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New BiPAP ST user Vet with complex apnea
RE: New BiPAP ST user Vet with complex apnea
I've been tracking my sleep patterns with my ticwatch. This will help me justify my lack of good sleep.  I am taking notes. My percentage of sleep efficiency has been 85% over the last 12 days even though I realize my watch isn't the most accurate method.  

So far,  

The initial setup with BiPap 15/10 didn't help at all and was difficult to get used to. I didn't get much sleep and they said it wasn't helping with my Obstructives. I didn't notice feeling any better. The machine would stop randomly during my inhale and either wake me up or surprise me. 

They changed the settings to 16/12 and it was harder to breath "normally" so it kept me awake more and I didn't feel any better.  The machine didn't stop during inhalation anymore. 

At both the BiPap settings I noticed that the machine did not coincide with my actual attempted breaths all the time. If there was a pause by me, the machine didn't not always notice the pause and it continued to breath when I wasn't. 

I've now been on CPAP 10 has been easier to breath "normally" (by that I mean it doesn't keep me awake) but I don't feel any different. 

Overall, I'm not any better as far as I can tell and I can't tell any difference in my quality of life so far. 

That's all I can recall right now. 

I did tell them I'd downloaded a "program" that broke my information down into several catagories but didn't tell them the name of the program.
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RE: New BiPAP ST user Vet with complex apnea
   


Rough night sleeping.  Tossed and turned a lot.
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RE: New BiPAP ST user Vet with complex apnea
Events are steadily coming back. I don't think Dr. Ducks plan B is working so good. Keep in touch with them about how you feel and lack of efficacy, be sure to keep the subject of ASV front and center.
Sleeprider
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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.
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RE: New BiPAP ST user Vet with complex apnea
(03-17-2020, 08:18 AM)Sleeprider Wrote: Events are steadily coming back.  I don't think Dr. Ducks plan B is working so good.  Keep in touch with them about how you feel and lack of efficacy, be sure to keep the subject of ASV front and center.

I wrote them back and told them that my obstructive's didn't seem to be getting any better.  I also told the I  downloaded "an app" that showed lots of other information.  We'll see what they say about that.  The next time I write then I'll start mentioning ASV as an alternative.  


I must say,  with my machine set on CPAP and at 10 it sure doesn't seem like there's much pressure.  When it starts up I can feel pressure but it subsides down to the 10 rating and by morning I can barely feel the pressure.  Occasionally I wake up and wonder if the machine is even on.  

I've also run into my airtouch F20 mask rubbing a raw spot on my nose.  

My soft collar should be here today so we'll see what that does.  Even if it doesn't help, it didn't cost that much.
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RE: New BiPAP ST user Vet with complex apnea
IMO best not to beat around the bush or they may beat you with their ignorance

state your research indicates medical necessity of ASV and they need to see it quick or you fire them, assuming that you have the option, myself I stated it and got PCP referral to do so when duck 1 saw need for ASV magically, I was ready to jump and let them know it
Dave

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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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RE: New BiPAP ST user Vet with complex apnea
Your machine feels like there is no pressure by morning as your body gets used to it, lift the corner of the mask and the rushing air will prove its still working Big Grin
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RE: New BiPAP ST user Vet with complex apnea
   


Here is my chart from last night.  Unfortunately, I forgot to put my SD card in. I put it in this morning and data was transferred, but apparently, it doesn't transfer all data to the SD card, such as the Flow Rate. 

I tried a soft cervical collar last night as suggested.

Around 2:15 in the morning I had a coughing fit and had to take the mask and collar off.  I left the collar off the remainder of the night because my airtouch F20 mask bumps up against it at the mask's lower straps. I can't tell by looking at OSCAR if the first two and a half hours were any different wearing the collar or not.  

Here is my state at this time. The VA technicians/nurse are telling me that they still feel using CPAP at 10 with 20 H2O is improving my total AHI. They tell me it went from 13 down to 9 so it's an improvement. They're telling me, 

"The clear airway that the PAP mentions can be tricky in reading and we take other factors into play when looking at any of the info the PAP gives us. In this case, your periodic breathing shows to have increased some since moving to 10 cmH20 but the actual view of your breathing pattern is much improved which is important."

I'm continuing to learn what OSCAR is saying with much help from Sleeprider.  I may reach out to a VA Advocate and ask some questions in the near future, but I do not have another avenue (read a civilian doctor) to pursue my apnea issues because of my insurance. 

I have asked about another type full face mask to try as my airtouch F20 has rubbed a spot on the bridge of my nose raw. (ALTHOUGH I have loosened it due to the CPAP 10 constant low pressure and it seems slightly better, but still a tad too tight.)  

That's my current state.  I appreciate the assistance and recommendations everyone has given so far, especially Sleeprider.
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RE: New BiPAP ST user Vet with complex apnea
Don't forget the RERA is also important. Your RDI remains near 15-16 per hour. Doesn't look like great sleep from this side of the planet.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
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RE: New BiPAP ST user Vet with complex apnea
   


Last nights chart. 

Had one coughing fit and had to take mask off for a few minutes.  

Did not wear collar (forgot). 

Question:  Are the RERA's a combination of the Hypopnea,Obstructive and Clear Airway numbers on the left side of Oscar?
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RE: New BiPAP ST user Vet with complex apnea
Respiratory Effort Related Arousals (RERA) are flagged when a period of increasing flow limitation ends abruptly with larger volume breathing. This is interpreted as an arousal in sleep stage or awakening in response to the increased effort of respiration and lower volume of air exchanged. They are very similar to hypopnea, but fall shot of the criteria of a greater than 50% decrease in respiratory volume. It is disruptive to sleep and a part of sleep disordered breathing. The Respiratory Disturbance Index (RDI) is the sum of AHI plus RERA, so consider RERA additive to AHI for the extent of sleep disturbance.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
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