Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

In Need of Noobie Education
#11
RE: In Need of Noobie Education
Hi TheOutlier,
WELCOME! to the forum.!
Good luck to you with CPAP therapy and getting it fine-tuned to meet your needs.
trish6hundred
Post Reply Post Reply



Donate to Apnea Board  
#12
RE: In Need of Noobie Education
Thanks, personal111! I didn't realize the 50F had the ability to set the time - good to know!!  The 50D+ doesn't have a time set feature that I know of.  It does seem to share the feature that anytime you record, it wipes and overwrites the existing data.  Since I plan on using it nightly, I will need to download daily.

I will have to see about USB.  I thought you mentioned you're running Windows in a VM.  That means that USB has to talk to the hardware on your computer AND the hardware emulators within your VM.  You might be having issues with support at the VM layer.  Are you running Fusion or Virtual Box?

Now I don't want to work but go play with my new toys instead!!  Big Grin
Post Reply Post Reply
#13
RE: In Need of Noobie Education
Thank you, triash6hundred!! I'm looking forward to learning so much here!! I'm amazed at the collective knowledge we have here!!
Post Reply Post Reply
#14
RE: In Need of Noobie Education
impressive that your tolerating that air pressure with just nasal pillows.  with the severity of your sleep apnea I'd think you'd require a full face mask.  I anticipate you requiring higher pressures still to fix your apnea.  

The statement about ASV from the sleep lab is just ridiculous.  I'd keep pressuring you DME company and DR. about the ASV.  There are many advantages to the ASV over bipap s/t and titrating someone in ASV is so much easier than in bipap s/t.  My guess is your sleep tech doesn't do many asv titrations. 

good luck with your bipap, your apnea is quite impressive but i've seen worse.    Smile
Post Reply Post Reply



Donate to Apnea Board  
#15
RE: In Need of Noobie Education
(06-02-2017, 11:42 AM)TheOutlier Wrote: The fact that I'm getting under 5 suggests it's possible to the current machine may meet my needs.  That's why I wanted to tweak it a bit and play with variables within my control.  I can see the value of an ASV if warranted as well.

Hopefully, I can attach my screenshot - it shows my AHI from MyAir since I started treatment.

I certainly will spend time in the titration guide!!  Thanks!!

That 5 may be a fluke looking at the different nights, When you get sleepyhead working, if they are  OA and obstructive H, I'd persevere with the ST, if they are central, I'd be fighting/asking for an ASV, given you have a good heart. AFAIK I think ST and ASV are on the same insurance code, so the insurance won't care.
(It seems, the cheyne stoke breathing pattern is actually protective to a CHF patient and why ASV doesn't work for left ventricular HF.)
I found these videos very informative on ASV from this symposium 
https://www.youtube.com/watch?v=Nr08K5IfzzY&t=2401s
https://www.youtube.com/watch?v=AuKeCUNlxdQ
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
Post Reply Post Reply
#16
RE: In Need of Noobie Education
Question for you on this Sleeprider:
When you say if you have centrals, "raise PS" do you mean lower the number so you have higher EPAP?
In other words if my PS is at 5 and I am trying to stop more of the CA I would change to 4 correct?

Sounds simple but wording ...

Just wanted to check to make sure I understand correctly.
Post Reply Post Reply
#17
RE: In Need of Noobie Education
Theoutlier off Topic:
I use Windows 10 in a VM on Parallels.
Where I work is all Mac and I got sick of having to maintain multiple systems at home and work as they invariably
get intermixed when the work machines go down etc.
Basically two desktops, two laptops, two phones, an iPad etc running on 3 different OS's
I ended up converting everything to Apple simply to make my life easier, not because I hate Windows or love Mac.
They both have their pros and cons.
One thing Apple has figured out is that an ecosystem of these things makes life a little easier.
I used to love messing with all of that when I was younger but now I do whatever I can to make it easy.
I have a full time job plus I am an adjunct instructor at a local technical college where today's youths drive me half insane
so just don't have time for any of that anymore.
I did have just a couple programs that run on Windows only that I run on VM.
The adapters for USB-C are really shaky right now. 
Be careful buying hubs or cables, for now I would go with ones from major names, the cheap ones don't seem
to be uniform at all and mostly don't work right or intermittently.
Any of the USB-C stuff I have bought that is from a major manufacturer has worked right all the time.
If you are a Mac fan I can say I do like the new MBP as I travel so lighter and thinner is always good.
Just be prepared for the adapter issue.
Is it worth the money? We'll see. The last MBP lasted me about 7 years and still works fine, but I wanted something new and could use it as a tax write off :-)

On topic:
If you need to be able to record constantly with multiple day files, I don't think there is a simple one that is available for a reasonable cost.
They have more hours they can record, a lot have 30, but still only save one record at a time.
If someone makes one that can work with Sleepyhead, Mac and be between 100 and 200 bucks I would love to have one.
This is the only one I know of that has multiple recordings but don't know if it can work with anything but it's own software:
Commercial Link Removed.  Instead search Amazon for Oximeter, MTS Auto

It's made by an outfit Medical Test Supply.
Has anyone been able to make this one work with Sleepyhead?





-----
Moderator Action: Link Removed

To maintain our status as an educational organization, the only commercial links allowed in this forum are to CPAP-related manufacturer websites.  This is stated in the Apnea Board Rules with details given in the Commercial Links Policy section.

-----
Post Reply Post Reply



Donate to Apnea Board  
#18
RE: In Need of Noobie Education
(06-02-2017, 08:25 AM)Sleeprider Wrote: Outlier, you clearly have mixed apnea with both central and obstructive events. I will be very very surprised if you control that without a different technology called ASV (adaptive servo ventilator).  Your doctors know that you have mixed apnea, and apparently started you on a ST (spontaneous/timed) bilevel that can provide timed backup to help you breath during centrals.  The ST is relatively primitive compared to ASV.  What you need to know, is that will likely fail ST before you get promoted to ASV.  Once that happens, you will be a much happier camper.

The ASV works using an auto-adjusting EPAP pressure to address obstructive apnea. It then uses a variable pressure support (PS) from 0-15 cm to create an IPAP that is comfortable during normal spontaneous breathing, and that can induce a breath during a central event or increase volume during hypopnea or periodic breathing.  There are two ASV machines in common use; the Resmed Aircurve 10 ASV and Philips BiPAP Auto SV Advanced.  Of those two, I would have a strong preference for the Resmed due to its more comfortable algorithm (PaceWave) to maintain a respiratory rate and volume based measurements of your own respiration rate from the previous 30 minutes.  So the rate changes naturally and is personalized, rather than timed.  The ST provides fixed pressure and can never auto-adjust the EPAP to prevent obstruction with changing sleep position and needs, and it provides fixed pressure support, so it nearly useless for central hypopnea, and is a comparable "kludge" compared to ASV in resolving central apnea.  Your profile shows "Airsense 10 ST", that is probably an Aircurve 10 ST. The only catch on whether you will be approved for ASV is, you must not have congestive heart failure with a left ventricular ejection fraction less than 40%.  You will need to be screened, using an echocardiogram to be approved for ASV.

In order to optimize your current ST therapy, I recommend reading Resmed's Titration Protocol.  The basic principles are that if you are seeing obstructive events, raise EPAP; if you have centrals raise PS, and of course you will need to fine-tune the backup rate (timing) for machine induced breaths. This link to a PDF file will explain much of this to you, but focus on page 37 for the ST titration https://www.resmed.com/us/dam/documents/...lo_eng.pdf

Don't hesitate to let your doctor know the ST is not working.  He is probably expecting that and will move the process forward once it is determined you fail with ST, assuming you can be approved for ASV.

(06-03-2017, 01:19 PM)personal111 Wrote: Question for you on this Sleeprider:
When you say if you have centrals, "raise PS" do you mean lower the number so you have higher EPAP?
In other words if my PS is at 5 and I am trying to stop more of the CA I would change to 4 correct?

Sounds simple but wording ...

Just wanted to check to make sure I understand correctly.

I guess I said that. Oh-jeez The ST machines are far from ideal to treat CA.  What I would really like to do is have you on an ASV with a minimum PS of zero because pressure support usually increases CA.  However when you don't have ASV, and are using a ST machine, the only way CA is treated is through the fixed PS and backup timing of the ST machine.  That is far from ideal!

Use higher EPAP for OA.  If you need more pressure support along with a timed breath to overcome CA, then that is what you have to do.  But go kick your doc in the butt and get the ASV!
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Optimizing Therapy
Organize your OSCAR Charts
How To Attach Images And Files to your posts
How To Deal With Equipment Supplier
Mask Primer
Beginner's Guide to Sleepyhead

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.
Post Reply Post Reply
#19
RE: In Need of Noobie Education
Folks, I apologize for going dark - my job is just crazy. However, a lot has changed in the intervening weeks. Sleeprider - THANK YOU for suggesting that my doctor was expecting the bipap to fail. When I did a follow up call, I complained A LOT that my therapy was failing. It got me a new sleep study titrated using an ASV. I've had my new ASV for a couple of weeks now and my AHI is generally less than 5 with my lowest ever at 0.5!!! I was prescribed oxygen and have a concentrator now as well. While my apnea events are under control, my oxygen evens are not. I spend anywhere from a few seconds to 20 minutes or so under 88% sat. I'm titrating it up tonfint the sweet spot.

While I did the sleep study with a full face mask, I have not successfully adopted it at home. This would be because the ASV typically kicks in (often while I'm awake) the moment I breathe in. It then thinks it's inflating a hot air balloon and simply is not happy unless it does that in a fraction of a nano second! It nearly blows the mask off my face!! Do I have a good seal, you ask?!! Yes, I wake up with a slight headache and sore cheek bones because it's cranked down so tight. But that does not stop my trust sleep aid from trying to separate the mask from my face!! Needless to say, I can't sleep when that happens!! So I'm still on pillows. The effect is nicer when the machine tries to inflate my lungs and entire being!

Other than the mask issues, adjusting to the ASV hasn't been an issue and I'm FINALLY experiencing HEALING SLEEP!! Enough that I'm thinking of starting my kung fu training back up.

The other thing I wasnted to share is that I somewhat randomly tried an elimination diet. The idea was to get rid of all daily foods for a period of time. I chose a juice fast and when I started to break my fast, I thought it'd be OK to eat a pear. So I did. Turns out, I have a high sensitivity to pears!! I spent the next day sneezing my head off and my nose was so raw from blowing, it hurt to touch it. So I find out that people with pear allergies often share a birch pollen allergy. The protein structures in many foods look like birch pollen to the body. Long story short, I found a book that explains using heart rate to detect food sensitivities. This allowed me to eliminate virtually all foods I'm sensitive to. The 'so what' is that when I did, even on bipap, all my AHI numbers were under 5. You can argue that the effortless 20lb weight loss is affecting it (but you'd be wrong because I gained that 20 lbs after my first sleep study while waiting for treatment). You may be able to argue that I eat earlier in the evening and that's affecting it. That may be - I haven't tested time of day eating enough to know. But I did want to share with everyone that I saw a clear demarc in my AHI stats that coincided with the elimination of foods that I am sensitive to.

Thank you again for everyone's warm welcome and sharing of experiences and suggestions!!
Post Reply Post Reply
#20
RE: In Need of Noobie Education
Do you want to just use the o2, or do you want to try and get the machine to help get your o2 levels better, too? It's probably is going to be a bit of both. Epap and PS adjustment can help too.

cleaning up food allergies can only help.
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
Post Reply Post Reply



Donate to Apnea Board  


Possibly Related Threads...
Thread Author Replies Views Last Post
  Noobie has Ramp Start and Stop Question tsolanto 4 649 09-10-2017, 06:07 PM
Last Post: bonjour
  Need humidifier education Rcgop 6 901 12-25-2016, 09:50 PM
Last Post: Crimson Nape
  Noobie - Trying to get himself set Headly 11 1,696 11-11-2015, 04:22 AM
Last Post: Headly
  Noobie with comment and question Snowbird47 12 1,725 10-07-2015, 09:16 PM
Last Post: zonk
  Support and Education for cpap Patients can Improve Compliance zonk 4 3,063 03-13-2012, 12:00 AM
Last Post: SuperSleeper
  Sleep and Health Education Program zonk 1 2,327 02-25-2012, 04:35 AM
Last Post: zonk


New Posts   Today's Posts






About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.