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Hide the hammer I'd like to smash it! Feel worse then before I started
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Sleepster Offline
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Posts: 4,995
Joined: Feb 2012

Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #31
RE: Hide the hammer I'd like to smash it! Feel worse then before I started
(05-11-2013 04:12 PM)John J Wrote:  
(05-11-2013 03:38 PM)Sleepster Wrote:  By inducing central apneas.

And man, you do NOT want those!

CPAP-induced central apnea often subsides as the user adapts to CPAP therapy. Central apneas are no worse than obstructive apneas in that they have the same effect on oxygen levels. They are harder to treat, though.

Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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.
05-11-2013 04:51 PM
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vsheline Offline

Advisory Members

Posts: 1,908
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #32
RE: Hide the hammer I'd like to smash it! Feel worse then before I started
(05-09-2013 12:43 AM)MsDixie Wrote:  Here is the report for 4/17 - 5/7

Avg % night in PB - 0.1
Avg CA index - 2.2
Avg OA index - 1.5
Avg Hypopnea index - 2.6
Avg RERA index - 0.2
Avg AHI index - 6.3
Avg FL index - 0.0
Avg VS index - 7.2
Avg % night in Large Leak - 2.1
Avg Large Leek - 5 min 34 sec
...
I have C-flex set on my machine it's at a 3 is that supposed to be the easiest setting to exhale?

Hi MsDixie,

Turning C-flex down to 2 or 1 or Off may improve the CA Index (average number of clear airway apneas per hour).

But I think there is no need to reduce the C-flex setting right away, before you would be comfortable using a lower setting. Your CAI number is fairly small and not much larger than your OAI. Further, it is fairly common for the CAI to become smaller during the first few months of CPAP therapy as our system gets used to the pressure while sleeping.

Many think Philips Respironics C-flex is the same as ResMed EPR (Exhale Pressure Relief), but C-flex is different than EPR. Unlike using EPR, I think using C-flex can't increase the number of obstructive events when in CPAP mode (constant pressure mode, meaning not APAP mode), because, unlike EPR, with C-flex the reduction in pressure lasts less than half of the exhale time, returning to full pressure well before you are done exhaling. In one of my sleep studies C-flex was used and I hated it. I think C-flex is far less comfortable than EPR, but I can understand why PR decided to design C-flex that way - it provides pressure relief at least during the start of exhale and does not mess with the ending exhale pressure. The ending exhale pressure is very important in avoiding obstructive events. (I think using EPR on an APAP machine would not affect the number of obstructive events because the APAP algorithm can increase the base EPAP pressure as may be needed.)

But both Philips Respironics flex and ResMed EPR can increase (make worse) the CAI number, for the minority of patients who are susceptible to central events. Some long-time CPAP users have found that their CAI numbers improved a lot when they turned off flex or EPR.

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.
(This post was last modified: 05-12-2013 05:52 PM by vsheline.)
05-11-2013 05:14 PM
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archangle Online
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Advisory Members

Posts: 3,159
Joined: Feb 2012

Machine: ResMed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: ResMed Swift FX
Humidifier: ResMed S9 H5i
CPAP Pressure: 16-20
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments: Happy PAPper

Sex: Undisclosed
Location: USA

Post: #33
RE: Hide the hammer I'd like to smash it! Feel worse then before I started
(05-11-2013 05:14 PM)vsheline Wrote:  Turning C-flex down to 2 or 1 or Off may improve the CA Index (average number of clear airway apneas per hour).

But both Philips Respironics flex and ResMed EPR can increase (make worse) the CAI number, for the minority of patients who are susceptible to central events. Some long-time CPAP users have found that their CAI numbers improved a lot when they turned off flex or EPR.

Flex/EPR/Exhale relief may make CA better or worse. You need to have a good, fully data capable machine, and examine the results as you vary it.

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.
05-14-2013 05:32 AM
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MsDixie Offline

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Posts: 37
Joined: Apr 2013

Machine: REMstar Auto A-Flex system One
Mask Type: Nasal pillows
Mask Make & Model: Bella Swiift FX
Humidifier: Respironics System One / heated hose
CPAP Pressure: 9
CPAP Software: EncoreBasic Compliance Manager

Other Comments: Have tried the Swift FX , Wisp Nasal mask, now Bella Swift

Sex: Female
Location: Mississippi

Post: #34
RE: Hide the hammer I'd like to smash it! Feel worse then before I started
Hello fellow hose heads :-)
Thanks for all the helpful comments I've had a busy week and just getting back to the board.
Ill read back over tomorrow and try to take all advice in and understand it a bit better than tonight as I'm pushing to clock and need to be hooked up hosing and sleeping :-)

Since I've last post:
* now have heated hose ( Woo-Hoo luv it )
* trying a Bella mask with nasal pillows

I've worked on the leaks and have managed to keep leak level 0 for past few days :-)
My AHI for last night was down to 4
Ill give more through numbers tomorrow when on pc I'm on ipad now and software on pc
I'd love to post some of the pages but think maybe my being a new member doesn't allow me to yet?

The med supply RT ( DME? ) brought the hose out and new mask. He said my card goes to my doc and he reviews all the data info (so I feel good knowing that) he told me to give him a call mid week when he'd had a chance to read the most recent. He swapped my card for a new one and said he was sending that one to him

I'm feeling good about getting the leak level to 0 and feel from what I'm reading from y'all that's the only true way to distinguish what is and isn't caused from leaks.?
So working hard on that and being compliant with keeping the mask on at night. I'm just past 30 days and feel I'm making ground and feeling much more positive.
I'm not as tired as I was and am adjusting some to having a mask and hose on my head while sleeping - fighting it less. I'm determined to get to the point my ahi is 0 or as close as I can get.
Still having tiredness during the day, and a couple hour 'get it together' time after waking. For the most part though I do feel better, and mental clarity is returning. Feeling very hopeful last couple days I can see the prize ahead of me. It is all thanks to the advice and compassion and encouragement I have received from all of you here at this board. I thank you and wish all of us a good nights sleep! :-)

Ill get y'all some numbers tomorrow and see what ya think.
I'm still planning a visit to the doc and plan to discuss with him my being involved with awareness of my data so that we can work together for the best outcome.
Again, I really thank y'all!
05-15-2013 12:56 AM
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