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New Data Please Help /Advise
#1
New Data Please Help /Advise
I have 2 screenshots that I would appreciate any advice to what is going on.  I recently received a new airsense 10 for her.  This event has never showed up until recently.  I am using apap for almost 2 years and very rarely wake up refreshed.  My last sleep study showed an RDI of 17.9 with mostly RERA's (101 in total)
Really need help as these 2 days don't look good.   Thanks.

https://i.imgur.com/EZNjZkh.png

https://i.imgur.com/QsCh5Qv.png
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#2
RE: New Data Please Help /Advise
There were 2 threads just yesterday on Cheyne-Stokes sleep waves (that green highlight area) with relevant charts. Both threads will likely be helpful to you. You can search the forum for Cheyne-Stokes, or just look at yesterday's threads.

I'm sure someone will be along soon to address the rest of your issues.
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#3
RE: New Data Please Help /Advise
With respect to the Cheyne-Stokes indication, do you have any symptoms of swelling in the lower extremities which is suggestive of CHF (systemic fluid backup)or heart arrhythmias? Do you show Cheyne-Stokes frequently? Or are these infrequent indications?

Is there any reason you were prescribed the "for her" model which features an additional algorithm designed for women? Are you sure that your mode setting is correct for the therapy your physician intended?

Have you discussed your overall feelings with your sleep doctor as he may wish to try different settings to deal with your central apneas or another device (bi-pap) altogether?

Other than visual observation, your physician can see signs of CHF with an echocardiogram or a simple, inexpensive BNP blood test. (B-type natriuretic peptide)
"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius
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#4
RE: New Data Please Help /Advise
I would google periodic breathing and it can be a normal sleep rhythm. When you google CS it is going to scare you. As said, CS is associated with heart failure. You and your doctor would know if you had heart failure, it's not something you can miss.
I think if you raise your min to 10, it will clear up some of the OA and H. The CA You may find turning the EPR down to one or off can help, but there are only a few and I would have the epr where it was comfortable. Because it is contained in a cluster, it may also be a positional apnea. It can also be REM sleep, or o2/co2 re-balancing
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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#5
RE: New Data Please Help /Advise
Besides osa in good general health.  No heart issues at all.  Sleepyhead just started recording csr recently and have seen it just on two days data.  
My last sleep study showed a high number of rera events, so my doctor said why don't we try the for her mode.  
Anyone else use this rationale?
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#6
RE: New Data Please Help /Advise
First of all, the charts above don't resemble Cheyne-Stokes respiration in any way. That is some periodic breathing, and I have also had some brief experiences with it.  It is transient, and will go away.  The Autoset For Her algorithm differs from Autoset standard, mainly in the way it responds to flow limitation.  The image below summarizes this difference, and you can read about it on the Resmed site:  https://www.resmed.com/us/en/consumer/pr...r-her.html  

In short, it responds faster to the initial flow limitation by increasing pressure, but it does not increase pressure to subsequent flow limitations as quickly as the standard Autoset algorithm, nor does it increase pressure for flow limits above 12 cm.  Whether this is a better solution for you is just something you'll have to try and judge for yourself.  You definitely have some flow limitation indicated in your charts and summary statistics, so the faster pressure response to early FL may be a good thing.

[Image: AutoSet-for-Her_chart.png]
Sleeprider
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#7
RE: New Data Please Help /Advise
The thing that confuses me is that I have a great deal of flow limitations and unsure why the algorithm doesn't take care of these.  
Would the standard algorithm respond better to reduce these?
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#8
RE: New Data Please Help /Advise
Another question is my tidal volume too high?  What should it be and what does a high reading mean?  
I am 6 feet and 185 pounds.  
Thanks all.
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#9
RE: New Data Please Help /Advise
Your Tidal Volume is normal.
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#10
RE: New Data Please Help /Advise
Personally, I would use the standard algorithm. I have observe several members with severe flow limitations on the forum, including females, and the For Her algorithm quits too soon. In addition, in your case, the flow limits are leading into OA and the pressure is not increasing as needed to prevent that.
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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