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New Guy, Central Sleep Apnea, wrong machine?
#31
RE: New Guy, Central Sleep Apnea, wrong machine?
Take PS Min to 2.0. Other than that, please post the data, it's important to see where the machine is actually going within those settings.
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#32
Gross 
RE: New Guy, Central Sleep Apnea, wrong machine?
Attached.

Here is last night/today. 
For the first few hours I had the settings:
Min E 6
Max E 15


Min PS 4
Max PS 15

Which is what the respiratory therapist put onto the machine when she delivered it. It's a madhouse here, the doctor doesn't go over anything with you, the respiratory therapist for the office does...they get the sign off form the doc, and send off for the machine, the distribution company gets the machine order and uses their own respiratory therapist to deliver the machine. So i imagine with this huge game of telephone, things can get messed up. The therapist at my house was calling the director of her company and asking about settings, so that was kind of a red flag to me. She wasn't sure what she was doing, and I could hear him on the phone going....eh....just set it at this......ehhhh...just do that...When I asked her what the hell that was about, she just kinda shrugged it off. "These machines are automatic so there really isn't much you need to do other than set the prescription settings"....ok, i totally get that, but that seems to be the important part.  I'm sorry I'm just venting, it just makes me mad how long this process has been. It's Christmas eve!   So they took the VAUTO away and gave me the ASV air curve. As my previous post said, i just struggled and struggled. I felt so foggy and confused, and the machine was literally doing ALL the breathing for me. My chest hurt, (lungs not heart). The pressure is a bit higher than I'm used to, so i'm trying to get used to it. But i was so freaked out, anxiety, groggy, confused, tremors, just crazy. I was researching co2 washout, because i feel like the ASV could potentially put me in like a feedback loop of that, where my body doesn't think it needs the air, so it forces it, and dominoes to me just not doing sh*t but going along for the ride.  I'm a light weight dude. 6'1", 165lbs, So even light to moderate pressure is hard for me to tolerate. I know i'll get used to the machine, but it's just nuts. The first night (night before last) was significantly better for some reason. I felt like garbage yesterday, groggy etc. But my AHI was super low, 3.4. So I figured I just need time to adjust myself to it and get acclimated, I don't know. But I can for sure tell you one thing.... Something isn't right. It's too much of something and something is making me not breathe correctly. After the first 3 hours, i woke up, I started have loads and loads of central with the mask off.  I get the transitional central, where when I'm about to fall asleep, all of a sudden i start fast-forward dreaming crazy dreams for 6-7 seconds, then I wake up because I'm trying to breathe. It's bizarre. I just laid there for about 90 minutes trying to relax, meanwhile researching stuff and getting myself worked up, because nothing is more relaxing than medical hopelessness! And I shouldn't be bitching because just a few weeks ago my ahi was hovering in the 30's, all central. So, 

 After reading the reply above, i changed my settings to 

Min e 5
Max e 15
Min PS 2
Max PS 15    

I definitely didn't feel the insane rush of pressures and constant changes, the machines auto - kick in was significantly less noticeable for some reason. It had been startling me because it was so much and so intense. The whole "it adapts based on your previous breathing patterns" is crap, because that thing pushes air into my lungs like someone kicked me in the back, which scares me awake.  Like I said, the first night was easier, but i was soooo groggy when I woke up, i did have tons of dreams so that's a good sign. Tonight i only had dreams the last few hours, the 10:15-12 ish time. I feel better than I did, for sure, but i still feel kinda sh**ty. I was looking and it looks like I actually had quite a bit of apneas at the very end. It's just weird. 

They told me in sleep study (respiratory therapist) that I had 0 apneas of any kind on the ASV during the study, which can't be right, because i remember it constantly kicking in during my wake-sleep transitions and startling me awake. I guess if it breathes for you and freaks you out, at least you didn't actually have the """apnea""". Either way, I'm not 100% my settings are good but I really don't know. It's Christmas, y'all! I'm hosting this year, so I gotta get my act together! On a serious note, I really appreciate everyone's support and guidance. This has been a horribly isolating journey for me. My wife is unbelievably supportive, but it's difficult to explain pressures etc when I barely understand them myself.  Thank you again,  RG


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#33
RE: New Guy, Central Sleep Apnea, wrong machine?
I have a second image that isn't letting me attach because my allotment is up.
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#34
RE: New Guy, Central Sleep Apnea, wrong machine?
Post it to imgur.
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#35
RE: New Guy, Central Sleep Apnea, wrong machine?
If it was my chart, I'd raise the epap to 7.
For now, the rest of it looks alright to me and see how everything settles down. You know there are some leaks and possibly mouth breathing to fix. later you can look at the minute vent chart, to see how it's going.
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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#36
RE: New Guy, Central Sleep Apnea, wrong machine?
Yea i woke up today with crazy dry mouth, a few times i could tell it was blasting out of my mouth. I typically don't ever have that problem though. I'll upload the second image to imgur and link here. 

https://imgur.com/a/bBVMg


I have to mention also that last night it said i had 0 apneas, but 2.whatever Hypopneas. I've never scored any hypopneas, ever. Just weird. I also know that it's just one of my first nights with the machine. Just hard.
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#37
RE: New Guy, Central Sleep Apnea, wrong machine?
(12-24-2017, 05:30 PM)ajack Wrote: If it was my chart, I'd raise the epap to 7.

Since I was prescribed at a 6, and moved to 5, i'll bump it back up to the 6, now that the pressure support is down to a 2. That definitely helped me sleep, but I had the most apneas after that.  Dont-know
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#38
RE: New Guy, Central Sleep Apnea, wrong machine?
It's early days, I would get a f20 full face mask, because it seems to fit most people. It removes one variable, then later, after you have settled down. Go back and see if a nasal will work as well. If you breathe back hard when the machine raises pressure, as you are going to sleep. It will reset it a bit and ease off.

You can zoom in on the H, if there is a deep breath in front of them, I ignore it and think that it's just waiting for the co2 to catch back up. The labs have the right stuff, to tell what are apnea and what isn't. The machines can get it wrong. You could have epap6-7. I don't think 5 is enough by your chart. I would just use the machine for a few weeks and then see how everything else settles down.

What you cut back on the min PS, you add to the min epap, this will still keep the same initial breathe in pressure. Nothing is set in stone, if you are having apnea recorded. At these low pressures, I would bump up the min epap till it's about 1cm under the epap 95%.
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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#39
RE: New Guy, Central Sleep Apnea, wrong machine?
The biggest issue I seeem to be having is the random blasts at transition being so intense that it fills my Lungs up to the top and literally fills up my stomach. Causing me to immediately burp. And then I’m awake. Right now. Would lowering the maximum pressure support from the 15 it’s currently on down to say like 11 help? Maybe lowering the maximum Epap to that as well? I want to make sure I understand. But that’s my problem. When I was on the Autobipap I was on 4 and 8 and had no problems.
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#40
RE: New Guy, Central Sleep Apnea, wrong machine?
(12-24-2017, 08:10 PM)ajack Wrote: At these low pressures, I would bump up the min epap till it's about 1cm under the epap 95%.

So I should bump up the min epap to be close to the maximum epap? 
^ doesn’t having them close together make it more like a cpap and causes more central events?

Also I’m confused about what you take away from pressure support you add to the epap. I don’t understand. I’m sorry.
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