No relief after 1 year of CPAP

[Sleeprider]

Take a look at Supplier #2. They ship internationally and provide pertty good prices for current equipment that is new "open box" or "gently used". Either one is going to give you a great machine at a better price than most sources in the UK with a warranty. We can find lower prices here in the U.S. but a gently used Aircurve 10 Vauto with humidifier and climateline tubing is $799 and they currently have 12 units available. I figure you could add $100 USD for shipping and have it in your hands pretty quickly. Don't think about it too long, or these deals tend to go away. Look or ask for Product ID # 37211

[SarcasticDave94]

Touching a bit on COPD: I had been diagnosed with COPD for well over 2 years. As best as I understand it, I'm between levels 1 and 2 out of 4, where 4 is the most severe. I have some symptoms of COPD, but not all of them. I sometimes have a cough, not much though, chronic breathing difficulty that varies by day, time of day, and by weather variables, more humidity, and temperatures under 60 and above 80 are bad for me. I had 3 pulmonary function tests on the spirometer, results are "mild restrictions" with no oxygen percentage lower than 93% recorded. I do take 2 maintenance powered inhalers daily and one rescue inhaler that is for "as needed". I used to smoke at least a pack of cigarettes daily until I quit in 1994; started smoking at 10 and quit at 25. If truck exhaust fumes count, I dealt with that for 11 years.

Regardless of the above, I get the best rest possible with my ASV. My setup must play well with my COPD. I think the ST is supposedly better in some to most cases involving apnea and COPD, but as almost everyone on Apnea Board would be aware, I may be a case, but I'm nowhere near becoming your average Joe. Extreme of some sort all the way...

PS I am not suggesting the OP needs ST or any other anything...

[PoolQ]

My current issue with COPD is flying. I went camping at 8,500 feet and could not walk 500 feet without gasping for air.
Airplane cabins are pressurized to 8,000 feet. At that level I drop to 88% going to have to have O2 on the plane. Might keep this in mind for others. They can test for altitude so at least you know before you go.

[bpn1]

Take a look at [....]. They ship internationally and provide pertty good prices for current equipment that is new "open box" or "gently used".  Either one is going to give you a great machine at a better price than most sources in the UK with a warranty.  We can find lower prices here in the U.S. but a gently used Aircurve 10 Vauto with humidifier and climateline tubing is $799 and they currently have 12 units available.  I figure you could add $100 USD for shipping and have it in your hands pretty quickly.  Don't think about it too long, or these deals tend to go away.  Look or ask for Product ID # 37211

Thanks for the information. I think ASV is only for cases with complex apnea, yes?

I found that a lot of my breathing during sleep is similar to the attached image. Any thoughts on this? Last night was a really good example of how AHI (only 0.33!) seems to be completely divorced from my quality of sleep. The more I read the old threads the more paralyzed I become from the complexity of this stuff.

[SarcasticDave94]

Yes ASV is for complex apnea.

[Sleep2Snore]

Hi bpn1,

My average sleep is 6.5hrs according to my machine, I used to need more sleep, but with the machine I get better sleep than I used to.
I see by your first data posts that the machine pressure has a max flat line, I think you should let it have a bit more freedom to give you a little more pressure if you need it.  CPOD is something I have no experience of.

[Sleeprider]

Take a look at [....]. They ship internationally and provide pertty good prices for current equipment that is new "open box" or "gently used".  Either one is going to give you a great machine at a better price than most sources in the UK with a warranty.  We can find lower prices here in the U.S. but a gently used Aircurve 10 Vauto with humidifier and climateline tubing is $799 and they currently have 12 units available.  I figure you could add $100 USD for shipping and have it in your hands pretty quickly.  Don't think about it too long, or these deals tend to go away.  Look or ask for Product ID # 37211

Thanks for the information. I think ASV is only for cases with complex apnea, yes?

I found that a lot of my breathing during sleep is similar to the attached image. Any thoughts on this? Last night was a really good example of how AHI (only 0.33!) seems to be completely divorced from my quality of sleep. The more I read the old threads the more paralyzed I become from the complexity of this stuff.

My suggestion was based on the cost of the Aircurve 10 Vauto at Supplier #2 at 799 USD.  I never mentioned ASV for you.  The Vauto is an ideal bilevel machine for COPD and resolving the issues you have discussed here, with the ability to provide bilevel pressure and to modify trigger and cycle sensitivity and inspiratory time. The reason I suggested bilevel for you is that you have chronic inspiratory flow limitation. In the image you posted, look at the flat tops of the inspiratory wave. That is a restriction or resistance to freely fill the lungs with air, so inhale starts normally, but the flow rate stalls somewhere around 25-30 mL/sec. With bilevel pressure, you would have a pressure support assist to help your respiratory muscles fill your lungs easier and faster with the same effort. Your AHI is fine, but you don't feel rested, and this is why. BTW, flow limitation is not flagged in your case because this is your normal. Flow limits are only flagged when they increase from the baseline.

Edit to add: On your flow rate graph, you would get better definition if you right-click near the title on the left over Flow Rate, and format the Y-axis. Override the auto and use a minimum of -80 and maximum of 80 (mL/sec). This will make the wave-form taller and easier to interpret.

[bpn1]

A little update: I've ordered a cervical collar and I also sent an email to Supplier #2 about the Aircurve 10 VAuto. Hoped they would reply sometime today but guess it will have to wait until Monday now. Also tried to call them (internationally ) but no one was picking up. If anyone here can share their experience with Supplier #2 then I'd appreciate it, it's a large chunk of cash to drop.

Sleeprider I took your advice on the flow rate graph, things are indeed clearer now thanks.

Hi bpn1,

My average sleep is 6.5hrs according to my machine, I used to need more sleep, but with the machine I get better sleep than I used to.
I see by your first data posts that the machine pressure has a max flat line, I think you should let it have a bit more freedom to give you a little more pressure if you need it.  CPOD is something I have no experience of.

Unfortunately my machine is just a plain CPAP with C-Flex, no APAP functionality. If you see the pressure changing then that is just the ramping feature.

[PoolQ]

I have heard many people refer to them and never heard anything bad, ever. THe AirCurve 10 is a BiLevel machine and not an APAP. It will do the APAP function, but much more. When I was getting my first machine I thought why not go for the top with an ASV, just in case. ASV is not "top ot the line" it is a machine for very specific breathing issues. There are indeed "low end machines". pretty sure that AirCurve will do everything you need and you'll get lots of help here.

[ardenum]

When I started taking Zyrtec each night I stopped waking up during the night, weird but true, as far as allergies go.

Also you need an EEG during the sleep to really tell you if your sleep is good or not.

For peeing in the night try asking your doctor to give you Desmopressin, its relatively safe for a few nights and youll see if it helps.