I AM BACK !!

[Lost53]

Thanks Rich. Just had a Physical done with blood work at the end of June and am still waiting for the results from my Primary Care Physician. Maybe it will be Low T or something like that. By the way, what does it look like if I had awakened?

[richb]

Thanks Rich. Just had a Physical done with blood work at the end of June and am still waiting for the results from my Primary Care Physician. Maybe it will be Low T or something like that. By the way, what does it look like if I had awakened?

I can't tell if you awoke another times other than during the power outage. You could look at a time when you woke up and took off your mask and turned off your machine to use the bathroom. The brief period before shutting off your machine would be a time you were awake. Since you would be in conscious breathing mode I would expect less machine intervention and a flatter flow rate graph (fewer spikes). This should also be the case prior to turning off your machine in the morning.

Rich

[Lost53]

Thanks Rich, By the way, I never use the bathroom during the night because I don't need too. Probably a carry over from my piloting days. Anyway, not really sure how to remove mask during the night without turning machine off and doing the ramp up all over again. I do know how to turn the ramp up off though. Thanks again.

[weff]

Hey Rich,

I also have been using a Resmed S9 VPAP Adapt ASV machine and am interested in how you overcome the transition from falling sleep to the Ramp ending as the VPAP machine, as soon as the Ramp ends, starts to treat any events - leading to significant LARGE variations in pressure just as you are trying to transition to sleep - such that it wakes me up each time.

I initially was using an S9 Autoset until I started experiencing a significant number of centrals and after trialling the VPAP Adapt ASV these were successfuly converted into brief hypopneas and generally (when I can get through the wake transition to sleep) have fairly low AHI's. Health wise I have chronic pain from a car accident/osteo-arthritis and damaged nerves such that my initial AHI (untreated value) was 67 but after using the Autoset for a couple of years (with very low AHI's) experienced the increase in centrals (possibly brought on by an increase in the morphine dosage (now on slow release 24hr dose) - but as I verified recently if I go back to using the Autoset it treats the obstructive events but not the centrals - and I confirmed I am still having central events so I have to get used to the VPAP Adapt ASV machine again.

What initially prevented my continuing to use the VPAP machine was an Alar Collapse of the nose such that I couldn't breathe with nasal valves blocking - especially with the high pressure fluctuations just as I transition to sleep.
So I have had that surgically repaired (nothing else worked) and am currently trialling a Full Face mask - which lets me breathe easier without any alar problems - but it feels like a vacuum cleaner has suctioned the mask to my face as the VPAP goes through the large pressure variations just as I am transitioning to sleep.

I currently have a Ramp time of 30 minutes and when my nose wasn't blocking would generally have to stop the machine instead of fighting the pressure fluctuations at the end of ramp#1 - then restart the ramp again - and by the end of the ramp#2 time would generally have been fully asleep such that the pressure variations either didn't bother me - or more likely I had fully transitioned to sleep during the Ramp period such that when the ramp#2 had completed and treatment started I was not woken up.

I may have to retry a ramp of 45 minutes each ramp time (what I originally used) as that was more successful in getting me fully asleep and not blasted awake at each 30 minute ramp. But it also means that for 1.5 hours I don't get treated either - which is not very effective.

I had a similar problem at the sleep labs when the VPAP treatment was verified as each time as I was transitioning to sleep there were extreme pressure fluctuations with the machine trying to make me breathe while I was still awake - resulting in my fighting with the machine. What they did there to overcome it was run the therapy machine in CPAP mode until I was properly asleep - then switch the machine into VPAP mode and from then on there was no issue with the machine pressure.

I know that I have had some extremely weird and vivid dreams not using the sleep machine (while nose was healing after Alar Collapse repair) - but it has now been several months since I have been able to fully use the VPAP machine properly. It also hasn't helped that I have been getting up a few times of a night (caused by some of the meds I take - but also need to retrain bladder too for longer period as can manage longer times during the day - so why not at night.)

I also feel that the VPAP Adapt ASV treatment algorithm is too aggressive at the end of the ramp time. I am operating in ASVAuto mode - it should gradually increasing the pressures - not the current huge pressure variations in such a short space of time. It shouldn't behave like a vacuum cleaner immediately after the Ramp time.

Any suggestions as to how best to resolve this issue with the VPAP Adapt ASV would be very helpful.

Regards

Geoff

[richb]

Hi Goeff. Sorry for all of your troubles. I am not using any ramp at all because I saw that I had a significant number of Central events during ramp that were not treated but were counted. My initial pressure is EPAP 6 and IPAP 8. I don't usually have any Obstructive events thus the low starting pressures. I suggest that you install the Sleepyhead software so that we and you can get a better look at what is actually going on with your treatment. There are a number of us using ASV machines so you might get more suggestions based on the Sleepyhead graphs. I also suggest that you start a new thread with your question/problem. Your pressure problem is significant and deserves the attention that a new thread would generate.

Rich

[Sleeprider]

Geoff, it would help if you would download #Sleepyhead, and post some graphs, or at least summarize your settings. The people here that use these machines could probably help give you some tips on limiting those big pressure variations. We especially need to know your Min EPAP, Max EPAP, Min PS Max PS. If you need a supplier manual follow the link at the top of the page.