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Switched from APAP to BIPAP
#11
RE: I've been using my APAP for a week, symptoms wors V2e.
Your flow Limits are high at EPR=3. That means that you may need more pressure support/EPR. And yes, that would likely increase your CA events. Set your EPR=2. I'd like EPR to be as high as you can handle so you can adjust to lower CO2 levels..
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#12
RE: I've been using my APAP for a week, symptoms wors V2e.
Hi Gideon, 

I sent you a pm with the same message but wasn't sure if you'd check that. You seem like a very busy person.


While I've only been on CPAP therapy for a week, I've only noticed that it's made my sleep and daytime symptoms of cognitive impairment, sleepiness, and fatigue even worse. I doubt my doctors and/or insurance will adhere to my request, but should I consider using a BiPap or ASV instead of an APAP?
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#13
RE: I've been using my APAP for a week, symptoms wors V2e.
IMO you'll need to exhaust all options on the AutoSet first. If there were indications of whether you'd be prone to Centrals then that helps determine the direction your therapy needs will go. Some have had success in VAuto with higher trigger settings, and others will find no success on any BPAP. I don't know which of these 2 you'd be.

Those that report higher CA on a diagnostic like myself will likely not find CA treatment other than ASV.
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.
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#14
RE: I've been using my APAP for a week, symptoms wors V2e.
If you didn't have CAs on your diagnostic, then you're probably going to have to give APAP a bit longer to see if your body will adjust to the therapy and the centrals will stop. A week isn't very long, and these are relatively short periods of sleep being recorded, so it's a little hard to say what's happening over the rest of the time that you are asleep. And even if it IS helping, if you're only using APAP for a couple of hours a night, the rest of the night without it might very well just undo any good that the therapy would have provided. The broken sleep alone is going to make you feel like garbage too. Unfortunately, sometimes when you're adjusting to being on APAP, you do start off feeling worse because of having all this new stuff on your face and head, the extra noises, the anxiety etc. But only doing a couple of hours of therapy is unlikely to make a huge difference overall to how you're feeling.
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#15
RE: I've been using my APAP for a week, symptoms wors V2e.
And to add on, if only getting a few hours at a time on the meter, you're going to come across compliance issues with the insurance. If you are going to intentionally fail compliance, they will need a VERY VERY good reason to push you on BPAP and/or ASV. I think like in my case, failing BPAP was more understandable due to a background of high CA. They are going to be less forgiving about CPAP/APAP failure without solid causes.
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.
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#16
RE: I've been using my APAP for a week, symptoms wors V2e.
I'm not intentionally being non-compliant. I don't even remember doing it, but at a certain point I unconsciously take off the mask and end up going back to sleep. As well as that, my results are split between 2 days since my circadian rhythm is completely off and leaves me sleeping between 5-7am Sad  A result of taking naps almost every single day and throwing off my rhythm little by little till I've reached this point. The mask itself is extremely uncomfortable but I still force myself to sleep with it. The only issue is that I can't control my unconscious self :/
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#17
RE: I've been using my APAP for a week, symptoms wors V2e.
OK I understand that. I'd said if you were trying that... Wasn't meant as accusing.

It sounds like there's still some work to be done on your pressure set. A lower min pressure may cause one to rip the mask off seeking air. I took my mask off before too, when pressure set was off, not correct for me.
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.
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#18
RE: I've been using my APAP for a week, symptoms wors V2e.
PS as EPR 3 doubled the CA or somewhere about that, EPR needs to go down to help cut the CA. I'm going back to look at the charts again for other stuff.

How about an exchange of EPR 3 to 2 and raise EPAP... Min pressure up 1 to 8? Maybe your CA would like more of a straight CPAP, so maybe we need to flatten your pressure set around 11-14 or so... Just out loud thinking...
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.
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#19
RE: I've been using my APAP for a week, symptoms wors V2e.
I can upload more images for analysis. Last night I had an EPR of 2 and for at least the first part of the night, it significantly helped reduce the frequency of CA's. 

06/25/2021

[attachment=33205]

[attachment=33206]


A closer look at some CA's:

[attachment=33207]
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#20
RE: I've been using my APAP for a week, symptoms wors V2e.
Yep ok the CA are quite a bit better here. Your pulmonary state must be a bit sensitive to pressure swings IMO. May be a case to flatten pressure, as in lower the spread between low and high. Maybe an 8-12 or something like that.

We've already got rid of Ramp, EPR 3 isn't so good right now.

Ever try taping the mask so you can't rip it off without knowing? Ditto thought on wearing mittens?
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.
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