RE: New to the World of Apnea
Quote:Is there similar type of relationship between the terms Obstructive, Central, RERA, and Hypopnea, or are they each a separate animal?
If apnea is treated by exhaling against pressure to splint the airway, then wouldn't using the EPR feature be compromising the treatment in exchange for comfort?
Does the Resmed machine with the EPR feature actually function in a similar way to a Bipap machine?
No. Central events occur because your nervous system fails to send a signal to breathe. These may be for apnea, hypopneas, or flow limits similar to obstructive events. It is very difficult to distinguish Central hypopneas or Central flow limits on our machines because we do not record eeg brain activity to determine cause.
RERAs are by definition a series of flow limits ending in arrousal
On a simple fixed pressure and adding epr would compromise treatment for comfort so several of us routinely increase pressure to compensate. This is factored in even when we see a need to alter pressure.
When properly configured epr does act like a BiLevel Junior, up to 3 cmw of pressure support and with a max pressure of 20 cmw. One of the reasons we prefer ResMed over other brands.
RE: New to the World of Apnea
I saw my GP last Friday and shared with her some of my first O2 and HR sleep results, and then some of my most recent results after starting treatment with the Resmed Autoset. She was impressed, to say the least. She seemed to have some knowledge of Apnea and was very interested in which machine I had chosen, and why. She commented that she had other Apnea patients who might benefit from this type of therapy. I asked her about a sleep study, and she said that, considering the results I have already achieved, it was unlikely that a sleep study would be of much benefit.
So, here is where I am today; After testing O2 Supp levels for a while, I finally settled on 2 Liters. I also set the Min Pressure on the machine at 7. It appeared by my night time HR levels that I was over medicated with Levothyroxine, so I dropped the dose significantly, and after a week of reduced Levo intake, my night time HR came into a range that I would consider to be normal. I am completely satisfied with my night time O2 Sat levels, and also my HR. The SH charts look good to me, in that the machine appears to be catching problems before they become events. I am still somewhat groggy in the morning, but I feel good throughout the day. My most recent charts are posted below. Is there any fine tuning that might be needed, or should I stick with the settings I am using?
RE: New to the World of Apnea
Your numbers are great, no awesome. You do not require any adjustments there. Any adjustments made should consider how you feel. The only thing I see are 3 episodes of flow limitation. This is totally optional. On a bilevel I would bump my pressure support just to see if they lessen. On your machine, I would increase min by no more than .4. Again optional
Fred
RE: New to the World of Apnea
Fred,
Thank you for the input. The A10 seems to work quite well for my type of apnea, but I am not feeling all that good in the mornings. I seem to be getting progressively worse each day. Today is the worst morning since I started treatment, and I went back and slept for an additional 2 hours, (after getting 8 hrs last night). I will up the min pressure to 7.2 and see what happens. Thanks again.
HP
RE: New to the World of Apnea
Fred,
I raised the min to 7.2 last night, but my chart appears to be considerably worse. Interestingly, I feel much better this morning. AHI jumped from 0.43 to 1.15, as there were more events last night. I will post both charts side by side for your review. Thoughts?
RE: New to the World of Apnea
Your Centrals are inconsistent, that's normal. Watch them but view those number on their own.
Your obstructive difference was abourt .2, that is below normal variation.
With these levels it is not at all about the numbers, it is all about how you feel, even if the numbers go up a bit.
RE: New to the World of Apnea
Greetings!
I have continued to experiment with settings, and I settled at 6.4 as a min pres setting. Last night was my second night in a row with an AHI of 0.0. O2 Sat and Heart Rate have both been good. But, something went wrong last night. At around 04:15 I started an abnormal breathing pattern. My breathing woke my wife up, and she in turn woke me up at 04:19:15. During this period there were no indications of abnormalities, other than my breathing. Please advise. Thanks
