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Requesting Sleep Report Analysis & Second Opinions
#11
RE: Requesting Sleep Report Analysis & Second Opinions
(07-21-2020, 09:27 PM)Sleeprider Wrote: ...Considering the denial in Canada that CSA even exists, it might be your best choice.  This is the downside to social medicine...you can't always get what you need, you get what they give you, when they get around to it.

what in the god's name!?
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#12
RE: Requesting Sleep Report Analysis & Second Opinions
(07-21-2020, 09:32 PM)SarcasticDave94 Wrote: Touching on masks for you, the one(s) you have now assuming good fit and close to leak free will be fine with an ASV. I find leaks need to be more controlled under ASV therapy, but if yours are well controlled, you'll be OK.

Good to know thanks for confirming!
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#13
RE: Requesting Sleep Report Analysis & Second Opinions
(07-22-2020, 08:31 AM)ardenum Wrote:
(07-21-2020, 09:27 PM)Sleeprider Wrote: ...Considering the denial in Canada that CSA even exists, it might be your best choice.  This is the downside to social medicine...you can't always get what you need, you get what they give you, when they get around to it.

what in the god's name!?

Fair question.  We have seen our Canadian members, as well as those in U.K have results from very good to very poor as the medical system is administrated on  provincial level, or regional NHS in U.K.  In general, wait times for testing and to obtain equipment are long and there is no individual choice of equipment...you get what is issued when they get around to it.  It is very difficult to obtain advanced respiratory assist devices, and many members have just sourced their own machines rather than going through the medical coverage.  I know of only a few members that have obtained appropriate care and therapy where central apnea indicates a need for advanced therapy.Not only are advanced machines difficult to obtain, but high import taxes often apply to machines brought from the U.S.   There are quite a few Canadian and U.K. members on the forum, and I'm sure they can correct or confirm my impressions.
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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#14
RE: Requesting Sleep Report Analysis & Second Opinions
"...Considering the denial in Canada that CSA even exists, it might be your best choice. This is the downside to social medicine...you can't always get what you need, you get what they give you, when they get around to it."

I won't argue that this isn't correct, just that it isn't much different in the U.S. when it comes to CSA and ASV. treatment through our sleep med & private insurance systems is slow and inefficient with unsatisfactory results seeming to be the rule rather than the exception.
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#15
RE: Requesting Sleep Report Analysis & Second Opinions
Hey all! After months and months of waiting, still have not found the solution but I'm now testing the ASV. It's been a loooooooong journey and who knows how much longer I still have, but I'm keeping at it. This is only night 1 on ASV (I have this thread + an older linked thread to explain how I started with CPAP which was a misdiagnosis and now on ASV as my most-recent sleep study showed majority centrals but high hypopneas).

Attaching an Oscar snapshot from last night. I'm working remotely with a lab tech who will monitor my data and alter my settings but the main issue I had from last night was what felt like excessive air blowing during the inhalation, but not too bad in the exhalation. The inhalation literally felt like I was swallowing gallons of air at a time, although this wasn't consistent, sometimes it was consistent for maybe 10-15 breaths then when I switched my body positioning it would slow down to a very comfortable inhalation pressure. No clue if this is an ASV thing or a settings thing or both, the settings were left on default so I haven't touched it, and I'm waiting to hear back from my sleep tech which might not be until tomorrow or Monday so any advice would be appreciated.

As I had experience with CPAP on my first test run months ago, I fine-tuned my setup to nasal pillows, the knightsbridge dual-band chin strap and mouth tape, although I still get severe dry mouth and I'm suspecting it's because of a chin-tuck, which I tried to use a SCC but it was too tight around my neck and kept getting in the way of my thick beard. Gonna stick with the usual protocol (minus SCC) and see what happens after a week. Any advice regarding the data so far and the chin strap/SCC/mouth tape protocols is greatly appreciated!

   
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#16
RE: Requesting Sleep Report Analysis & Second Opinions
The two things I see is they chose not to run ASV Auto and your high FL chart.

As is, ASV is set to static EPAP 6 and PS starts at 5. This combo give you higher IPAP, much more than you're used to. It will also be uncomfortable. EPAP 6 is not high enough to combat the FL. If the tech is open to suggestions, ASV Auto mode needs to be On with EPAP 7 Min and Max of about 13. PS needs to drop to 3 on Min and Max of about 12.

In other words:
Mode ASV Auto
EPAP 7-13
PS 3-12
IPAP is automatically determined via algorithm in the ASV and equals the EPAP and PS at that moment.
Dave

OSCAR
Standard OSCAR Chart Order
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Dealing With A DME
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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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#17
RE: Requesting Sleep Report Analysis & Second Opinions
(10-03-2020, 05:04 PM)SarcasticDave94 Wrote: The two things I see is they chose not to run ASV Auto and your high FL chart.

As is, ASV is set to static EPAP 6 and PS starts at 5. This combo give you higher IPAP, much more than you're used to. It will also be uncomfortable. EPAP 6 is not high enough to combat the FL. If the tech is open to suggestions, ASV Auto mode needs to be On with EPAP 7 Min and Max of about 13. PS needs to drop to 3 on Min and Max of about 12.

In other words:
Mode ASV Auto
EPAP 7-13
PS 3-12
IPAP is automatically determined via algorithm in the ASV and equals the EPAP and PS at that moment.

Thank you very much for the prompt imput!
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#18
RE: Requesting Sleep Report Analysis & Second Opinions
You're welcome. I think the static EPAP of 6 and then hitting you with PS 5 or more is your gallons of air delivery feeling. As is, the ASV has no choice but to add PS to attempt addressing issues like FL. If you had an EPAP range, it may then increase EPAP to combat the FL. And I think your comfort would increase drastically.
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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#19
RE: Requesting Sleep Report Analysis & Second Opinions
Attaching last night's report after the recommended changes. The main issue I had, which I see shows in the leaks, was waking up a few times throughout the night with dry mouth, despite using the strap+tape+ergonomic pillow combo, reversing the mouth-breathing tendencies is proving quite difficult.

I still felt like there were moments of taking in gallons of air, but it wasn't as bad as the night prior. I still feel like the increase in inhalation pressure is faulty, especially during the times that I'm conscious but with eyes shut, if I take an extra 1-2 seconds to clear my through or not breathe normally because I'm moving body positions, the inhalation feels like it doubles on the next breath, I assume because the machine thinks I'm not breathing for 1-2sec so it immediately changes its algorithm.

   
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#20
RE: Requesting Sleep Report Analysis & Second Opinions
I think Dave has given a pretty good lead. You might want to reduce EPAP min to 6.0 based on your original settings. Results look great, but you should expect it to take some time to fully adapt to the use of ASV. When you tolerate it, turn off ramp or switch to shorter ramp time. The few events you had were mainly during the ramp.
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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