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One month in - how can I do better?
#1
One month in - how can I do better?
Hello all, I really appreciate this forum. I am about one month in and have finally settled in to a mask that is totally comfortable. 
I am posting a typical night for me. Normally I fall asleep immediately and last about four hours pretty deep. Then I wake up (not sure why) and try my best to get back to sleep. Sometimes I can, sometimes I just lie there and sleep intermittently on and off. I started wearing a soft cervical collar several nights ago. This graph is with me wearing it. I would appreciate any help that you guys could provide. Also, my MD wants to move me to a BiPAP. There would be no downside to this I am assuming. Insurance will pay. Thanks.


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#2
RE: One month in - how can I do better?
Right now you're on a Respironics APAP that is running a fixed 5. As is, it is not set to do a good job for you. I would consider running it in auto mode at around 6-14. If the doc or DME/RT set this up this way, I can speculate they'd set a BPAP to run like an ST, static exhale and inhale. For some reason they are staying away from variable pressure. Now that brings a question, was your sleep study report posted on AB before or not? You should have a detailed copy for your records. If you don't you need to get it. Then post the detailed and redacted image here. We need historical info on your apnea.

As is, this OSCAR data states plainly your therapy is poor and resulting in mediocre results. I'm going to make the guess you don't feel well treated. I suggest you stand your ground on which machine you get. You say they've decided you need BPAP. OK fine, you tell them it is going to be ResMed AirCurve 10 VAuto. Nothing other than this should be accepted.
Dave

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#3
RE: One month in - how can I do better?
I do not understand why you are fixed on 5 for pressure and fixed with a Auto type machine, Your chart has indicated OB and H apnea's that usually need a higher pressure to treat. At that  low a pressure you do not need Flex either.
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#4
RE: One month in - how can I do better?
If your doctor wats to prescribe a bilevel, take it and request the Resmed Aircurve 10 Vauto. It is the best machine on the market for obstructive apnea and upper airway resistance.

Your current machine is set for a fixed pressure at 5.0. I think you need a minimum pressure of 7.0 and I agree setting to Auto mode with a maximum pressure at 12 makes sense. It should help to clear up the obstructive events we see in your chart.
Sleeprider
Apnea Board Moderator
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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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#5
RE: One month in - how can I do better?
Thank you so much. That was me setting it at a fixed pressure and experimenting! They set it up at the typical 5/20 and results were worse. I noticed my best AHI's were generally at 5 cm so maybe I mistakenly thought if I fix it at that it would be better. I can certainly try auto again and move it to 6/14 if you feel that would be better. Any other feedback would be helpful. Unless I hear otherwise I will go to 6/14 tonight.

Actually I will try 7/14 as sleeprider suggested!
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#6
RE: One month in - how can I do better?
Just reset my machine to auto 7/16. Will try tonight! 
Question: should I use A Flex?

sorry I meant 7/14
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#7
RE: One month in - how can I do better?
I'd go with the suggestion from Sleeprider over my own. Setting changes are for Auto mode and pressure of 7-12. Do follow-up after use with an OSCAR chart and tell us how you feel with the changes.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#8
RE: One month in - how can I do better?
Perfect! I will use 7/12. 
Thank you all so much and I will report back after a few nights! 
My personality wants me to have quick results but I know this will take some time! 
Thanks again!
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#9
RE: One month in - how can I do better?
Let me vote for the ResMed AirCurve (bipap) VAUTO. I owned a dreamstation bipap for 5 year and NEVER got good therapy. I got the VAUTO and went from over 25 events a night to 2 or less for over a month. The Resmed is so much better. The problem is the supplier gets more profit from the Phillips and will push it, some only Carry Phillips. You may have to go to another supplier or at least threaten to. Don’t settle - this machine will be your and you cannot get another one for 5 years at a minimum.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed 
Cervical Collar     Dealing w DME     Chart Organizing
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#10
RE: One month in - how can I do better?
Thanks so much Stacey! 
If my doc wants me to stick with my Philips Dreamstation APAP, do you feel I can do ok? I know you all feel the Resmed is better but this is what I have! Wish I would have known all of this a month or so ago!! Wink
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