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Future BiPAP user.. Which machine to ask for?
Thanks for the info Herb. I'll be looking into Oximeter like what you've got. Daily downloading isn't a big deal. I'll update y'all when there's something to share. Best wishes in your pursuit of ASV. IMO you shouldn't be detoured around like this. Keep fighting bro
Sarcasm is a hobby of mine. I am not sarcastic on serious issues, implied or otherwise.
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Looking forward to seeing results on the ST. Good luck!
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Thought I'd get a few BIPAP ST days under my belt and get my bearings before reporting my progress.

First, an observation.

Sleepyhead is an absolute godsend.

I haven't been able to get ResScan 5.7 to show detailed chart data from the AirCurve 10 ST, but it does report apnea and hypopnea events. It doesn't break out the centrals though.

Sleepyhead seems to read the AirCurve 10 ST data just fine, so I don't think I'm missing a thing.


4/28/17  FIRST NIGHT ON BIPAP ST:

Well Sleeprider, looks like it's proceeding according to script.

First night AHI almost 16. Felt worse than on CPAP. LOUSY.

Not a good benchmark though, with Santa Ana winds over 40 mph that night.
I can't sleep too well when it sounds like a jumbo jet is taxiing around on the roof.
 
Had a hard time adapting to the machine, and it didn't help much with the hypopnea just as I was falling asleep.

The machine would kick in with a timed breath, but it only felt like a half breath.
When I took over to complete the breath, it timed out and cut over to EPAP.

This jarred me, and felt worse than the CPAP did.



I'm new at this, but it looks like Cheyne-Stokes to me (I thought the BiPAP ST would over-ride this stuff):

CHART 1, 4/28/17 [ROUGH FIRST DAY]:
[Image: BjZGkO0l.png]




4/29/17 SECOND NIGHT ON BIPAP ST:

I made some adjustments to the rise time from EPAP to IPAP reducing from 300 ms to the default "Min" setting 
(I'm guessing it's 100 ms) so my lungs would fill sooner.

I still had AHI 12.58 on sleepyhead (mostly UA), and AHI 12.5 on ResScan listed as Apnea Index 9.0 / hr. and Hypopnea Index 3.5 / hr.

Not feeling rested. Sleepy in the afternoon the way I felt before CPAP.

CHART 2, 4/29/17 [BETTER SECOND DAY]:
[Image: bysVJZhl.png]


4/30/17 THIRD NIGHT ON BIPAP ST:

I'm starting to get the hang of it, AHI down to the single digits. (Not great, but better)

Kind of early in the day to make an assessment, but feeling a little more rested.

At least it looks like I'm going into REM now, but big deal, I went into REM on CPAP, and even without.

With the Wrist Oximeter, REM was indicated by SpO2 leveling out and pulse steady below 60.
Now with sleepyhead I can see that corresponds to periods where the AHI drops to 0.

The flow rate, minute ventilation, presure pattern, pulse rate all steady, and SpO2 ruler flat:

CHART 3, 4/30/17 [REM SLEEP?]
[Image: xTWS8JMl.png]


Great, but the story is the same.

Rough going 80-90% of the night with limited REM:

CHART 4, 4/30/17 [SAME DISTURBED SLEEP]
[Image: r9rGjx9l.png]


One more thing.

I have glaucoma, which I've read can be a product of sleep apnea.

It's controlled with latanoprost drops, but I had an episode with the vision in my right eye this morning.
Temporary blind spots, and flashes.

I've had eye surgery and temporary vision problems before.

I hope the pressure induced by BIPAP ST isn't a problem.

I have an appointment Fri. with my eye surgeon so I'll ask him.


Point is, I can feel the strain when I start BIPAP every night.

I've learned how to let the machine do the work instead of fighting it, but I feel as if I'm hyperventilating for a while, and my pulse rate goes above normal before dropping back.


Now that I have the charts, I can see how adjusting to BIPAP presure is hard on my system:

CHART 5, 4/30/17 [GETTING TO SLEEP]
[Image: Eh8iPC1l.png]


So, Medicare requires a follow up appointment to review progress (or in this case, lack thereof) between the 31st and 90th day on the machine.

28 days to go on ASV quest I hope.  Thanks
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Eww this sounds kinda painful Herb. I hope ST phase passes quick and safe for you. I stopped at pulmonary office 2 of mine today so they could copy my SD card info. I'll call there tomorrow to see how my ASV path sounds to them.

With me never experiencing an ST machine, does it seem to you that you adapt to it more than you rather than the machine adapts to you? Asked as a learning tool, because that's the impression I'm getting. As before, wishing you the best.
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(05-01-2017, 07:42 PM)SarcasticDave94 Wrote: Eww this sounds kinda painful Herb. I hope ST phase passes quick and safe for you. I stopped at pulmonary office 2 of mine today so they could copy my SD card info. I'll call there tomorrow to see how my ASV path sounds to them.

With me never experiencing an ST machine, does it seem to you that you adapt to it more than you rather than the machine adapts to you? Asked as a learning tool, because that's the impression I'm getting. As before, wishing you the best.

As far as adapting, I had to relax and let the machine begin to pressurize my lungs and breathe with it.

In spontaneous mode, it triggers from my breath, so I have some control.

There is a window of time the ST allows, so I can take a short or long breath as needed.


The problem came when I needed to take a deep, long breath. 

If I waited too long, the machine would switch to EPAP mid breath.

What I learned was to wait and start taking a deep breath right at the beginning of the next machine timed breath.


So far, I've described the conscious breathing.

The sub-conscious falling asleep part happened by letting my natural breath timing adapt to the machine.

Learning to ride a bike kind of thing, it almost feels normal now.

I just hope I can get a better night's sleep.
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Well I really hope it helps being on the ST, even if it's just a stop on the path. I know how I feel on this BiPAP, it's making me feel worse, more tired etc. Regardless, hope your results continue to improve and you gain sleep time.

No real news in my case just now. Second opinion doctor was given a copy of my SD card data this Monday afternoon. I'm going to call them Tuesday to see what they say.
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In your chart, do you have the CA turned off? I can't see it in your event flags chart and statistics column
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(05-01-2017, 11:53 PM)ajack Wrote: In your chart, do you have the CA turned off? I can't see it in your event flags chart and statistics column

Nope, all events turned on.

I think it's because the ST kicks into timed mode as I start central hypopnea or apnea and hides the central events.

I know the chart seems to show CA (I'm just getting started with charts), but SH shows them as UA. 


BTW, the ResMed AirCurve 10 VAuto, ST and S combined clinical manual states:

Central sleep apnea detection
Central sleep apnea detection is available in VAuto, CPAP and S modes (when Easy-Breathe is
enabled) on AirCurve 10 VAuto and AirCurve 10 S devices.

So the AirCurve 10 ST is not listed in the manual for Central sleep apnea detection.


I sure wish it did somehow.

EDIT: I got the ResScan detailed data problem solved, but it doesn't show detailed spontaneous/timed events.
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The UA events are centrals, and you are having plenty that the machine does not mitigate. I think these results were predictable, and are actually better than I expected. What we have is a bilevel with fixed PS of 5, which is generally not enough to initiate a breath on the backup rate. The machine detects an apnea, increases mask presure and nothing happens. On the last chart, the detailed flow rate shows the backup breaths cause nothing more than a small squiggle in the flow rate. I would expect it to take about 7 to 8 PS to cause a breath, which is what ASV would deliver, but that is a lot for each breath, which is why ASV is so nice. It only delivers what you need when you need it.

Don't necessarily wait 30 days to tell the doc he got it wrong. This clunker needs to go.
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(05-02-2017, 08:43 AM)Sleeprider Wrote: The UA events are centrals, and you are having plenty that the machine does not mitigate.  I think these results were predictable, and are actually better than I expected.  What we have is a bilevel with fixed PS of 5, which is generally not enough to initiate a breath on the backup rate.  The machine detects an apnea, increases mask presure and nothing happens.  On the last chart, the detailed flow rate shows the backup breaths cause nothing more than a small squiggle in the flow rate.  I would expect it to take about 7 to 8 PS to cause a breath, which is what ASV would deliver, but that is a lot for each breath, which is why ASV is so nice.  It only delivers what you need when you need it.  

Don't necessarily wait 30 days to tell the doc he got it wrong.  This clunker needs to go.

You're right.

I've got to get off this ST.

AHI 15.9 last night. No smooth REM.

No way am I going to let them increase pressure, it will only make centrals worse.

Now I have to worry about the effect this pressure has on my intraocular pressure / glaucoma.

Thank you Sleeprider.
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