How starting over augered in

[goodonya]

My effort to break free of the past and first sleep doctor/DME/sleep clinic/machine has so far been an interesting journey.

I got a new doctor. I got a new machine. I got a new sleep study. I use mail order for machine stuff and masks stuff.

The new doctor is hard to get a hold of and changed machine settings on the new machine with out telling me anything about what he did and why.
The new machine came set up with a variation of the original prescription that the new doctor came up with for the old machine as a last resort attempt to achieve a setting I could actually used the machine with.

In keeping with my effort to start over I wanted a new sleep study. I encountered resistance. It did not seem right to resist a patient that after 4 years and a failed situation wanting a new sleep study. I insisted. I told him my determination for a new start. He ordered a sleep study.

I got the sleep study 3 weeks ago. No results back yet. I learned here how to see the revised unprescribed setting the new doctor had changed my machine to. It is set on a straight 4-10 ASV(resmed vpap machine).
I was previously diagnosed with 85 percent Central Sleep Apnea. I wake up and look at the machine in the mornings and I see mostly close to 0 AHi. I still am not rested and have cognitive struggles and so on.
I called in to see why no sleep study results. My new doctor had been the guy interpreting results. His office said he has stepped down from that position. I am on hold.

I asked for a new prescription. That is on hold as well.

[herbm]

If you are running "near 0 AHI" and don't feel great yet, then give it time or look for other causes (e.g., other illness or environmental issues).

You body has years, perhaps decades, of OSA abuse -- most people don't recover overnight or even in the first few weeks.

Are you 100% compliant? If not, determine to achiever that immediately.

[diamaunt]

It is set on a straight 4-10 ASV(resmed vpap machine).
I was previously diagnosed with 85 percent Central Sleep Apnea. I wake up and look at the machine in the mornings and I see mostly close to 0 AHi.

what model machine do you have? (look on the back, there's a "ref" and a number that should start with 36.

you should get the software and look at how you're doing throughout the night, see what kind of breathing incidents you're having.

also, consider getting an oxymeter, you can get a cms50d+ (the plus is important) for under 50$ and record your oxygen saturation levels to make sure you're getting enough oxygen into your bloodstream. (which, when it all comes down to it, is the whole reason for all the other stuff.

I have a friend who's on a S9 vpap adapt (36037) and even with that doing his breathing for him, he was dropping into the mid 80s. he's now had a night with an oxygen concentrator and spent it up in the 90s... we'll see how that effects him after a while.

[DeepBreathing]

G'day Goodonya.

It sounds like you still have a fight on your hands. If you have a very low AHI and are still not feeling rested there may be other issues preventing you from having a sound sleep. These might include things like leaks which are not enough to affect the therapy but still disturb your sleep (especially if it's blowing in your eyes or making fart / trumpet noises agianst your skin). Another possible issue with bilevel machines is that the high pressure might rouse you. And there might be external factors like traffic noise or a barking dog. The net effect is that you are still having disturbed sleep, but it's being disturbed by factors than the apnea.

Alternatively it might just be that your body will take a while to completely heal itself after years of sleep deprivation.

You mentioned you now have a Resmed VPAP - can you tell us which model? I assume it's the VPAP Adapt ASV given your high number of centrals. The pressure setting on this is a bit complex and involves setting max and min limits for EPAP and pressure support and a maximum for IPAP. Remember that EPAP + PS = IPAP. You need to discuss this with your sleep doc (if you ever get to see him). I don't think it's wise to play around too much with the settings until you have a good understanding of what each one does and how they interact.

And how are you finding the Resmed? I remember you really hated the Respironics - I hope the Resmed is a improvement for you.

[goodonya]

If you are running "near 0 AHI" and don't feel great yet, then give it time or look for other causes (e.g., other illness or environmental issues).

You body has years, perhaps decades, of OSA abuse -- most people don't recover overnight or even in the first few weeks.

Are you 100% compliant? If not, determine to achiever that immediately.

Hi, thanks, I am on the central sleep apnea side of things. Very little OSA, the first sleep study was at a time when I snored a lot more than now and even then only 15% of events were obstructive. That is something that happens in the first part of sleeping and especially if I have worked too hard. It is just not my thing.
Without the machine the thing I do is breath evenly in and out with longer exhalations than inhalations... and according to girlfriend reports as well as the sleep study... I just stop breathing and...and...
eventually just start again with no fanfare just start as quietly as I stopped.
Just the gentlest nudge and I start breathing again but the length of time is something that seems to bother her a lot. She is my younger woman by a couple of decades it freaks her out to wake up to a totally silent room when I am there beside her.
I have a lot of money and time and frustration invested in this situation. I am when I have a machine that is working properly 100% compliant even with settings that have in the past been as close to unbearable as torture.
The Phillips Respironics algorithm must work for some people but for me it is a complete fail. The S9 Auto Vpap is a huge relief for me. I did get this new sleep doctor to get the pressures down.

The old sleep doctor had me at a max pressure of 24 on the PR Auto Serve with the backup rate turned off and through the whole miserable agonizing enraging two and a half years. Refusing adamantly to change any numbers. I was compliant while using up two machines. Barely compliant but I was still there. Sleep deprived and P*ssed off, and complaining, watching my career swirl down the toilet bowl.

I have not been into adjusting these machines myself. I walked into this situation trusting the medical profession. Now I do not trust them at all but I am still not tweaking on this new machine. It is not right yet for me but it is still better than what was.

I was hoping the new sleep study results would come about in a professional and timely fashion. I was hoping to get a fresh prescription that acccurately follows recent applied medical science upon myself the patient.

What has happened is nothing at all. No results from the Sleep Clinic. No follow up by the new doctor. I call in and get a story. Huh?

I come from a medical family. It is like I am in the Twilight Zone where things have gone into some kind of eerie slow motion and all these smart people all around me are watching the bus slowly leave the road coming at me. Their mouths are just starting to move to make sounds but nothing is coming out. I am standing there like a brave little Scottish Terrier not moving with my little chest puffed out as the bus inexorably bears down upon me.
Grr.