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Should I be concerned about last nights results?
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justMongo Offline

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Post: #11
RE: Should I be concerned about last nights results?
(12-02-2015 06:57 PM)cate1898 Wrote:  I can't help wondering when long apneas like these happen if using an Auto CPAP would help one recover from it faster? So far I'm slated for a fixed CPAP.

Not in the sense that you have phrased it.

If you were on APAP, and had that pattern, an increase in minimum pressure would generally be suggested.

with APAP, the longer apnea would signal the APAP to increase pressure; and perhaps the second, shorter, OA could have been prevented.

An APAP will run at min pressure until an event signals it to increase pressure. Then it retreats from max pressure back to min pressure over some minutes.

An APAP is more flexible; but generally needs to be tuned for optimal results.

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.
12-02-2015 07:08 PM
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Sleeprider Online
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Post: #12
RE: Should I be concerned about last nights results?
To add to JustMongo's post, an APAP will not increase pressure during an event, it is programmed to interpret snores and flow limitations and other breathing patterns to increase pressure to prevent the OA. There is not enough information in your chart to see what happened before the event, and your CPAP does not flag flow limitations.

I agree with the idea of increasing the CPAP pressure if you're going to use EPR of 3, or decrease EPR to 2. When using bilevel treatment, the EPAP pressure is increased to the point where OA is resolved, and IPAP (pressure support) is used to improve H, snores and RERA. The Resmed machines uniquely act as a limited bilevel, and it could be your airway closes at the 6.5 expiration pressure. Overall, you have great results, but those really are long OA events.

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12-02-2015 07:22 PM
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archangle Offline
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Post: #13
RE: Should I be concerned about last nights results?
(12-02-2015 04:37 PM)cate1898 Wrote:  Here is an enlargement of 2 apneas, first 57 seconds, then second 30 seconds. So how do I know if it's good or bad?

This is a "real" apnea of that length. Note that your breathing is essentially zero for about a minute. There's just a bit of "fuzz" and some "bumps" on the curve, but your airflow never gets above a small percentage

The apneas that fall into the "gray area" are the ones where there's some breathing, but it's not clear you're getting enough air.

As for how harmful they are, probably not that bad as long as you're not having too many per hour. The are a lot more meaningful than a 10 second long apnea.

(12-02-2015 07:08 PM)justMongo Wrote:  
(12-02-2015 06:57 PM)cate1898 Wrote:  I can't help wondering when long apneas like these happen if using an Auto CPAP would help one recover from it faster? So far I'm slated for a fixed CPAP.

Not in the sense that you have phrased it.

If you were on APAP, and had that pattern, an increase in minimum pressure would generally be suggested.

with APAP, the longer apnea would signal the APAP to increase pressure; and perhaps the second, shorter, OA could have been prevented.

An APAP will run at min pressure until an event signals it to increase pressure. Then it retreats from max pressure back to min pressure over some minutes.

An APAP is more flexible; but generally needs to be tuned for optimal results.

It's not QUITE that simple. The modern APAP machines look at flow limitations and other "secret" algorithm things and will often ramp up before an apnea occurs. Some people show the warning signs before they go into apnea, some don't.

In general, only ASV or T/ST mode bilevel machines change pressure quickly enough to stop an individual apnea while it's happening.

An APAP machine is always the right choice, in my opinion, because you can either set it to APAP mode or CPAP mode. Unfortunately, many doctors don't understand that an APAP machine can and should be set to a pressure range, not simply left on the default 4-20 setting. Or that they can look at the results and tune in the right reading.

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12-02-2015 09:04 PM
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justMongo Offline

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Post: #14
RE: Should I be concerned about last nights results?
(12-02-2015 09:04 PM)archangle Wrote:  In general, only ASV or T/ST mode bilevel machines change pressure quickly enough to stop an individual apnea while it's happening.

I wasn't suggesting that. I was suggesting an auto could prevent couplets or clusters of obstructive apnea.

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.
12-02-2015 10:03 PM
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zonk Offline

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Post: #15
RE: Should I be concerned about last nights results?
(12-02-2015 05:14 PM)justMongo Wrote:  I wonder if you would do better with a little less EPR. You are set at 3 which means you have 6.5 cm-H2O holding your airway open between inhalation. That might not be enough. YMMV
I'm wondering too Smile. In my opinion (take it with a pinch of salt), when on fixed pressure, one need to increase set pressure to compensate for pressure relief drop or turn it off and see how thing pan out
12-02-2015 10:51 PM
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zonk Offline

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Post: #16
RE: Should I be concerned about last nights results?
(12-02-2015 07:22 PM)Sleeprider Wrote:  There is not enough information in your chart to see what happened before the event, and your CPAP does not flag flow limitations.
My machine flag FL on both CPAP and AutoSet mode. FL looks better on AutoSet mode, but the machine use more pressure to achieve the results and that in turn could skew pressure statistics somewhat
12-03-2015 02:25 AM
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Machine: Resmed Aircurve 10 Vauto
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Post: #17
RE: Should I be concerned about last nights results?
(12-03-2015 02:25 AM)zonk Wrote:  
(12-02-2015 07:22 PM)Sleeprider Wrote:  There is not enough information in your chart to see what happened before the event, and your CPAP does not flag flow limitations.
My machine flag FL on both CPAP and AutoSet mode. FL looks better on AutoSet mode, but the machine use more pressure to achieve the results and that in turn could skew pressure statistics somewhat

True, but Cate has a fixed CPAP Airsense 10 Elite, and it's my understanding that machine does not sense or report flow limitations. Fixed CPAP does not have any use for that data to affect pressure, but all APAP machines do register FL, even in CPAP mode.

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