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Grandfather's Results
#11
RE: Grandfather's Results
The machine says AHI was 4 last night which is promising. Will collect another night of data and get them to upload data tomorrow.
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#12
RE: Grandfather's Results
I just think the wide-open pressure was all wrong for an 80 year old guy. There are certainly issues, but this does sound like a big improvement. If events are not obstructive, we can continue to drop a bit of pressure or play with EPR.
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#13
RE: Grandfather's Results
Got the 2 nights of data.

AHI of 4 the first night, 12.2 the second night. Data looks promising though, when they turned EPR back on they didn't change it to 1 so that was causing centrals again which makes up most of the AHI. OA + H index was only 1.5 and 2.1 respectively. The leaks are still present but they aren't large leaks anymore due to lower pressures. Minute vent still around 4 and tidal volume 300 so no significant change there, respiration rate lowered though and it does seem like he was having a harder time breathing at the higher pressures. Flow limitations are lower which is interesting and I am guessing some flattening of his breathing is due to higher pressures and trouble breathing against them although he doesn't complain about this. On first night of data you can actually see how it appears his breathing gets depressed and flow limitation increases after pressure increases. With EPR on he doesn't max out the pressure even with 12 max but I imagine that will change once EPR is reduced.

We set EPR to 1, min pressure to 7, max to 10 to see what that does. 

   

   
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#14
RE: Grandfather's Results
Grandfather got a new full face mask to try and stop the mouth breathing/leaks, it is an Airfit F30. It had a surprising effect on the results.

AHI increased to around 20 and mostly obstructive apnea which I believe is due to positional issues. This was with min 8, max 12, EPR 1.

   

   

Overview shows how large leaks are non existent now but shows the increased obstructive apneas. The one day with little to no obstructive apneas was him switching back to nasal pillows which supposedly greatly reduced apnea. Is that common? They said it is easier to breath with the FFM and that the nasal pillows feel like they provide much more force/pressure. I am wondering if it has to do with venting as I noticed my P10 seems to be much more forceful then P30i which appears to vent more?

   
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#15
RE: Grandfather's Results
Increasing max pressure back to 20 and EPR to 3 changed some of the obstructions into hypopneas at least on one night. I am trying to talk them into trying out a cervical collar to see if that helps. Not really sure what to do with settings at the moment and stuck wondering what is better FFM or nasal pillows.

   

   

   
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#16
RE: Grandfather's Results
The one night with nasal pillows. Leaks were actually good that night too but not the norm.


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#17
RE: Grandfather's Results
Your grandfather has persistent flow limitation that needs pressure support, but has a lot of CA when pressure support of only 3 cm is provided. His particular combination of respiratory restriction and pressure support related centrals would be much better treated by ASV. Good luck with that in Canada. The obstructive pattern point to positional apnea, and I agree a soft cervical collar to protect the airway may be a valuable tool
Sleeprider
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____________________________________________
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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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#18
RE: Grandfather's Results
That is what I was thinking as well. I have been trying to get them to set up an appointment for a titration study which will hopefully end with an ASV.

Any thoughts on whether the nasal pillows or full face mask is better while waiting for that?

I am going to get him to try the FFM a few more nights as he was just recently having a cold too and maybe the high AHI recently was partially related to that.
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