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New Dreamstation Auto Bipap - lost on support settings
#1
New Dreamstation Auto Bipap - lost on support settings
Hello,

I am trying to help my wife.  First diagnosed 20 years ago.  Same settings and same machine for 20 years, set at 12.  

Last year she was hospitalized three times with very high co2 levels, which then shut her kidneys down.  They always fix the co2 levels with bipap.  They only asked what her cpap was set at and they set it and forgot it.  I had no knowledge about bipap.

She has a sleep study this week, but no follow up for another 5 weeks. We know here co2 levels are rising.  They would never discharge her at these levels, but they seem unconcerned.

When we mentioned bipap to the doctor, his eyes glazed over, like it was the dumbest thing we could have said, until we mentioned an auto device. He comes off as being the king who is the only one who knows all there is to know about this, and we cant do a thing about anything until he reviews the sleep study. Auto machines seem to minimize their self importance in all this, and it threatens them.

Trying to save her life, we jumped through the hoops the get a brand new Dreamstation auto bipap. We've used it three nights and the 95% pressures have been widely different all three night. That proves to me that one setting forever is totally worthless.

I can't make any sense out of the minimum and maximum support settings. I'm trying to tweak it, but I made it worse last night.  I know for a fact that she breathes shallow almost all of the time.  My concern with the cpap setting of 12 is that she couldn't exhale fully against that pressure. Her max epap values are anywhere from 7 - 14, so i guess that disproves that theory.

I am kind of desperate to get the exhalation pressure and the support pressures right on this one.  If we can't help her get rid of the co2 better, another hospitalization will soon be inevitable.

Thanks in advance
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#2
RE: New Dreamstation Auto Bipap - lost on support settings
Hi Russ702!  -  Welcome

In order to help we need to see a sample of her sleep data.  To do this, you will need to download a free copy of OSCAR (link is in the name).  If you don't already have one, you will also need an SD card 2 GB to 32 GB in size.  These cards are readily available from most big box stores, local pharmacies, and online.   The lower the price the better.  Another item you might need is an SD card reader to attach to your computer.   Some computers have this built-in but if not, you can pick up one that uses the USB as a connection for less than $15 USD.  You will need to have the card in the CPAP while she is sleeping to record the high resolution data.  The next day insert it in your SD card reader connected to your computer and running OSCAR.   For additional help on how to post an image here, please review the links in my signature for more detailed information.  

Good luck!
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
___________________________________
Useful Links -or- When All Else Fails:
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Beginner's Guide to Sleepyhead and OSCAR
Apnea Helpful Tips

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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#3
RE: New Dreamstation Auto Bipap - lost on support settings
Welcome to Apnea Board,

I'd suggest a few things then we're better equipped to assist. Download OSCAR the free report tool that works with PAP therapy. You'll also need an SD card between 2-32GB, any brand, and can be found at Walmart, Staples, etc. Shop least expensive. This card needs dedicated to a single PAP machine. You'll need this to show us where going on during PAP therapy.

Request your copy of sleep study and titration reports, full details reacted. Also get a copy of the script. HIPAA allows you to get these, so don't accept you don't need them. Request and get. You need these for your personal health file. Post them here too.

And mention other health conditions and medications. These can impact PAP therapy and sleeping in general. Carbon dioxide build up is mentioned, but anything else? What was the Apnea diagnosis? List settings your using on this PAP.

We will help but need details to give best answers.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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#4
RE: New Dreamstation Auto Bipap - lost on support settings
We can and will help if you will supply the OSCAR data. For a person that fails to expire CO2 adequately, pressure support, (the difference between inhale pressure and exhale pressure) is very important. Posting the Oscar data will allow us to see her settings, and look at why the problem is occurring. The problem with many sleep specialists is...well they are incompetent, and can't do anything but read a technician's count of the obstructive apneas. We can get you on track to find someone that will work with your wife's health and you can fire the quack.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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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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#5
RE: New Dreamstation Auto Bipap - lost on support settings
Little late for Christmas songs but "Quack Docs Roasting On An Open Fire" seems to bring out the goosebumps doesn't it?
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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#6
RE: New Dreamstation Auto Bipap - lost on support settings
I can't figure out how to post the charts.  Are we supposed to use full size image?

Thanks
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#7
RE: New Dreamstation Auto Bipap - lost on support settings
While in OSCAR's Daily screen, press the F12 key to take the screenshot.  Upload the file using the controls at the bottom of the full editor.
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
___________________________________
Useful Links -or- When All Else Fails:
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Beginner's Guide to Sleepyhead and OSCAR
Apnea Helpful Tips

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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#8
RE: New Dreamstation Auto Bipap - lost on support settings
Follow this tutorial:

http://www.apneaboard.com/wiki/index.php...ganization
OpalRose
Apnea Board Administrator
www.ApneaBoard.com

OSCAR Chart Organization


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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#9
RE: New Dreamstation Auto Bipap - lost on support settings
                 

Here are the charts.  Hope I got this right.

She has congestive heart failure, COPD, anemic iron deficiency (being corrected), and bouts of acute kidney failure, which happen at the same time she is hospitalized for the high co2 (88)
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#10
RE: New Dreamstation Auto Bipap - lost on support settings
OK we have OSCAR. Good job. A few things cross my mind and others better than I may say otherwise, in which case I defer.

As it is now, this Respironics isn't doing a good job. 4 as starting pressure seems low to me, and maybe is one source of poor therapy results.

I think the big thing is however that with COPD and CHF there's maybe a need of something with backup rate, ST-A or an NIV; I'm leaning this way as my own COPD needs AVAPS, timing controls as well.

And part of the issue is probably that Respironics units are slow to respond, so there's that handicap too.

Possible but some of this may be positional as well, but I am not certain.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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