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Help! My bipap experience has gone off the rails!
#1
Sad 
I have been using a Resmed Aircurve 10 VAuto in S mode for almost 2 1/2 years.  Getting this machine was one of the great events of my past few years.  After a few weeks of getting acquainted, my AHI went down below 5, and I was very happy.  A couple of minor tweaks, and I soon settled into a pattern where I very rarely saw an AHI above 1.  I was sleeping well and life was good.

...

After writing a page or two, then realizing nobody's going to read all that,  I decided to just shout "HELP" and wait for your questions to probe the background/context.

Here's my call for help:

A couple of months ago, while I was on a three-week vacation, I started to feel starved for air at night.  I assumed that meant that I was having trouble with exhalation, leading to CO2 levels increasing.  I also noticed that I felt like exhaling required too much effort.  At first, this would happen at even at the beginning of my sleep period.  A couple of small changes seemed to help, but if I woke up during the night (and I always wake up during the night) I had serious trouble falling back to sleep.  Another subjective impression is that the machine is making me breathe in too deeply and too frequently.  If I turn the @#)*$%# thing off for a bit, relax, and start drifting to sleep I find myself settling in to a pattern of relatively slow, shallow respiration, compared to what happens when I put the mask back on and turn the machine back on.  I have tried fighting with it to achieve a breathing pattern more like my default, but the machine will not allow that.  At least not with the changes I have tried so far.

This really bothers me, because my apnea was diagnosed because my cardiologist was trying to find a reason for my enlarged heart/afib.  Her explanation of my situation included the slight possibility that effective apnea treatment to allow me to really rest during the night might reduce my afib symptoms.  So, extra work just to breathe out is going in the wrong direction.

What should I be doing?  I've tried a few things, making gradual changes and waiting to see how my response settles in.  Obviously, that isn't working, or I would not have posted this.
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#2
Can you post a daily graph from sleepyhead ? (Details in my signature)

Are you using genuine Resmed Filters.

Anything else changed that you are aware of ?

Eg your machine settings, medications, mask or anything else
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#3
Welcome back. I think at least a chart or two and some idea if there are events associated with what you describe might help. If you feel over-ventilated, then cutting back on pressure support might help. So far, not much to go on.
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#4
what is your Ti min and Ti max settings at? also your trigger and cycle?
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#5
Thanks for the quick responses.

JasWilliams and Sleeprider - I thought I could post graphs, but it'll take some time.  I've been using the broken-GL version of SleepyHead that runs on my Linux laptop.  I don't appear to have the option to export a set of graphs from the program - I can only make screenshots, and only about 3 graphs fit into a given screen...

Did not expect a new version of SleepyHead from JediMark (sorry), attempting to upgrade my system enough to get all the required tools to run so I can try building again...

PoolQ - Ti Max   2.0
            Ti Min   0.3
            Cycle    Med
            Trigger  Med
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#6
I don't know where the Linux system stores screenshots by default, but it is in the same place as your user profile. In Windows it is User/Documents/Sleepyhead directory/Profile/Screenshots. The Sleepyhead screenshot utility is one of the absolute best graphics engines out there, and the files are stored in .png format. So maybe if you search that file type you may find it...try searching screenshot*.png
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#7
Running Linux here:
There is a Screenshots directory in my SleepyHeadData directory - it has all my sleepyHead screenshots.
Advisory Members serve as an "Advisory Committee" to help shape Apnea Board's rules & policies. Monitors are also Advisory Members, just with Extra Work assigned.

Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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#8
(09-15-2018, 11:31 AM)jaswilliams Wrote: Can you post a daily graph from sleepyhead ? (Details in my signature)

Are you using genuine Resmed Filters.

Anything else changed that you are aware of ?

Eg your machine settings, medications, mask or anything else

Sorry, I missed the last three questions.
Yes, genuine filters.

Not aware of any significant changes in, say, three months prior to the onset of the problems. I was on vacation for 3 weeks - I gained something like 5-6 pounds. If there are/were other changes, I'm not aware of them.

I'll have to write down the machine settings and post them later. Basically, I'm running in S mode and have inhalation set around 9.0 and exhalation was at, probably, 5.0 when this started. Since I felt that lowering the exhalation pressure might be useful, I have lowered it gradually to 4.0.
Last night I decided to go down to 3.0. Interesting result - my OAs went up enough to bring my overall AHI to 5.2 for that night. The previous night (still at 4.0) was 0.5.
So that's something.
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#9
Don't waste your time with screenshots.  Post an SD card image to dropbox.
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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#10
I got a hold of a Mac, installed "real" SleepyHead there, and discovered that all the features work exactly the same way as the version I've been running on Linux.  So, I have made a series of screenshots that include all the graphs I can view.  I am going to try an attach them here.

Ok, I was able to attach 5 of the 6 screen shots, so I guess that'll have to do.


Attached Files Thumbnail(s)
                   
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