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Need help adjusting pressure
#11
RE: Need help adjusting pressure
We almost all go up and down each nite. That is the nature of sleep apnea. Its never consistant. The important thing is how you feel.
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#12
RE: Need help adjusting pressure
(01-13-2018, 09:07 AM)Sleeprider Wrote: Sleep Therapy, your events are nearly all central or hypopnea.  I'm certain we can find some more comfortable settings using some pressure support (higher inhale pressure, lower exhale pressure), but first I'd like to know more about your diagnostic and any titration study.  Do you have copies of your sleep reports?  Were central apnea a prominent feature?

If we can setup your Aircurve 10 Vauto it's going to be much more comfortable and easy to breathe, but if you actually have central or complex apnea, then you are possibly on the wrong therapy device.

Yes I do but the sleep report showed no centrals but just hypopneas. Though these were done in home but with 12 channels apparently. Here is one I did last night where the IPAP was at 14 and the minimum EPAP at 4.0.  I am a bit concerned that I now all of a sudden am having central episodes. Although, it's mild, it's still 10 too many. Though, the machine helped a lot. I had this on for about 5 hours, but slept so much better than the stupid cpap setting. VPAP seems far more gentle. 

https://imgur.com/a/tGLB4

There are a few people saying that this vauto is not meant for centrals but you are suppose to get ASV. Is this correct?
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#13
RE: Need help adjusting pressure
(01-13-2018, 01:49 AM)ajack Wrote: I'd get back to your respiratorist and get the machine set up for you. You're aussie and get access to decent health care, including free at a public hospital. Is it a months trial or what is the story for swapping over.

On it already but my sleep has been thrown off. I could have had this condition due to multiple head injuries I sustained a while back.
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#14
RE: Need help adjusting pressure
That's probably even more reason to go back to the doctor. If you haven't got private cover, get referral to outpatients, your next sleep test will be in a lab if you need it and there can be a wait, so it's best you are seeing a sleep doctor there. You only get one home study a year, but as many lab ones as needed.

That's a big improvement on the other chart. No one will worry about under 2 ca an hour. The odds are they are pressure induced and will settle withing 12 weeks. especially when you didn't have CA in the study.

I would set the pressures up different than you have, I would move the min epap up higher, 1cm at a time towards the Med/median epap, or just 7 and adjust as it goes. As long as it stays below the 95% epap. The max 14 is fine for now.
The PS can be left at 0.0 Your breath rate per minute and tidal volume etc, has improved from your first chart. I'd be happy enough for now.
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
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#15
RE: Need help adjusting pressure
I wouldn't worry about those central episodes, there is so few.  Also, the amount of time appears to be around 20-25 seconds, that is better than 40-50 seconds at a time.  It takes time for the body to adjust to CPAP with the extra air flow washing out the carbon dioxide, the brain will need to reset the baroreceptors.  I'm not expert, but it doesn't look like you need to push for an ASV machine at this stage in the treatment.
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#16
RE: Need help adjusting pressure
(01-19-2018, 08:11 AM)ajack Wrote: That's probably even more reason to go back to the doctor. If you haven't got private cover, get referral to outpatients, your next sleep test will be in a lab if you need it and there can be a wait, so it's best you are seeing a sleep doctor there. You only get one home study a year, but as many lab ones as needed.

That's a big improvement on the other chart. No one will worry about under 2 ca an hour. The odds are they are pressure induced and will settle withing 12 weeks. especially when you didn't have CA in the study.

I would set the pressures up different than you have, I would move the min epap up higher, 1cm at a time towards the Med/median epap, or just 7 and adjust as it goes. As long as it stays below the 95% epap. The max 14 is fine for now.
The PS can be left at 0.0 Your breath rate per minute and tidal volume etc, has improved from your first chart. I'd be happy enough for now.

The thing I noticed was that the APAP setting for the S9 was different than the S10. It was much harder to exhale the S10 than the S9. With the EPR off, I felt like I was suffocating. The S9 seems way more comfortable whereas the S10 just blows air straight in your face. Has anyone noticed this? The sleep labs have s9s as their cpap devices but you can't buy them anymore because these people want to make more money off you.
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#17
RE: Need help adjusting pressure
They really know how to rip into you with prices in AU. It is better to import from the US amazon, even including the exchange rate, reshipper and postage.

Just my opinion. ..If it's a rental, give it back till you decide what you want to do, you aren't using the functions of the Vauto and it will be a waste of money. It may have been a short term hiccup from the injuries. You may be able to get the s9 working for you again. your CA numbers are fine. Vauto is the wrong machine for a brain injury anyway. Your oa/h apnea is treated with very low pressure.
If you have bought the vauto, you can set it up better than it is down the road, there is no rush for now. When is the next appointment with the respiratorist and neuro?
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
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#18
RE: Need help adjusting pressure
(01-20-2018, 06:24 AM)ajack Wrote: They really know how to rip into you with prices in AU. It is better to import from the US amazon, even including the exchange rate, reshipper and postage.

Just my opinion. ..If it's a rental, give it back till you decide what you want to do, you aren't using the functions of the Vauto and it will be a waste of money. It may have been a short term hiccup from the injuries. You may be able to get the s9 working for you again. your CA numbers are fine. Vauto is the wrong machine for a brain injury anyway. Your oa/h apnea is treated with very low pressure.
If you have bought the vauto, you can set it up better than it is down the road, there is no rush for now. When is the next appointment with the respiratorist and neuro?

The S9 is discontinued product because the a**wipes at Resmed want to make more money from you. The S10 sucks. It's way too powerful.
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#19
RE: Need help adjusting pressure
If you haven't bought the s10 Vauto, you have options. Including going back to your old s9 autoset CPAP (your last chart stats look good and wouldn't indicate a need to use BPAP and should be talked over with your doctor. You are running it like an autoset CPAP without epr)
If you have bought it, then you need to make it work. It can be adjusted to feel like the s9 autoset.

If you are moving from a cpap to a bpap, you will notice a difference. The Vauto will shape your breath with trigger, rise time and Ti. In the rise time setting, the default may be 150-200 and be too fast. try 300, which is about cpap or standard time it takes from starting a breath to when the machine has reached it's pressure. use a PS:2, that should feel like EPR2. You can change these settings while you are awake and feel the difference. The next setting would be trigger adjustment, when the machine will start the inhalation if the machine feels like it's doing it by itself, ahead of you without waiting for you to start to breathe. Or you feel like you have to suck to get it to raise pressure.
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
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#20
RE: Need help adjusting pressure
(01-20-2018, 04:10 PM)ajack Wrote: If you haven't bought the s10 Vauto, you have options. Including going back to your old s9 autoset CPAP (your last chart stats look good and wouldn't indicate a need to use BPAP and should be talked over with your doctor. You are running it like an autoset CPAP without epr)
If you have bought it, then you need to make it work. It can be adjusted to feel like the s9 autoset.

If you are moving from a cpap to a bpap, you will notice a difference. The Vauto will shape your breath with trigger, rise time and Ti. In the rise time setting, the default may be 150-200 and be too fast. try 300, which is about cpap or standard time it takes from starting a breath to when the machine has reached it's pressure. use a PS:2, that should feel like EPR2. You can change these settings while you are awake and feel the difference. The next setting would be trigger adjustment, when the machine will start the inhalation if the machine feels like it's doing it by itself, ahead of you without waiting for you to start to breathe. Or you feel like you have to suck to get it to raise pressure.

All these machines seem to have different algorthm set for them. For example, the CPAP on the Vauto feels different to the CPAP on the elite. The CPAP on S10 auto feels different to the S9 auto. I already bought the vauto from the states but I can always resell it which is what I am going to do. Know any place where I can buy the s9 auto from? Also how do I change the rising time for vauto?
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