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New bipap machine troubles
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robotman Offline

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Posts: 38
Joined: Jul 2015

Machine: ResMed AirCurve10 ASV
Mask Type: Full face mask
Mask Make & Model: AirFit F10
Humidifier: Integrated
CPAP Pressure: unsure
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Canada

Post: #1
New bipap machine troubles
Hey gang,

Months ago I posted here about the problems I was having with my loaner cpap machine. You guys told me to try to get a bipap one, and I listened. It took me until 3 days ago, with visits to a sleep clinic and specialist, but I finally am trialing one and have one ordered, the ResMed AirCurve10 Vauto.

But I just checked the sdcard in SleepyHead, and I'm really disappointed. I'm getting 30 AHI every night, mostly central apneas. I spoke with the respiratory therapist yesterday (before I looked at the results) and he said it looked good!

The sleep clinic bipap test said "The most satisfactory pressure was IPAP 12.0 cm of H20 EPAP 5.0 cm H20, which resulted in an apnea-hypopnea index of 6.0 events/hour and a total arousal index of 2.0 events/hour." So why isn't it working? The doctor gave me a sleeping pill (zopiclone, a hypnotic) to take when I went to the sleep clinic; I was literally almost falling over when I walked in; do you think this could have affected the test results?

The nurse at the sleep clinic also said that maybe my raspy-can't-hardly-talk throat problem was caused by using the nose pads type of mask, and suggested using a full face mask. This has been uncomfortable, with constant leaks around the eyes and chin, no matter how much I try to fix it. I end up breathing mostly through my nose anyway (even though it's hard sometimes) because when I breathe through my mouth it actually hurts my brain in a couple of spots, which scares me a lot.

Frankly, I'm about ready to give up. Even though I have felt way more rested the past few days. I also think I might have made a mistake by getting this respiratory therapist to purchase the machine through my insurance; maybe I should have done that through someone else - doesn't that basically mean I'm committed to using him now?

I don't know what to do. I'm getting very frustrated.

Here's the data .zip.
04-16-2016 10:46 AM
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pupcamper Online

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Posts: 398
Joined: Nov 2015

Machine: PR DreamStation CPAP Pro
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10 Pillows; Quatro Air FFM
Humidifier: DreamStation Heated Humidifier
CPAP Pressure: 10.5 cmH2O; no ramp; no C-Flex
CPAP Software: SleepyHead EncorePro

Other Comments: Lung cancer survivor since 11/2004; CPAP since 11/2015

Sex: Male
Location: Van Buren, Arkansas, USA.

Post: #2
RE: New bipap machine troubles
Hello, robotman.

Sorry to hear about the problems you are having. Maybe making two changes at once was a bit much. For me personally, I think that before I gave up I would go back to my old mask until I got used to the new machine.

"....respiration,—a troublesome practice, but one which custom has rendered necessary to our easy existence...." Oliver Twist, Charles Dickens- 1837

I use FlashPAP to load data from a FlashAir III wifi sd card in my machine to my computer and display it with SleepyHead .
robysue's Beginner's Guide to SleepyHead
04-16-2016 11:24 AM
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JSL747 Offline

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Posts: 22
Joined: Feb 2016

Machine: ResMed S9 VPAP Auto
Mask Type: Nasal pillows
Mask Make & Model: Swift FX
Humidifier: ResMed S9 H5i
CPAP Pressure: 17/12 PS1
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Female
Location: Oregon

Post: #3
RE: New bipap machine troubles
I hear your flustration but hang in there. It just takes time to get everything worked out. I had the same problem as you when I switched to a bi-level. In my case it was too much PS. Everyone has their own issues.....you will get the help you need on this board....
(This post was last modified: 04-16-2016 12:23 PM by JSL747.)
04-16-2016 12:22 PM
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eseedhouse Offline

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Posts: 878
Joined: Dec 2014

Machine: ResMed Airsense 10 Autoset
Mask Type: Full face mask
Mask Make & Model: SimPlus
Humidifier: ResMed
CPAP Pressure: 7-10
CPAP Software: SleepyHead

Other Comments: Also on supplemental O2 at 3L/min. while sleeping.

Sex: Male
Location: Victoria, British Columbia

Post: #4
RE: New bipap machine troubles
(04-16-2016 10:46 AM)robotman Wrote:  Frankly, I'm about ready to give up.

I don't know what to do. I'm getting very frustrated.

I sympathize with that feeling, having felt it so many times myself.

It took me a long time to learn not to act on them, but that's what you have to do.

I think someone once said something about the main difference between a person who is very good at something and another who is world class can be boiled down to one thing: persistence.

I was a serious tournament chess player who reached official Expert level in Canada and the main difference between me and those just below me was that they tended to give up earlier. Good players never give up.

Better players than me (and there are hundreds of thousands of them) can still play chess badly, but they recognize their mistakes and put up maximum resistance. Making a bad move or having a bad position discourages the mediocre player and they stop trying. The great masters react to a mistake on their part by hunkering down and playing better and they often convert bad positions, or even lost ones, into wins.

Ed Seedhouse
VA7SDH

I am neither a Doctor, nor any other kind of medical professional.

Actually you know, it is what it isn't.
04-16-2016 06:35 PM
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justMongo Offline

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Posts: 3,839
Joined: Sep 2013

Machine: ResMed VPAP Auto (S9)
Mask Type: Full face mask
Mask Make & Model: ResMed Mirage Quattro
Humidifier: ResMed H5i
CPAP Pressure: 18 IPAPmax - 11 EPAPmin, PS=5
CPAP Software: Other Software

Other Comments: μολὼν λαβέ

Sex: Male
Location: Калифорния

Post: #5
RE: New bipap machine troubles
(04-16-2016 06:35 PM)eseedhouse Wrote:  It took me a long time to learn not to act on them, but that's what you have to do.

I think someone once said something about the main difference between a person who is very good at something and another who is world class can be boiled down to one thing: persistence.

I was a serious tournament chess player who reached official Expert level in Canada and the main difference between me and those just below me was that they tended to give up earlier. Good players never give up.

Better players than me (and there are hundreds of thousands of them) can still play chess badly, but they recognize their mistakes and put up maximum resistance. Making a bad move or having a bad position discourages the mediocre player and they stop trying. The great masters react to a mistake on their part by hunkering down and playing better and they often convert bad positions, or even lost ones, into wins.

Ed: I commend you. That is perhaps some of the best advice I have heard. And, it is applicable not only to CPAP -- also as a philosophy of life. Distilled to a few words: "... never give up."

Kindest Regards,

Mongo

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.
04-16-2016 06:53 PM
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PoolQ Offline

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Posts: 986
Joined: Jul 2015

Machine: AirCurve 10 VAUTO
Mask Type: Full face mask
Mask Make & Model: Amara View
Humidifier: Integrated
CPAP Pressure: 6.2, 15, PS4.0
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Sillicon Valley

Post: #6
RE: New bipap machine troubles
So lets take a look at this. 30 centrals a night, assuming (and this is a big assumption) 8 hours of use that gives an AHI of 3.75. if all this scopes out, that is not bad. You need to deal with two things regarding PAP therapy: first is the actual therapy and getting your numbers in place and 2. getting all the "comfort" settings adjusted so that you will tolerate the therapy. Give us all your numbers: hours slept/used, obstructive index, central index, hypopnea index. What's your pressure support setting, humidity, temperature? Besides just plain crappy, what do you feel like when using your VPAP? Congested? suffocated? can't get enough air? exhaling into a storm? like someone is putting their hand over your face right before you are done inhaling?

Many, many things to talk about and adjust to try and work things out.
04-16-2016 07:14 PM
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robotman Offline

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Posts: 38
Joined: Jul 2015

Machine: ResMed AirCurve10 ASV
Mask Type: Full face mask
Mask Make & Model: AirFit F10
Humidifier: Integrated
CPAP Pressure: unsure
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Canada

Post: #7
RE: New bipap machine troubles
Thanks for the comments, I appreciate them.

PoolQ that's 30 AHI an hour, isn't it? There were 300 events last night. I posted the full .zip with all the data in the first post.

The main things are that I breathing through my mouth hurts my brain, and the machine doesn't seem to be doing the job that it was when I was doped up in the sleep clinic.
(This post was last modified: 04-16-2016 08:09 PM by robotman.)
04-16-2016 08:02 PM
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eseedhouse Offline

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Posts: 878
Joined: Dec 2014

Machine: ResMed Airsense 10 Autoset
Mask Type: Full face mask
Mask Make & Model: SimPlus
Humidifier: ResMed
CPAP Pressure: 7-10
CPAP Software: SleepyHead

Other Comments: Also on supplemental O2 at 3L/min. while sleeping.

Sex: Male
Location: Victoria, British Columbia

Post: #8
RE: New bipap machine troubles
(04-16-2016 06:53 PM)justMongo Wrote:  Ed: I commend you. That is perhaps some of the best advice I have heard. And, it is applicable not only to CPAP -- also as a philosophy of life. Distilled to a few words: "... never give up."

Well, first I will say that I'm not always so good at taking my own adviceDont-know.

Second, there is a time to give up. Everyone has limits, and when we reach them and can't go further we will give up, like it or not. Of course, many of us underestimate where our limits lie, and we can only find out by trying to exceed them.

Referring back to chess, the time to resign is when the chance that you might be able to avoid loss is so slight that you would be better spending your time resting up for the next round than continuing to play.

Among good players that is generally when you are down a minor piece (knight or bishop) without any compensation for it.

I once watched a pretty strong player fail to win an endgame that I had thought everyone above beginner class knew. It was King and Queen versus King and a pawn about to Queen, with it's K nearby to support it's advance, and the side with the Queen with the move.

There is a simple process for winning these endgames unless the pawns are on the edge of the board or two squares from the edge. And a pretty strong tournament player failed to prevent the pawn from queening and so the game was drawn. So the side that was lost salvaged a half point by hanging in there.

Ed Seedhouse
VA7SDH

I am neither a Doctor, nor any other kind of medical professional.

Actually you know, it is what it isn't.
04-16-2016 08:31 PM
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palerider Offline

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Posts: 440
Joined: Nov 2014

Machine: s9 vpap auto
Mask Type: Nasal pillows
Mask Make & Model: p10
Humidifier: none
CPAP Pressure: 18/13+
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Dallas(ish)

Post: #9
RE: New bipap machine troubles
(04-16-2016 08:02 PM)robotman Wrote:  I posted the full .zip with all the data in the first post.

Unfortunately, what you posted was unusable.

what you need to do is zip up the *entire* contents of the SD card, and upload that.
04-16-2016 08:35 PM
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vsheline Offline

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Posts: 1,907
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #10
RE: New bipap machine troubles
(04-16-2016 10:46 AM)robotman Wrote:  Hey gang,

Months ago I posted here about the problems I was having with my loaner cpap machine. You guys told me to try to get a bipap one, and I listened. It took me until 3 days ago, with visits to a sleep clinic and specialist, but I finally am trialing one and have one ordered, the ResMed AirCurve10 Vauto.

But I just checked the sdcard in SleepyHead, and I'm really disappointed. I'm getting 30 AHI every night, mostly central apneas. I spoke with the respiratory therapist yesterday (before I looked at the results) and he said it looked good!

The sleep clinic bipap test said "The most satisfactory pressure was IPAP 12.0 cm of H20 EPAP 5.0 cm H20, which resulted in an apnea-hypopnea index of 6.0 events/hour and a total arousal index of 2.0 events/hour." So why isn't it working? The doctor gave me a sleeping pill (zopiclone, a hypnotic) to take when I went to the sleep clinic; I was literally almost falling over when I walked in; do you think this could have affected the test results?

The nurse at the sleep clinic also said that maybe my raspy-can't-hardly-talk throat problem was caused by using the nose pads type of mask, and suggested using a full face mask. This has been uncomfortable, with constant leaks around the eyes and chin, no matter how much I try to fix it. I end up breathing mostly through my nose anyway (even though it's hard sometimes) because when I breathe through my mouth it actually hurts my brain in a couple of spots, which scares me a lot.

Frankly, I'm about ready to give up. Even though I have felt way more rested the past few days. I also think I might have made a mistake by getting this respiratory therapist to purchase the machine through my insurance; maybe I should have done that through someone else - doesn't that basically mean I'm committed to using him now?

I don't know what to do. I'm getting very frustrated.

Here's the data .zip.

Hi robotman,

Until you are able to get a special type of bilevel machine called an Adaptive Servo Ventilator (ASV) bilevel, such as recommended by Sleeprider months ago in your early thread, your machine will not be able to prevent central apneas.

The AirCurve Auto is an excellent bilevel machine for optimal treatment of obstructive sleep apnea when not complicated by central apneas.

Standard bilevel therapy modes like S bilevel mode and Auto bilevel mode (which are what the AirCurve Auto can provide) usually increase the number of central apnea events, unless the pressure difference between EPAP and IPAP is small and/or the pressures are low, in which case treatment using a standard AutoSet would pretty much be the same as using the AirCurve Auto.

I suggest talking to your equipment provider about cancelling the order for the AirCurve Auto (it is unable to treat your central apneas) and asking your doctor to prescribe an ASV titration so you can get an ASV machine, which is very obviously what you will need. Or perhaps he would be able to prescribe an ASV machine without a special ASV titration, I don't know.

Meanwhile, either continue using the AirCurve Auto or use your AirSense AutoSet if you still have it.

If using the AutoSet, I suggest turning down EPR to 2 for a week or two and then 1 for a week or two and then Off for a week or two, and then deciding what EPR setting works best for you.

If using the AirCurve Auto, you will need to reduce Pressure Support (if you're using Auto therapy mode) or increase EPAP while keeping IPAP unchanged (if using S therapy mode). You may also need to lower IPAP or the max pressure.

If you set the AirCurve Auto to equivalent settings as the AutoSet it should provide equivalent treatment. For example, if the AutoSet had settings of AutoSet mode, Min Pressure 8, Max Pressure 12, EPR 2, then the equivalent settings for the AirCurve Auto would be Auto mode, Min EPAP = Min Pressure minus EPR = 8 - 2 = 6; Max Pressure = 12; PS = EPR = 2.

If in fixed-pressure CPAP mode, raising EPAP or reducing EPR tends to reduce obstructive events, and lowering IPAP or lowering PS tends to reduce central events.

And I encourage you to continue making sure you are never rolling onto your back in your sleep. Congratulations on that. Keeping off our back usually strongly reduces our pressure needs, such that we may be able to avoid most or all obstructive apneas without needing to use high pressures.

Central apneas, especially if short like less than 20 seconds, are usually far less stressful on the heart than obstructive apneas.

Good luck in continuing to avoid another stroke.

Take care,
--- Vaughn

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 04-16-2016 09:57 PM by vsheline.)
04-16-2016 08:41 PM
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