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PAP Therapy with HFrEF
#11
RE: PAP Therapy with HFrEF
Thanks Sleeprider.  I haven't noticed much sleep benefit from my PAP therapy in the past so recently committed to getting my usage up from an average of less than 2 hrs over the last 6 mos with avg AHI = 12.5 to averaging 7 hrs the last week but it seems I have a low quality of sleep and sleepiness in the day. I've ordered a collar to address the positional apnea you mention so I'll report back the Oscar results after I've used it, probably in a couple weeks. I'm certainly open to adjusting the machine settings as well if it helps.  I may even change them myself sooner toward the defaults rather than waiting for a revised doctor prescription so Apria changes them.  It's difficult getting to sleep and staying asleep where the setting are at now

Perhaps I should have mentioned this earlier but not only do I have HFrEF but I also suffered an out-of-hospital cardiac arrest almost a year ago, damn lucky to have survived without brain damage after 3 defibrillator resuscitations and out for 10 days in the hospital. It really was my sleep problems that, after some internet research, led me to ask my NP if heart failure could be the cause of sleep problems almost two years ago which led to EKG then echo then hospitalization for tests and prescriptions but my PAP therapy with ASV came after the heart testing hospitalization. Doctors hadn't spoke to me about changing my sleep therapy afterward cardiac arrest so I hadn't considered it a question until I stumbled on that resmed ASV warning.  

I read your wiki article link and it sounds like the jury is still out.  The doctors in our rural area don't seem very informed about sleep therapy so I wonder how helpful they'll be. I'm supposed to be referred to a "sleep specialist" so perhaps they'll be more knowledgeable.  I'll keep my eye on this thread if anyone has any further advice otherwise thinking I might adjust min EPAP and max PS toward defaults soon
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#12
RE: PAP Therapy with HFrEF
No offense but don't bet on the sleep specialist knowing much. Not exactly the same, but the RT that set my ASV had to guess. She had zero clues on setup. I took over my settings day 1, while I had the ASV that is.
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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#13
RE: PAP Therapy with HFrEF
Bruce, I would really like you to try settings closer to default on the ASV:
Mode ASVauto
EPAP min 5.0
EPAP max 15.0
PS min 3.0
PS max 15.0

You may have to do this in conjunction with a soft cervical collar to eliminate the positional obstructions. I will be very surprised if you don't experience a major improvement in both AHI and comfort. Also, read the Resmed Sleep Lab Titration Guide on ASV starting at page 28 of this link https://document.resmed.com/en-us/docume...er_eng.pdf I think this reference will get you up to speed on how that machine functions and responds.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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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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#14
RE: PAP Therapy with HFrEF
At or near default on the ASV will be a lot better than this, once the Positional Apnea clusters are beat.
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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#15
RE: PAP Therapy with HFrEF
Thanks Sleeprider & SarcasticDave! I'm getting the impression this board is better source of advice than my doctor or the local sleep specialist and I don't have to wait three months for an appointment. I'll try the recommended near default settings beginning tonight.  My amazon collar arrives on Sunday but I'll do my best to avoid chin drop in the meantime, perhaps improvise something.  I'll be back to reply on this thread next week!
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#16
RE: PAP Therapy with HFrEF
           
I've changed the machine settings before the collar even arrived and there's a drastic change to AHI, wonder if collar is needed with these numbers.  Oldest attachment is old settings then several days of new settings. Any thoughts?
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#17
RE: PAP Therapy with HFrEF
The setting change is helping, just try to get your leak rates down. They're likely robbing some therapy effectiveness and can be a source of disturbances.
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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