Feeling like I cannot breathe

[Jay51]

Nice to hear from you again Victoria.  Sounds like you have been busy with your apnea therapy.  In the 1st chart I see some positional apnea (the light blue clusters of OA's) and some CA's.  Where you wearing your soft cervical collar in this one?  The 2nd chart is the worst that I can remember regarding CA's.  Moving your trigger from high to very high might help (if you can tolerate it).  The last chart looks decent.  Still a slightly lower tidal volume.  I am going to guess that some of it is coming from your nasal breathing difficulties (from what you said about your sleep study and mouth breathing with higher pressures).  I wonder why they didn't do the ASV titration?  Do you feel better in the morning using Auto or S?  Oh well, I remember your history.  If anyone sees anything else, please post.

[vgrando]

    Good to hear from you also.  The second chart was with the Bipap set on S mode. When I look at my history, my AHI was much higher than usual almost every time I tried the Bipap on S mode. Interestingly, they set the Bipap on S mode during the titration study and my AHIs were very high.  

I will post a copy of my stat history.

I am most comfortable with Auto, even with my IPAP set to 21 and my EPAP set to 11 with PS set at 3. With these settings, my AHI is almost always under 5. I am still on 02 and set at one liter. This seems like a good combination because my 02 is fine and my apneas are low. 

I have a unilateral elevated hemidiaphragm caused by my severe stenosis at C 3, 4, & 6.  This is rare, and doctors do not know how to treat it. If things get worse, I can get a phrenic nerve stimulator (PNS) pacemaker!    

With such high CA and Complex Apane during my titration study, I would think that Medicare would pay for a ResMed ASV. However, the MD who rated the titration study never mentioned one. I think they are worried that Medicare will not pay for an ASV machine. The cheapest one I can find online is $3,000.

[Sleeprider]

Please be sure the calendar is minimized when taking screenshots. That will make the settings visible. Are you using Very-High trigger sensitivity? Your titration should have evaluated ASV. Predicting what Medicare will cover is not the doctor's job. Medicare covers what the doctor determines is medically necessary and beneficial. For lower price ASV, try the DotMed site and only buy from U.S. sellers that have positive seller ratings. There are Aircurve 10 ASV devices on that site ranging from new to very used. Note, that you can refurbish a device with new motor, seals, calibration and zero hour reset for under $300 including shipping at Supplier #28, so don't be afraid of the run -hours.

[vgrando]

           

Thank you! This titration study clearly shows the need for an ASV. I see my pulmonologist/sleep MD next month and will ask for the prescription.

In my opinion, the titration process's failure to meet with the Sleep doctor who evaluates these studies is a serious flaw.

My weakened diaphragm is causing my shallow breathing while at rest or sleep. After the Titration study, the respiratory therapist told me my AHIs were worse when sleeping on my back. But she also said that my AHIs were worse when sleeping on my right side compared to sleeping on my left side. My diaphragm is elevated on my right side.

Yes, I have the trigger set high.

Last night, I used an Auto at IPAP 21, EPAP 11, PS 4, Trigger on high, Cycle on medium, Ti-Max on 2.0s, and Ti Min on 0.2s.

And my AHI was 0.57! I deffentatly have less AHI on Vauto.

Besides nasal sprays at night, I have been taking one Sudafed to decongest my nose. It makes a big difference. I am also using the large mask for the F&P Evorafull face mask. 

My ENT does not want me to use nasal dilators because they dry out my nostrils.

[SarcasticDave94]

My opinion, this doctor doesn't want to bother helping when ASV is pretty clearly needed. "My medical crystal ball says Medicare may not approve." Really, did we ask that?

If they can't titrate ASV in reality and get you the script for it, they're incompetent. Myself I don't like doctors that think this is a game and that they get to give bogus info and that I'll buy it.

I'm seeing new ASV out there for $1,200...