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Post-radiation changes... help requested
#11
RE: Post-radiation changes... help requested
I'm basing my question on an AC10's configuration options.   Does your S9 have a Trigger setting?   If it does, and it is set to the default of Medium, try setting it to High.  If it is set to High, then bump it up to Very High.  This should aid in reducing the CAs.

How do you feel on the new settings?
- Red
Crimson Nape
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#12
RE: Post-radiation changes... help requested
Good morning, Crimson Nape. Thanks for your response.

It does have trigger settings. I just changed the setting to high.

I feel quite compromised today. The new settings nearly doubled the central events but we needed some data. I've been adjusting the settings over the past month or so, see attachment, trying to reduce the central events, but there are settings and data that I don't understand. The best results I have achieved so far was an AHI of 0.73 over a four-day period setting it up as a straight CPAP at a pressure of 16.6


Attached Files Thumbnail(s)
   
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#13
RE: Post-radiation changes... help requested
When you had it set to the static pressure, did you feel better?  Feeling good and a low AHI are 2 separate parameters.
Crimson Nape
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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: Post-radiation changes... help requested
No, I didn't feel good at those numbers.... better, but not good. That's why I'm here. I've been setting my own pressure since the late 90s and I've had the S9 since 2012. On the S9, and before the CA showed up, a good night was 0.3 AHI or less. I was getting those numbers better than half of the time. I felt a bit foggy in the 0.5 to 0.8 range, and anything over 0.8 was a bad night. Now, nearly every night is over 0.8, and the events have switched from almost entirely obstructive events to almost entirely central.
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#15
RE: Post-radiation changes... help requested
I forgot to ask, what are your Ti Min and Ti Max values?
Crimson Nape
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Useful Links -or- When All Else Fails:
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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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#16
RE: Post-radiation changes... help requested
TI Max: 2.0
TI Min: 0.3

And I don't have a clue how to set them.
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#17
RE: Post-radiation changes... help requested
If the Ti Min is too long or the Ti Max is too short, it can make for a very BAD night. The Ti Min controls how long it must provide IPAP pressure before it will allow it to drop to the EPAP pressure. Likewise, the Ti Max sets the maximum time limit it will allow the S9 to remain at the IPAP pressure. I would leave the Ti Min alone, but would increase the Ti Max to at least 3.0 - 3.2. This will give you some wiggle room for a comfortable, slow inhale without chopping off mid-breath.

- Red
Crimson Nape
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Useful Links -or- When All Else Fails:
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Attaching Images and Files on Apnea Board
Apnea Helpful Tips

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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#18
RE: Post-radiation changes... help requested
I think changing the trigger sensitivity to high is enough changes for now. Your chart looks very good and the CA events appear to be pauses in breathing during changes in sleep stage, but we can look at a zoom of a few events to see how they evolve. You mentioned that the lower pressure felt "strange", so the follow-up to that is strange good or strange bad? I'm sure it may take some time to become accustomed to the new levels, but they certainly did not increase obstructive events. Based on comparison to your Resmed chart, the flow limitations appear much lower and leaks have improved. 95% flow limits were 0.07 and that is acceptable, however we could drive that lower with more pressure support. I don't want to introduce pressure support too aggressively with the CA events present. We can't compare respiratory statistics, but you are showing good tidal volume and minute vents with a relatively slow/normal respiration rate. The flow rate chart does not have a lot of spikes that might suggest arousal.
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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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#19
RE: Post-radiation changes... help requested
Many thanks for your help, gentlemen.

Strange good or strange bad... for the last quarter of a century at high pressure, I really didn't have to make much of an effort to inhale. When I stopped exhaling, the machine kind of fed me a breath. Last night, that wasn't the case. I was conscious, at least at first, of the need to draw a breath. At such a low pressure, the machine almost felt like it was turned off. 

Subjectively, I'd say that last night was the worst night I've had in quite a while. That was my first impression when I awoke. I tried to do some physical work in the yard but was quickly fatigued, and I'm just not all here. I'm making silly mistakes. But I'm here to learn and you folks are quite sharp. So what's your recommendation for tonight? Other than the tweaks to the trigger setting and TI Max, the same settings?
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#20
RE: Post-radiation changes... help requested
I understand what you're experiencing.  I've been at my pressure for so long, I can no longer feel if it is on, until I feel my mask exhaust.  You shouldn't feel that way.  If you feel uncomfortable, try increasing the IPAP to 8.0 and try that. You don't need to suffer on our account.
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
___________________________________
Useful Links -or- When All Else Fails:
The Guide to Understanding OSCAR
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Apnea Helpful Tips

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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