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Stubborn Centrals
#31
RE: Stubborn Centrals
Hello,

I received the new machine.  First night doesn't look too good to me.  I had a lot of trouble falling asleep.  I tried a couple of starting settings to try and feel like I was breathing better to start.  I also set the ramp at my starting epap pressure for 30 min so it wouldn't start blowing hard at me till I fell asleep, but I didn't fall asleep soon enough.  I seem to have the habit of taking big breaths while falling asleep, then it seems to think my mv should be higher than it should and it tries to keep me breathing big breaths.  I had left the PS to the max of 15 to start with, but I kept swallowing air.  I am thinking maybe I need to raise my min ps to at least the recommended setting of 3.  I have 2 charts.  The first is the whole night it which I think I was awake for the first part.  The second is after the final time a made a setting change and finally fell asleep.

Thank you for any input!
Kevin

       
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#32
RE: Stubborn Centrals
Most of your events are happening during Ramp and that is setting you up for poor therapy. Things do calm down after a time. Adapting to the ASV takes time, and it's better to just deal with the fact you are getting used to very different approach to therapy. I don't think ramp is working for you, and you should turn it off, and learn the "blow-back" method of establishing the rate and volume when the machine is unruly. If you are experiencing aerophagia, then cutting PS max to 12 may help. Once you fall asleep the max PS of 15 is not being used anyway. The way I see it, you need to get past this initial transition to sleep, and you will be fine.
Sleeprider
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#33
RE: Stubborn Centrals
Thanks Sleeprider,  I will hang in there and expect it to improve.  I do see that most of the events are happening while I am falling asleep.  I am surprised at how much lower the epap needs to be with this therapy.  Would increasing my min ps to 3 improve my tidal volume?

Thank you,

Kevin
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#34
RE: Stubborn Centrals
My opinion, I'd probably leave PS where it is for now. However, I'd consider putting the axe to the Ramp if you can tolerate it. If that's not possible, shorten it to as little as you can. My usage of the ASV revealed that Ramp and ASV didn't mix well. Best to your success on this.
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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#35
RE: Stubborn Centrals
Kev, a PS of 3.0 might be more comfortable and may help stop some hypopnea, but I don't expect any big changes in tidal volume. I don't see much harm in trying it on that basis.
Sleeprider
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____________________________________________
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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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#36
RE: Stubborn Centrals
Thank you both.  I did turn the ramp off and had much better results.  RDI 1.7 with minimal osa.  The hypopneas that remained were mainly from a period that I was awake and fighting with the machine.  I tried to blow back, but after a couple of breathes, it went back to blowing just as hard as it was.  I may have had some results turning the machine off and back on.  I still had some pretty bad aerophagia.  Is my main option to help with that turning down ps max?  I was thinking that may help with the pressure swings keeping me awake as well. The highest my epap has gotten has been 8.  

Thank you all,

Kevin
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#37
RE: Stubborn Centrals
Thank you all for helping me get on what appears to be the correct machine for me!  I have improved further on the 3rd day and I feel much more rested.  I may actually become a morning person!  I am not sure why the new Oscar is not reporting my settings, but they were epap 6-9, ps 3-11.  I think I will raise min epap in small increments to try to clear up some obstructive issues and maybe min ps as well to see if that helps with some hypopneas.  I don't think I maxed out on the PS last night.  Aerophagia was better last night.  As it improves I may start trying to raise the max PS.  Is there anything I may be missing?

Again, thank you all!
Kevin

   
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#38
RE: Stubborn Centrals
Sounds OK on the plan as far as I see it. And correct on not maxing PS, as you just went over 18 for overall pressure. That puts your Max PS at about 9 I'm thinking.
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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#39
RE: Stubborn Centrals
That looks great, and I recommend you don't make changes for a few nights. A UA of 0.4 does not warrant increasing EPAP. Our objective is to have you feel as comfortable as possible, and you made great progress towards that goal. Keep that, and hold off on changes until you can establish a clear need or objective.
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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#40
RE: Stubborn Centrals
I am having a problem with low oxygen saturation averaging 92 down to 80%. I was thinking that increasing pressure support and improving tv should help with that, but after reading through some posts, it looks like the epap pressure has more to do with oxygenation. It is confusing because the titration for the bilevel machines say to increase ipap for low o2 saturation.
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