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There are some OA events, but your CA is higher, so I think you need to ride these settings as-is for a while. The important question is are you feeling better with the higher pressure, or was it better at the previous setting? I think you need to keep the EPAP at 7.0 with OA events still present, but you might want to back off IPAP to 10.6.
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.
07-15-2020, 11:43 AM (This post was last modified: 07-15-2020, 11:46 AM by Gtm4192.
Edit Reason: Clarify more
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RE: Help with s-9 Vpap in S mode
Sarcasticdave, I am also unsure if the centrals are treatment emergent. A little more background on me. I had an ABI anoxic brain injury in 2015 so it is possible that I do need a asv if centrals don’t sort themselves after a while.
Sleeprider, I am sleeping much better. Able to go back to sleep if I wake in the middle of the night without much fuss now. Feeling refreshed when I wake instead of wanting to go back to sleep. Also why so specific of a number 10.6 for IPAP decrease? Also why not increase EPAP to 8 to see if that helps stabilize my events and IPAP to 12?
I am torn in wether to increase 1cm all around or leave it as is for a few days.
Machine: Needing iVAPS but QUACKS refusing to help but they love testing Mask Type: Not using mask Mask Make & Model: F&P Vitera on shelf Humidifier: None/nada CPAP Pressure: 0-0 pressure set CPAP Software: Not using software
Other Comments: SCS PVC K9D** Untreated CA Asthma Dr. Donothings
I'll defer to Sleeprider with settings actions he suggested. As for ASV need, with results like this, therapy seems to be going well by the numbers. To get insurance to pay, lots of things need to line up to build evidence of medical necessity. A sleep study indicating CA at least equal to OA, and stacks of medical records from you doctor(s) about symptoms and patient complaints pertaining to CA disrupting sleep chronically. Further, evidence that CA has not been treatable via any other lesser priced PAP equipment would need to be in the stack as well. And you'd need to pass the still more or less required echocardiogram to show LVEF as a percentage of efficiency with a cardiac doctor signing off.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
07-16-2020, 09:13 AM (This post was last modified: 07-16-2020, 09:15 AM by Gtm4192.
Edit Reason: Added pressure numbers.
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RE: Help with s-9 Vpap in S mode
Thank you all for the help you have given me thus far. Upped the pressure 1cm again last night to just feel things out because why not. I think I need to back it off a little bit now like you all have suggested.
Atttached is a picture of part of the flow chart from last night. The thing that puzzles me is my flow is not not impended making me think more pressure is needed to keep the airway open. But I had a handfull of Large Leaks last night as well. Maybe just leave it like this for a few days and see if my body acclimate to it is best.
Any thoughts or tips would be greatly appreciated.
Epap:8, Ipap:12, PS:4
(07-15-2020, 11:43 AM)Gtm4192 Wrote: Sarcasticdave, I am also unsure if the centrals are treatment emergent. A little more background on me. I had an ABI anoxic brain injury in 2015 so it is possible that I do need a asv if centrals don’t sort themselves after a while.
Sleeprider, I am sleeping much better. Able to go back to sleep if I wake in the middle of the night without much fuss now. Feeling refreshed when I wake instead of wanting to go back to sleep. Also why so specific of a number 10.6 for IPAP decrease? Also why not increase EPAP to 8 to see if that helps stabilize my events and IPAP to 12?
I am torn in wether to increase 1cm all around or leave it as is for a few days.
My objective in backing off IPAP to 10.6 and keeping EPAP at 7.0 was to address the CA events without disrupting the progress already made. I think you will reduce CA by very slightly reducing pressure support. As we get closer to optimized settings I often suggest finer adjustments. We may need higher EPAP, but I'm going to try PS 3.6 instead of 4.0 and will recommend you maintain or slightly reduce PS as needed.
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.
So to be clear I am just backing Pressure support off to 3.6? No other settings changes. Sorry for all my questions just want to make the correct changes.
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.
Hello everyone another night in the books. I didnt change any settings last night and feel ok today. RHR seems ok as well. I am planing on just leaving the settings as is for at least a week now and see what happens to my AHI. I may at the end of the week switch the pap to VAUTO and see if that makes any changes. I think I am acclimating to the pressure because it doesnt feel as strong now.
Attached is my chart from last night.
If you want to see a closer look at an event just let me know.
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.
So I have just continued as is no changes for a few day’s. I am seeing’s drops in my respiration rate to 0. I think this means that my brain cannot correctly judge when to slow breathing and speed it back up. Feeling wise I am much better then before with no machine. But I think I can be better still. What do you all think?
