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Help ! Clear airway apnea 27.68
#11
(09-14-2014, 11:04 AM)surferdude2 Wrote:
(09-14-2014, 10:56 AM)justMongo Wrote: FYI folks: I use a digital manometer to check my machine pressure.
It measures in inches of water; the conversion is: multiply by 2.54
I usually can only catch the EPAP pressure as the display is still slewing during IPAP.
That's why an analog manometer -- even a u-tube with water in it is better.

Thanks for that, it confirms what I suspected, that the old U-tube wc is still alive and well (sometimes a little messy though). If you have the time to wait for a well calibrated digital instrument to make up its mind, it no doubt will give the most accurate reading with the highest degree of granularity.

Remember to only put teh hose in the water, not the machine! Had to say just in case anyone is watching Bigwink
If everyone thinks alike, then someone isn't thinking.
Everyone knows something, together we could know everything.
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#12
Thank you for,all your input. I have a an auto Bipap machine. What is an ASV machine?
I am still trying how to figure out how to get screen shots of my Sleepyhead graphs. (I am a little slow with computer software.) after I figure it out, I will post the graphs on here. I have carpel tunnel so I can't use computer a lot.
My sleep doctor is in Germany but I am one of the first patients he will see when he returns first week of October. I think Oct. second.
Good advice from you all. Yes, maybe he will want to reduce the incoming pressure.
Actually when I first started using the machine a month ago, I lowered my pressure to 10/07 myself as a way to adjust to using the machine and the central apneas were much less but the obstructive apneas were more. ( I don't have that data however because I switched agencies where I got the machine so I had to return the first machine and they insisted I return my card as well but I did not save that data. I didn't know how to use software at that time.) When I got my new machine I put it back to its prescribd setting at 12/7. I installed Sleepyhead software and I upload my data every morning now. My obstructive apneas are usually only 1 or 2 per hr and my mask leaks are 5.1 the data says. (I just got a new headgear for my mask so,it will be tighter tonight so the leaks will be gone, I think. My mask is so tiny and the headgear is only an elastic band which stretches easily. I love the mask though.) Last night the central apneas were 19, a bit lower than a few days ago.

Maybe the central apneas will reduce after I use the machine for awhile. I have only been using the machine every night, all night long, for about 3 weeks. The first week I was scared and uncomfortable and etc. etc. Now I put the mask on immediately and feel safe with the machine , like at least I know I will be having less events and more sleep. It is not uncomfortable at all. Except I wake for a drink 3 or 4 times a night.

I am curious about the ASV machine. Does it help with central apneas?
Thank you
Kim
Kimberly from HonoluluSleep-well
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#13
In regards to posting sleepyhead data, it is very easy.

Go to Sleepyhead, go to the screen that shows the data you'd like.
Right next to your F12 key is a PrtSc key (print screen)
All windows computers have a program called "Paint"
Open Paint
Click Control and V key and it will paste the image in there
You can then use edit and crop inside paint to get the image you want
Then go to http://www.tinypic.com
Click on choose file to upload
Upload your file
It will give you a link that says [img] your file name here [/img]
Paste that in your post
If everyone thinks alike, then someone isn't thinking.
Everyone knows something, together we could know everything.
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#14
(09-20-2014, 09:09 PM)kfujioka Wrote: I have a an auto Bipap machine. What is an ASV machine?
...
My obstructive apneas are usually only 1 or 2 per hr and my mask leaks are 5.1 the data says. ... Last night the central apneas were 19, a bit lower than a few days ago.

Maybe the central apneas will reduce after I use the machine for awhile. I have only been using the machine every night, all night long, for about 3 weeks. The first week I was scared and uncomfortable and etc. etc. Now I put the mask on immediately and feel safe with the machine , like at least I know I will be having less events and more sleep. It is not uncomfortable at all. Except I wake for a drink 3 or 4 times a night.

I am curious about the ASV machine. Does it help with central apneas?

Hi Kim,

Like on Auto CPAP machines and like on your BiPAP Auto machine, recent ASV (Adaptive Servo Ventilator) machines can slowly adjust EPAP within a range, to reduce/avoid obstructive events like hypopneas, snore, apneas and Flow Limitation.

Flow Limitation (FL) is a partial restriction in our airway during inhalation which can disturb sleep, because FL can cause RERA (Respiratory Effort Related Arousal). RERA is an arousal caused by the effort of breathing, but the reduction in breathing was not as much as the 40% or 50% reduction needed to be called a hypopnea, so it is called RERA instead. Although RERA events disturb sleep, RERA events are not counted in the AHI. (Which is one possible reason why some patients who achieve a good AHI may still be suffering from fatigue and excessive daytime sleepiness.)

On most Auto bi-level machines, IPAP is higher than EPAP by a fixed amount, called Pressure Support (PS). IPAP always equals EPAP plus PS.

On your Auto bi-level machine, however, PS does not have to be one fixed number all night; PS can be given a range and periodically (every few minutes) PS will be slightly changed to see if a higher value for PS would further reduce/avoid Flow Limitation. Periodically it also tests whether it can reduce PS without allowing FL to return.

With Auto CPAP machines and with Auto bi-level machines, if an apnea begins the machine will make no adjustments to the pressure during the apnea event.

Unlike your machine, an ASV machine will react nearly immediately (in perhaps a couple seconds) when an apna or hypopnea begins; the ASV machine will increase PS as much as needed (perhaps to 10 or higher) in order to keep us breathing. During the time we are unable to breathe adequately on our own the ASV machine will be cycling between the exhale pressure EPAP and the inhale pressure (IPAP) at a "back-up respiration rate" (such as 10 or 12 breaths per minute), or it may automatically calculate the backup rate so that it matches our own recent natural respiration rate. The ASV machine reacts the same way (increases PS as much as needed) whether the apnea is obstructive or central.

Unless the apnea is a very strong obstructive apnea, the PS will be able to be increased enough to immediately counteract or compensate for the apnea and keep us breathing. For example, if EPAP was already at 10 and the ASV machine quickly increases PS to 10 (to prevent an apnea) the machine would start cycling itself back and forth between 10 (which in this example is EPAP) and 20 (which in this example is IPAP, which always equals EPAP plus PS) to keep us ventilated. Later, when we are able to breathe on our own again, PS will appropriately return to its normal value.

The problems with ASV machines is it can be hard for patients to adapt to the machine quickly raising PS to force us to continue breathing. It is not painful at all, but can be very annoying until we get used to it. And even after we get used to it, the high pressures needed for ASV therapy can cause a lot of air to get swallowed.

Take care,
--- Vaughn
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. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
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#15
Good news! My clear airway apneas have reduced by 50 percent in two weeks! They are now 11 per hour they were 27 per hour. Hopefully they will
Continue to diminish.
Kim
Kimberly from HonoluluSleep-well
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#16
Great to hear indeed. So what have you done?
If everyone thinks alike, then someone isn't thinking.
Everyone knows something, together we could know everything.
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#17
I have done nothing. I am newly diagnosed with sleep apnea. I think the central apneas were a response to the treatment (bipap) and have subsided on their own. I'll see my sleep doctor on Oct 14th and maybe he can tell me more. I got my machine on August 12 or 13 and there were tons of issues with it not working properly and the company I got it from was not helping so I eventually left that company and got a new medical supply company who issued the new machine Sept 12th so I only have data for the new machine. (When I had the first machine I didn't know how to use the SD card or how to upload my data or use Sleepyhead software. So when I returned the machine I,left the SD card in it.) so I only have my data from Sept 12th but each day the central apneas are less than the day before. I see my doctor on the 14th Oct. so is will ask him about it. Unfortunately he has been out of the country for 3 weeks cause his mother died so I have not been able to see him sooner.
I'm not worried because someone here on the board said that with newcomers often the central apneas will kick in after treatment for the obstructive apneas but they often fade away after awhile. (I hope mine fade away completely. I would love to only have to deal with the obstructive apneas which are only 1 or 2 at most.)
Thanks for asking.
Kim
Kimberly from HonoluluSleep-well
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#18
Great sounds like you are on the right track then. I always ask as people around here like too know so in case they have similar issues other can see it and read it and possibly help them too. Best to you, I hope it continues to go well for you. All the best.
If everyone thinks alike, then someone isn't thinking.
Everyone knows something, together we could know everything.
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#19
Be sure and look at the duration of the CA's in SleepyHead. Click on the Event tab above the pie chart, and then click on the Clear Airway. The events will have a number in seconds, but you can also clik on the individual events and the graph will zoom in and you can look at how long and how completely you stopped.

Sometimes, you'll see a CA event that doesn't look as bad on the graph as the numbers suggest.
Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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#20
(09-28-2014, 11:44 PM)archangle Wrote: Be sure and look at the duration of the CA's in SleepyHead. Click on the Event tab above the pie chart, and then click on the Clear Airway. The events will have a number in seconds, but you can also clik on the individual events and the graph will zoom in and you can look at how long and how completely you stopped.

Sometimes, you'll see a CA event that doesn't look as bad on the graph as the numbers suggest.

Hi! Thanks for the advice. Yes, I did that today. I noticed that most central,apneas appear to last only,seconds. Some of them don't look like apneas at all on the flow chart because I see up and down breathing lines.

I am doing an Oximeter reading for my doctor starting tonight for a week so I will know if my oxygen is dropping while on the machine.

Last night my apneas were only about 11 (10 central) and .66 obstructive apneas.

Thanks
Kim
Kimberly from HonoluluSleep-well
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