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[Pressure] Help Calibrating APAP Pressure
#21
RE: Help Calibrating APAP Pressure
On board with Dave... in light of CA's and the lack of OA's a Bilevel would be good, ASV most likely. ASV initiates a breathe when you stop breathing, in your case. 10 seconds or more is a legit CA. Expand your flow rate to 2 minute intervals and see.
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#22
RE: Help Calibrating APAP Pressure
You can try the Soft response, that is an easy edit and you'll know soon if it's helpful and/or comfortable.

ASV is a special kind of bilevel so when I said bilevel isn't a good choice I should have said bilevel without backup rate. ASV is 1 bilevel with backup rate, but it's not the only one in this subgroup, however it's the one made specifically to combat Central Apnea.
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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#23
RE: Help Calibrating APAP Pressure
Adjusting to a soft response seems mildly helpful comfort wise, though I do not see any numerical difference as far as treatment is concerned. Almost every central I have had is greater than, or equal to 10 seconds, some reaching 20. My plan is to petition my way into getting a titration study specifically for ASV ordered. It seems alarming that I feel only 20% better, and cannot get my centrals under control. I am hoping I do not get hit with a, "well <5 AHI is technically treated". Despite the fact it is far less than financially ideal, I am willing to buy a ResMed ASV out of pocket if I have to. You know it is bad when a few thousand dollar gamble on a semi-reasonable shot in the dark is an easy decision to make. I know FitBit is no equal metric to a polysomnogram, but it would take a very large margin of error consistently over a period of almost 8 months to show that my sleep architecture is anything but bad, this, coupled with my Oscar data, should theoretically give me enough of a push to at least get myself into another lab study.
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#24
RE: Help Calibrating APAP Pressure
I'd note all your symptoms and the ongoing complains with Apnea, the treatment, etc. Tell the doc good how badly you feel. Then tell the doc again till his ears bleed from hearing it.
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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#25
RE: Help Calibrating APAP Pressure
In about two weeks I will be having a titration study done. I made sure that the study is specifically done for BiPap titration not APAP, I also made sure that I get to use my own full face mask in order to prevent mouth openings which would likely compromise the validity of the data, since I am more used to full face masks than nasal pillows. I will share a redacted version of the study once it is received.
My question to you all is whether or not there is something I am missing? Obviously getting a BiPap machine through my provider, or if I would benefit from one at all, is going to depend on the results of the study. Even if they do not recommend BiPap, I will still look into it because I know they may throw me in the 'treated' category despite how I feel on a day to day basis since my AHI is less than 5. Reading through these forums has made that all too evident. Is there something that should be on my radar prior to going into this? I knew to specifically request titration with the intent of switching to BiPap, so I do not get hit with a baseline study just to be told, yes, you have sleep apnea, now wear the mask, which is what I have heard before from their respiratory therapy department. My Pulmonologist was happy to comply with my request with the added caveat that she is uncertain whether this will be helpful or not. Is there a difference in different BiPap machines that have advantages or disadvantages for somebody in my situation? Again, I am fully aware that this may not be the solution, I just want to avoid wasting as much time as possible, so I want to have as much research done before hand.

On a second note, here is two nights of data that are over 4 hours for reference.
Thank you!


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#26
RE: Help Calibrating APAP Pressure
I'd suggest staying with ResMed as you've got one now and are used to its feel for doing things. There's differences in brands that'll give different breath patterns.
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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#27
RE: Help Calibrating APAP Pressure
Okay, thank you. Should the transition arise, I will be sure to specifically request a ResMed. Given I got a ResMed the first time around, I would imagine that is what I would get the second, again, if they approve it. Does it seem like an ASV would benefit me? From what I understand about the treatment from an ASV, they do treat centrals, its just whether or not you have them and whether or not they are affecting you much. If anything, I would think it would have to help even if just a little.
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#28
RE: Help Calibrating APAP Pressure
On the ASV, I'd like to give you a definitive yes but you know how picky insurance is. We can be headed towards being more certain after this upcoming test I'd think.

Be sure to request you copy of the detailed results.
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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#29
RE: Help Calibrating APAP Pressure
While there are other settings, the main difference in a BiLevel without Backup (VAuto) is the amount of PS that can be applied. The fact that you are on a BiLevel treatment now with a PS of 2 I doubt you will see significant improvement. I expected to see an EPR of 3. Is there a reason why you are not using an EPR of 3? If so those reasons will be multiplied with higher PS.
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#30
RE: Help Calibrating APAP Pressure
I do not have a reason to not use EPR at 3. A while back a few people recommended it be set at 2 and 3, and I only tried one night on 3. Truthfully, it is sloppy on my part to have not tried a full week at 3. I will do a few nights with that adjustment and see if anything changes.
Thanks.
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