point for you.

S, I've been on PAP for three years -- from the start I've had stellar SleepyHead reports. I've had maybe a dozen obstructive apneas -- total -- in these three years. And a few dozen hypopneas -- total. My AHI has consistently been below .5 consisting of a few 'centrals' flagged by my machine -- maybe real, maybe SWJ. Yet like you I've had little if any improvement in the quality of my sleep.

All this just to say that I empathize with your plight. I plod on with my machine because I was desatting in my sleep study and fear is a good motivator, but if I was in your situation with events continuing and/or increasing despite treatment, and not feeling any better, I'd be exactly where you are with it.

Thinking good thoughts for you.Smile

Thanks kaiasgram

It will be an interesting week...:-)

good thoughts back at you...

Storywizard

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#16
(08-23-2015, 07:46 PM)storywizard Wrote:
(08-23-2015, 07:10 PM)kaiasgram Wrote: How nice that you got with a good, caring RT. Whatever happens, you can say that you did everything you could. I'm really hoping the new machine marks a positive turning point for you.

S, I've been on PAP for three years -- from the start I've had stellar SleepyHead reports. I've had maybe a dozen obstructive apneas -- total -- in these three years. And a few dozen hypopneas -- total. My AHI has consistently been below .5 consisting of a few 'centrals' flagged by my machine -- maybe real, maybe SWJ. Yet like you I've had little if any improvement in the quality of my sleep.

All this just to say that I empathize with your plight. I plod on with my machine because I was desatting in my sleep study and fear is a good motivator, but if I was in your situation with events continuing and/or increasing despite treatment, and not feeling any better, I'd be exactly where you are with it.

Thinking good thoughts for you.Smile

Thanks kaiasgram

It will be an interesting week...:-)

good thoughts back at you...

Storywizard

Smile

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#17
Sounds like a good experience with an engaged RT. The PRS1 Auto BiPAP will not initiate breaths, but is a very comfortable machine to use, assuming it's the right one for you.

What became of the ASV? Still have it, or was it swapped?
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#18
(08-24-2015, 07:35 AM)Sleeprider Wrote: Sounds like a good experience with an engaged RT. The PRS1 Auto BiPAP will not initiate breaths, but is a very comfortable machine to use, assuming it's the right one for you.

What became of the ASV? Still have it, or was it swapped?

Hi there Sleeprider

my trusty ASV is safely tucked away in the CPAP closet, its not going anywhere...:-)

The BiPAP feels comfortable, half as many events last night as the first one, we are trying to find out if I can sleep better with no PS pulses...it was so good to find a receptive tech to work with...

Storywizard

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#19
Good. I hope you get some much needed sleep.

QAL
Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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#20
(08-24-2015, 02:05 PM)quiescence at last Wrote: Good. I hope you get some much needed sleep.

QAL

well, I am sleeping, but not restfully yet...

Titration Wednesday night, it will be interesting to see if the 118 CA's I had last night are actually centrals or SWJ...,OA's (8 for the night) , and Hyp 24 for the night), not great.

Lots of pressure pulses, 294...that can't be good can it??

well, one breath at a time in zombie land...lol

Storywizard

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