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Newbe with Complex Apnea - Best ASV to get?
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racprops Offline

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Machine: Respironics DS960HS
Mask Type: Full face mask
Mask Make & Model: Respironics FitLife FFM
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CPAP Pressure: ????
CPAP Software: SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Phoenix AZ

Post: #121
RE: Newbe with Complex Apnea - Best ASV to get?
OK For the first time I seem to making some progress:

I have tied my CAs to my EPAP setting.

By lowering my EPAP MIN to 6.5 I have been able to go from 33.37 to 6.90, and twice, first time for about 2 hours in bed and the second was 3 hours in my recliner.

This also checks with a couple of days ago when I set the EPAP Min to 7cm which I only had 10.25 CA events.

The other days with 8 to 10cm for my EPAP has given me: 10cm=30.45, 8cm=32.3, 8cm=33.37 CAs

My AHI Has run: 10cm=36.61, 7cm=23.83, 8cm=48.08, 8cm=46.19 and 6.5=20.88

It will be interesting to see what my Doctor says today when he reads these reports.

Rich
(This post was last modified: 04-25-2013 05:52 AM by racprops.)
04-25-2013 05:51 AM
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Sleepster Offline
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Posts: 4,988
Joined: Feb 2012

Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #122
RE: Newbe with Complex Apnea - Best ASV to get?
Rich, if you go back and read this thread you'll see one piece of important advice that's been given repeatedly. Set the machine back on the settings that it had when you got it. If you have questions about these settings being the correct ones for you, call your providers and ask those questions.

Data-capable machines are wonderful but you have to leave them with consistent settings for a period of at least a week or two before you can get any data that's meaningful enough to interpret.

Sleeping in your recliner may help your apnea but it's no substitute for a CPAP machine. You can do both if you like.

Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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.
04-25-2013 07:13 AM
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racprops Offline

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Posts: 260
Joined: Mar 2013

Machine: Respironics DS960HS
Mask Type: Full face mask
Mask Make & Model: Respironics FitLife FFM
Humidifier: Respironics
CPAP Pressure: ????
CPAP Software: SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Phoenix AZ

Post: #123
RE: Newbe with Complex Apnea - Best ASV to get?
So your saying I should allow my body to have 30+ Central apneas per night (or is that per hour??) and NOT take action to make things better and lower not only how many CAs I have but also how long they run??

Also I should allow my AHIs to read in the serious side when I can lower them to only bad??

PS I was taking about using my machine and sleeping in my recliner...

At this point it seemed to make no difference.

Rich
04-25-2013 10:50 AM
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Sleepster Offline
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Posts: 4,988
Joined: Feb 2012

Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #124
RE: Newbe with Complex Apnea - Best ASV to get?
(04-25-2013 10:50 AM)racprops Wrote:  So your saying I should allow my body to have 30+ Central apneas per night (or is that per hour??) and NOT take action to make things better and lower not only how many CAs I have but also how long they run??

Also I should allow my AHIs to read in the serious side when I can lower them to only bad??

Not at all. I think it'd be better if you discussed any changes you make with your doctor before you make them.

Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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.
04-25-2013 09:39 PM
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vsheline Offline

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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: #125
RE: Newbe with Complex Apnea - Best ASV to get?
(04-24-2013 10:40 AM)racprops Wrote:  So tonight I will return to my recliner and see.

Has anyone found they do better in a near chair like sleep position?

My heart surgery caused my sleeping in my recliner, it is a side effect from this surgery, and while I waited for my sleep studies we SEEMED to see less apneas when I sleep in a more upright position.

Hi Rich,

Yes, it is well known that obstructive apneas happen less often when our head is elevated, as in a recliner, compared to in a bed flat on our back. I suggest sleeping in the recliner until your therapy is more successful.

Here were the original settings you reported your machine had when you received it:
Min EPAP: 10.0
Max EPAP: 15.0
Min Pressure Support: 0.0
Max Pressure Support: 15.0
Max Pressure: 25.0
Flex Setting: 2
Backup Rate: Auto

You said you changed the pressure to 9/15.
I suppose the 9 was the EPAPmin. What was the 15? EPAPmax, or what? IPAPmax?

I hope you did not set the IPAPmax to 15. If you did, your machine will not be able to adequately treat your central apneas. In any case, I recommend putting the IPAPmax back to 25, the doctor's original prescription. (The machine will never go there unless it needs to, to prevent central apneas.)

From the SleepyHead data you posted, it looks like your machine is not adjusting the Pressure Support high enough to treat your centrals. You can see from the bottom two plots, "Mask Pressure" and "Pressure" that around 3:00 your EPAP adjusted itself to around 13 (to treat OAs). At this time you are having many CAs (this is shown in the Event Flags time plot) but the PS (which is the difference between lower and upper pressures) is small, just a few cmH2O. To treat the CAs the PS would sometimes need to go nearly to 10 cmH2O, but for some reason it doesn't. (Maybe this is somehow related to the small PSmin you are using, since you reported earlier that the machine reponded to your breathing more strongly when the PSmin was set to 2.)

In the statistics section it says your PSmin was 13, PSmedian was 39, PS95% was 68, and PSmax was 90. This is obviously impossible and looks like a SleepyHead bug. None of the other statistics look unreasonable or obviously impossible.

Keep an eye on your minimum respiratory rate (8 breaths per minute). That is a little low. Probably should be closer to 10 or 12.

Does SleepyHead allow you to zoom in on the time plots to see more detail?

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: 04-26-2013 06:41 AM by vsheline.)
04-26-2013 06:31 AM
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SuperSleeper Offline

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Machine: PR System One REMstar Auto (DS560)
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CPAP Software: SleepyHead

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Post: #126
RE: Newbe with Complex Apnea - Best ASV to get?
How did it go at the doctor's office, Rich?

SuperSleeper
Apnea Board Administrator
www.ApneaBoard.com


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.

04-26-2013 08:00 AM
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racprops Offline

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Posts: 260
Joined: Mar 2013

Machine: Respironics DS960HS
Mask Type: Full face mask
Mask Make & Model: Respironics FitLife FFM
Humidifier: Respironics
CPAP Pressure: ????
CPAP Software: SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Phoenix AZ

Post: #127
RE: Newbe with Complex Apnea - Best ASV to get?
Current settings are:

Min EPAP: 6.5
Max EPAP: 15.0
Min Pressure Support: 0.0
Max Pressure Support: 10.0
Max Pressure: 18.0
Flex Setting: 2
Backup Rate: Auto

As I was unable to have a good talk with my Doc:

In fact at one point he said if I was not going to do as he tells me to do I can find another Doctor…

When he saw I was not falling apart and crying "forgive me please" he then tried to convince me he was right and I loved this one."You cannot come in here with one night's results and say you settings are better… "

Funny as he prescribed from one nights study and from one 18 minute run at the pressures he prescribed, where I had 6 + hours of data. And I had 6 days of data clearly showing a lower EPAP pressure caused a lower CA events.

As well as all the other events. AND my CA were of much short duration to boot. As were the others.

We left things at: I am to not change anything for 60 days and see him then....???

Well that was for only two nights, things fell apart last night:

AHIApnea / Hypopnea Index 53.54
HypopneaHypopnea 10.01
ObstructiveObstructive Apnea 3.88
Clear AirwayClear Airway Apnea 39.64
RERAResp. Effort Related Arousal 0.00
Flow LimitFlow Limitation 0.00
VSnoreVibratory Snore 14.51
PB/CSRPeriodic Breathing 10.10%

So unless you see something really wrong or bad for me I plan on leaving the settings alone for at lease a week.

Rich
04-26-2013 01:26 PM
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racprops Offline

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Posts: 260
Joined: Mar 2013

Machine: Respironics DS960HS
Mask Type: Full face mask
Mask Make & Model: Respironics FitLife FFM
Humidifier: Respironics
CPAP Pressure: ????
CPAP Software: SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Phoenix AZ

Post: #128
RE: Newbe with Complex Apnea - Best ASV to get?
I am hoping for some feed back...
04-26-2013 06:40 PM
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Sleepster Offline
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Moderators

Posts: 4,988
Joined: Feb 2012

Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #129
RE: Newbe with Complex Apnea - Best ASV to get?
I'm not convinced that anything you did had any effect on your AHI. The AHI changes when you do nothing, especially if you're new to CPAP therapy. The only way to determine if a setting has an effect is to keep the machine on that setting for at least a week or two.

Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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.
04-26-2013 07:06 PM
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racprops Offline

Preferred Members-2

Posts: 260
Joined: Mar 2013

Machine: Respironics DS960HS
Mask Type: Full face mask
Mask Make & Model: Respironics FitLife FFM
Humidifier: Respironics
CPAP Pressure: ????
CPAP Software: SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Phoenix AZ

Post: #130
RE: Newbe with Complex Apnea - Best ASV to get?
I am learning that and will do so.

Rich
04-26-2013 07:13 PM
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