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[Pressure] Do I need a Bi-Pap or higher pressure APAP?
#31
RE: Do I need a Bi-Pap or higher pressure APAP?
       

Here are my last two nights' results and as a note, last night I made my bed completely flat and I was kinda surprised the RDI didn't shoot up.
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#32
RE: Do I need a Bi-Pap or higher pressure APAP?
I am seeing more tendency for positional apnea http://www.apneaboard.com/wiki/index.php...onal_Apnea Even with the maximum pressure of 20, clusters of OA are breaking out and only changing after you shift position. This was definitely more prevalent on 9/22 than 9/23, so your flatter bed position is helping. I still think that in view of your high pressure, a bilevel like the Resmed Aircurve 10 Vauto would be very beneficial and more comfortable, and I am certain it will actually lower the therapy pressure required to resolve you obstructive breathing.
Sleeprider
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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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#33
RE: Do I need a Bi-Pap or higher pressure APAP?
(09-24-2020, 08:51 AM)Sleeprider Wrote: I am seeing more tendency for positional apnea http://www.apneaboard.com/wiki/index.php...onal_Apnea  Even with the maximum pressure of 20, clusters of OA are breaking out and only changing after you shift position. This was definitely more prevalent on 9/22 than 9/23, so your flatter bed position is helping.  I still think that in view of your high pressure, a bilevel like the Resmed Aircurve 10 Vauto would be very beneficial and more comfortable, and I am certain it will actually lower the therapy pressure required to resolve you obstructive breathing.

Yeah, I think I am going to get store credit from my DME for my Dreamstation APAP and switch to the VPAP. My parents are still a bit on the fence about spending the extra cash to buy that unit but more importantly, I think they are thinking am playing doctor lol. My doc has to write an updated script for the Vauto my parents were just like "well why did they tell you to go with an APAP when you needed a BIPAP" I told them it's because of the price differences and because I never got an in-lab titration study, they probably would have pointed me in the direction of the bi-level if they saw the pressures I require. My untreated AHI was 84 I don't know what my actual RDI would have been if REPA were included. They are also skeptical of trusting people on a forum.... honestly some of you guys can probably interpret the data just as well as a polysomnography technologist.

I breathe through my mouth because of the congestion I get. If I were to use a cervical collar will it make it hard to breathe through my mouth? Obviously, I am using a full face.
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#34
RE: Do I need a Bi-Pap or higher pressure APAP?
See my signature and read about a collar
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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#35
RE: Do I need a Bi-Pap or higher pressure APAP?
Just ordered the 3M futuro collar. I should get it by tomorrow and I’ll send out an update.
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#36
RE: Do I need a Bi-Pap or higher pressure APAP?
Update: Doctor agreed with you suggestions and sent a bipap/vpap script to my DME
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#37
RE: Do I need a Bi-Pap or higher pressure APAP?
ResMed 10s VAUTO is what you want not a dreamstation!!!
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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#38
RE: Do I need a Bi-Pap or higher pressure APAP?
I know, I can't say I dislike the dreamstation that much, other than its small humidifier and non-agrssive algorithm. I went with Phillips because of the name recognition and even though I did some research, it seems unanimous on these forums that the ResMed is the superior brand. I mean from what I hear even there APAP kinda functions like a BIPAP in a was. Plus, I have heard complaints about A-flex but I do personally like it, but lowered it to 1 as I read somewhere that it can cause events in some people. EPR I have heard is much better. 

The Vauto looks very nice, too bad we will have to spend 800 after what I get back in store credit from my DME to get it and I will be a few days without a unit until it arrives. That is unless I can get my DME to apply a post-sale price reduction so I can order the machine first then get the money from the old stuff deducted. My parents will probably want to get the store credit first though.
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#39
RE: Do I need a Bi-Pap or higher pressure APAP?
"They [your parents] are also skeptical of trusting people on a forum...."

in the fwiw category, the parent in me wants to address this. imo it's sound counsel and probably like most members is exactly what I would say to my kids. I'd be very reluctant to pony up for a pap machine based on what my kid read on the internet.

obviously it's important to read with caution and act with discretion; become knowledgeable enough to filter what we read and judge it's validity and applicability. that said, while I don't have a lot of experience with other sites, I've learned over about 4 years here that this one is an exceptional resource, providing a valuable service, filling a niche in which the medical and insurance systems fail us. no one here stands to gain from the opinions, experiences and advice they relay. just keep in mind, that's all it is: our opinions and experience. some members are more knowledgeable than many in the sleep med profession, at least with regard to the practical application of pap therapy, but most of us are simply helping each other feel our way around. fortunately, it's all but impossible (I'd say impossible but there's probably an exception somewhere) to hurt oneself with cpap so the worst case is that a suggestion that works for some doesn't work for everyone.

I'm among those that think you'll do better with a more advanced machine but if it you find that's not the case, you can sell it and recover much of your cost.

sorry for the tangent and good luck with your parents and with your therapy!
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#40
RE: Do I need a Bi-Pap or higher pressure APAP?
Johnnyde, glad to hear you have the script in hand. It's justified based on your need for higher pressure. I'm pretty sure once you have the machine in-hand, you will be starting at EPAP min 10, PS 4.0, Max pressure 20. That will start you at 14/10 and allow up to 20/16. It's possible that with the collar you will fully resolve the need for higher pressure, and if that's the case, lower pressures are possible. I just think that is a good starting place, and with a Resmed we will have a better handle on the impact of upper airway restriction (flow limitation) on your therapy. I got pretty good therapy with Philips machines before switching, but in coaching many members, I find it much easier to get better results with the Resmed machines. Their reviews are pretty persuasive, especially when based on comfort.

I'm glad we got your doctor's seal of approval on what we have suggested here. We're actually pretty conservative in reviewing therapy, and take time to consider individual variations. In your case, you are getting decent results with CPAP, but still showing lots of signs of obstruction or flow limitation, even with high pressures. You're young, and bilevel has a better chance of being a great long-term solution for you.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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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