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New bipap- help!
#1
New bipap- help!
Here's the quick rundown:

I used a Respironics System One for the last 6 or 7 years now to pretty good results, my AHI results usually around 2.5 - 3.5. Probably could've been tweaked better, but I generally felt pretty good with it.

That machine was getting real old so I did some research and bought a Dreamstation DSX700T11. I figured I could input my old settings and carry on with my life- nope! From the start I've been having a much higher AHI and I need some help figuring out why.

NOTE: I don't have as much data as I should right now, I was hoping to have info from the last few nights of (poor) sleep but I forgot to put the SD card back in it to collect the data. Shoot! But I haven't changed the settings since the last time I imported to Sleepyhead so I'm hoping (HOPING) it's good enough data to start working from.

I don't have enough posts on the forum to post direct images so here's a little gallery: https://imgur.com/a/n6EDYjg

Any help would be greatly appreciated.

Julia
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#2
RE: New bipap- help!
It seems that your increased pressure support is causing CA’s I would try reducing the max pressure support to 3 not is current value of 8
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#3
RE: New bipap- help!
What were the settings on your last machine? Your best AHI was with an EPAP min of 8.0, and until you lowered it, your median was 9.7. I think you need to move EPAP min back to 8.0. Your most recent pressure support range was 2.0 to 8.0 which was considerably worse for central apnea, and again your best results were with a range of 2-3. I think it would be good to get back to the pressure 8-14 PS 2-3 and we can try to optimize from there.
Sleeprider
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#4
RE: New bipap- help!
Ok! That makes sense. I’ve set it back to those numbers and see where I stand tomorrow.

Thank you!
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#5
RE: New bipap- help!
Alrighty! I changed the PS min/max back to 2 and 3 the past couple nights. It definitely helped some, knocked my AHI down a few points! So thank you!

I’m still not getting as good a sleep I’d like though. Any thoughts on my new results?

http://www.Imgur.com/a/YpUOnkm

Unfortunately the forum isn’t letting me post a link to the gallery yet so I had to break up the url. Sorry for the inconvenience!
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#6
RE: New bipap- help!
OceanChild,
I fixed your link for you.

Next time you post your data, follow the links in my signature line below.  
The first link shows you how to organize the SH screenshot.
Then use the attachment feature to post your data here.
OpalRose
Apnea Board Administrator
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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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#7
RE: New bipap- help!
I'm starting to see a more classic complex apnea syndrome in your results. While a bilevel with backup rate may be in your future (ASV), I think you're going to have to stick it out a bit longer if you want insurance and your doctors to pick up the tab. Meanwhile, I'm seeing a lot of obstructive activity in addition to the centrals. It would help if you included the statistical data in the left margin so we can quantify that and your pressures. I don't want to increase pressure support as that might make some of the CA worse, but I think you should try adding 0.5 cm to EPAP min. If we can get your airway more stabilized for obstructive physiology, the rest might quiet down as well. At this point, we will move pretty slowly in adding pressure here and there to make this happen.

Quote:https://i.imgur.com/K0YKHgc.jpg
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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#8
RE: New bipap- help!
Thank you Opal Rose, I’ll take care to follow your guide in the future.

Sleeprider - Really? Oh jeez. I certainly hope not but feel like it kinda makes sense. Despite my using various machines the last 5 years I’ve always still been fatigued during the day. 

Oops, didn’t realize that would be needed as well. I’ll include it moving forward and try raising the EPAP min tonight.

Thanks for all your help, you’re an absolute life-saver.
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#9
RE: New bipap- help!
(08-16-2018, 06:09 PM)OceanChild Wrote: Sleeprider - Really? Oh jeez. I certainly hope not but feel like it kinda makes sense. Despite my using various machines the last 5 years I’ve always still been fatigued during the day. 

Oops, didn’t realize that would be needed as well. I’ll include it moving forward and try raising the EPAP min tonight.

Thanks for all your help, you’re an absolute life-saver.

I'm not really that sure.  The event rate is down and the remaining events are mixed centrals, a single cluster of OA, some flow limits and RERA. I think taking more time and a closer look is in order.  I do notice the CA events seem less prevalent at 2 cm PS, so something to keep an eye on.
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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#10
RE: New bipap- help!
The one thing that stands out to me is the Insp. Time of 3.24 vs the Exp. Time of 1.50. I only bring this up as I had the same issue and once I went to the VPAP, those values reversed and I had a much better time breathing comfortably, hence better sleep.
Sleeprider, is this something he should be concerned about or is the pressure low enough at a EPAP of 8 that it is not a concern.
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