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New Dreamstation Auto Bipap - lost on support settings
#11
RE: New Dreamstation Auto Bipap - lost on support settings
           

Got it this time
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#12
RE: New Dreamstation Auto Bipap - lost on support settings
I have your solution. I will link two wiki articles below to positional obstructive apnea and using a soft cervical collar to resolve it. These obstructive apnea occur in clusters because your wife is tucking her chin. This is amazingly easy to solve and fix. When you read these articles, not how similar the other member's graphs are to your wife's. Heavy clusters of obstructive apnea that do not respond to pressure. The solution is to prevent chin-tucking which obstructs the airway with a soft cervical collar that supports the jaw and chin, without impinging on the neck or throat. A proper fit and support are important, and may take trial and error to find. The Positional Apnea article suggests an easy test to see if this is the problem, and convince your wife to move forward to the Soft cervical collar. This is just classic!

Positional Apnea: http://www.apneaboard.com/wiki/index.php...onal_Apnea
Soft Cervical Collar: http://www.apneaboard.com/wiki/index.php...cal_Collar

Please raise the EPAP min pressure to 7.0 and everything else can stay the same. She can use a soft pillow or towel tonight between her shoulder and jaw, and it will make a difference. A very effective sleep position is on her side with a towel or soft pillow pulled around the neck onto the shoulder to support her jaw...at least until she moves. Read the reviews linked in the soft cervical collar wiki and make a choice based on her measurements.
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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#13
RE: New Dreamstation Auto Bipap - lost on support settings
Thanks, that will be a tough one. When first diagnosed, she was ordered to sleep on her back. She has complied with that perfectly. I am shopping now.
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#14
RE: New Dreamstation Auto Bipap - lost on support settings
The collar will work. At least make sure she is using a single pillow of minimal thickness. It is chin-tucking that is causing this problem. I can't imagine any competent doctor prescribing sleeping supine as part of a solution for obstructive sleep apnea. That's a new on on me, and there is a strong possibility the doctor is dangerously wrong or misunderstood, and meant to say avoid the supine position. If you have a copy of the sleep study we could tell you. Most studies document apnea by sleep position.

https://pubmed.ncbi.nlm.nih.gov/26116298/
https://www.atsjournals.org/doi/full/10....180.1.101a
https://en.wikipedia.org/wiki/Supine_position
https ://pubmed.ncbi.nlm.nih.gov/9400908/
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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#15
RE: New Dreamstation Auto Bipap - lost on support settings
I have a question about Oscar.  Every time I put the data card back in the machine it changes settings. Not sure where to edit that if possible
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#16
RE: New Dreamstation Auto Bipap - lost on support settings
Yes, the card has a prescription written on it. Save the data, but format the card.
Sleeprider
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____________________________________________
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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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#17
RE: New Dreamstation Auto Bipap - lost on support settings
This is why we want to see the data. Very, very few doctors recognize this form of positional apnea, only the same very few would consider a soft cervical collar. When the right collar is used this problem will essentially disappear overnight. excellent advice above.
Gideon - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter

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#18
RE: New Dreamstation Auto Bipap - lost on support settings
   

Here is last night's results.  First thing we tried was a much flatter pillow

Here are my concerns:

IPAP can't even possibly be right.  We knew for a fact she was having trouble exhaling against 10cm on CPAP, there's no way she can exhale against the pressures last night.  Her respiration rate is double what it ever was in the hospital. We need to increase flow in an out.  Her volumes are dropping every night we've done this.

She says the BIPAP in the hospital felt like it was forcing her to take deeper breaths, and she could strongly feel the EPAP pressure release. None of that ever with the settings I have.

Thanks to those who weigh in on this
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#19
RE: New Dreamstation Auto Bipap - lost on support settings
You lost your pressure support when you changed settings.  You want 7.0 EPAP min and PS 4.0. You have single pressure CPAP setup right now.  Please set to:
Mode Auto BiPAP
EPAP min 7.0
Max IPAP 20.0
Pressure support (PS min) 4.0
Pressure support (PS max) 5.0

Here is the recommended titration protocol for your wife's machine. Note my recommendations are exactly in-line with this protocol. BTW, the lower pillow helped, but her pressure will stay low and the events will significantly drop with a soft collar.

[Image: attachment.php?aid=9716]
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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#20
RE: New Dreamstation Auto Bipap - lost on support settings
Thanks, I will change from yesterday's recommendation.  I have zero understanding about the pressure support.  I'm just going to have to pick something and leave it alone until after the sleep study, or she is again hospitalized for the co2.

We are working on getting a collar.  I am also incapable of understanding why the EPAP settings were so ridiculously high.

She also turns the machine on and keeps saying it doesn't feel right. It seems it doesn't do anything at all until she goes to sleep, which stresses us both because of her sensation from the hospital of it actually helping her breathe.  She could hardly tolerate it at first so she was awake a lot of the time and well aware of this feeling. That feeling was what cleared the co2, and that is what she needs. I'm beginning to think it's impossible with home units, and we'll just repeat the cycle every 7 or 8 weeks.

Thanks again
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