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Suggestions for "Fuzzy-headed, hungover" Feeling?
#11
I feel better when I increase my minimum pressure a bit above where my AHI looks good.
Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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#12
vsheline, When the machine was auto, the settings were Min EPAP 4.0 Max IPAP 25.0 PS 2.0-8.0 (cmH2O).
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#13
For what it's worth, my Thursday night data was:
AHI: 3.39
Fixed 10.0-14.0

Readings were:
Date Sleep Wake Hours
1/8/2015 22:17:52 06:50:42 08:32:50
Cheyne Stokes Respiration 0.00%
Large Leak 0.30%
Clear Airway 2.22
Obstructive 0.47
Hypopnea 0.70
RERA 0.82
Flow Limitation 0.00
Vibratory Snore 0.00
Vibratory Snore (VS2) 1.99
Pressure Pulse 15.09
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#14
(01-10-2015, 07:15 PM)kinger62 Wrote: vsheline, When the machine was auto, the settings were Min EPAP 4.0 Max IPAP 25.0 PS 2.0-8.0 (cmH2O).

Hi kinger62,

What were the results on the night of Auto Bi-level?



Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
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#15
vsheline, here's the data from the night in auto...

Philips Respironics System One
RemStar BiPAP Auto with Bi-FlexModel 750P - P049615031A49
PAP Mode: Auto Bi-Level (Variable PS)
Min EPAP 4.0 Max IPAP 25.0 PS 2.0-8.0 (cmH2O)

Date Sleep Wake Hours
8/21/2014 23:52:27 06:41:32 06:49:05
Cheyne Stokes Respiration 0.40%
Large Leak 0.00%
Clear Airway 5.28
Obstructive 2.93
Hypopnea 1.47
RERA 0.73
Flow Limitation 0.88
Vibratory Snore 1.47
Vibratory Snore (VS2) 5.28
Pressure Pulse 25.23
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#16
(01-10-2015, 09:29 PM)kinger62 Wrote: vsheline, here's the data from the night in auto...


Hi kinger62,

What were the Median, 90 percentile and Max statistics for the pressure and for the PS?

The Min EPAP and Max IPAP settings were wide open, which is a common issue with many pressure prescriptions for Auto therapy modes.

Take care,
--- Vaughn

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
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#17
vsheline, Thank you very much for your time and help. Here's the stats:

EPAP 7.60 4.00 8.40 9.10 10.10
IPAP 10.53 6.00 10.40 14.00 14.50
PS 2.93 2.00 2.00 5.00 5.50
Minute Vent 8.12 0.12 7.88 13.38 44.12
Resp. 13.01 4.92 13.00 15.60 20.58
Leak Rate 1.79 0.00 0.00 8.00 63.00
Total Leaks 29.05 15.00 29.00 45.00 82.00
Snore 0.43 0.00 0.00 2.00 13.00
Insp. Time 2.53 0.74 2.34 3.94 11.94
Exp. Time 2.19 0.34 2.10 3.50 11.60
Tidal Volume 628.00 13.33 600.00 1080.00 3820.00
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#18
Just like getting used to treatment when you first start, trying a different form of that treatment requires giving it more than one try. I am on a VPAP and my RT wanted me to try it on straight VPAP and not AUTO and I did that but his request was to do it for a week and see the results. One night is not enough to see how it would work. Also, having an open mind that it will at least have equal results as the other way it was being done (as using the machine for treatment has to be equal to fixed pressure vs. auto when compared to NO TREAtMENT). It is all in the attitude. If a person goes into any treatment for any illness/disease with the attitude they will not get better or it won't work, it probably won't or it will be an uphill battle.

EX: My cousin's spouse was diagnosed with cancer and opted for no treatment at all and was told death was imminent in the near future. No treatment worked well and 10 years later he was doing well. Then, he passed out and was taken to the hospital where it was discovered that there was a tumor in his brain and he did pass away but he lived a very good life for those 10 years and worked up until the brain tumor was found. Had he received treatment, he wasn't given very long to live either way (I believe it was 2 years tops). I AM NOT SAYING DO NOT GET TREATMENT OF SOME SORT. HAD IT BEEN ME, I WOULD HAVE LOOKED INTO SOMETHING OTHER THAN RADS OR CHEMO. IT WAS HIS DECISION THOUGH AND HE HAD 10 GOOD AND HEALTHY YEARS WHICH IS MORE THAN THEY PROMISED HIM WITH TREATMENT.

(01-10-2015, 09:29 PM)kinger62 Wrote: vsheline, here's the data from the night in auto...

Philips Respironics System One
RemStar BiPAP Auto with Bi-FlexModel 750P - P049615031A49
PAP Mode: Auto Bi-Level (Variable PS)
Min EPAP 4.0 Max IPAP 25.0 PS 2.0-8.0 (cmH2O)

Date Sleep Wake Hours
8/21/2014 23:52:27 06:41:32 06:49:05
Cheyne Stokes Respiration 0.40%
Large Leak 0.00%
Clear Airway 5.28
Obstructive 2.93
Hypopnea 1.47
RERA 0.73
Flow Limitation 0.88
Vibratory Snore 1.47
Vibratory Snore (VS2) 5.28
Pressure Pulse 25.23

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#19
(01-10-2015, 07:28 PM)kinger62 Wrote: For what it's worth, my Thursday night data [when in fixed BiPAP mode] was:
AHI: 3.39
Fixed 10.0-14.0

Readings were:
Date Sleep Wake Hours
1/8/2015 22:17:52 06:50:42 08:32:50
Cheyne Stokes Respiration 0.00%
Large Leak 0.30%
Clear Airway 2.22
Obstructive 0.47
Hypopnea 0.70
RERA 0.82
Flow Limitation 0.00
Vibratory Snore 0.00
Vibratory Snore (VS2) 1.99
Pressure Pulse 15.09

(01-10-2015, 09:29 PM)kinger62 Wrote: vsheline, here's the data from the night in auto...

Philips Respironics System One
RemStar BiPAP Auto with Bi-FlexModel 750P - P049615031A49
PAP Mode: Auto Bi-Level (Variable PS)
Min EPAP 4.0 Max IPAP 25.0 PS 2.0-8.0 (cmH2O)

Date Sleep Wake Hours
8/21/2014 23:52:27 06:41:32 06:49:05
Cheyne Stokes Respiration 0.40%
Large Leak 0.00%
Clear Airway 5.28
Obstructive 2.93
Hypopnea 1.47
RERA 0.73
Flow Limitation 0.88
Vibratory Snore 1.47
Vibratory Snore (VS2) 5.28
Pressure Pulse 25.23

(01-10-2015, 10:00 PM)kinger62 Wrote: vsheline, Thank you very much for your time and help. Here's the stats [when in Auto BiPAP mode]:

EPAP 7.60 4.00 8.40 9.10 10.10
IPAP 10.53 6.00 10.40 14.00 14.50
PS 2.93 2.00 2.00 5.00 5.50
Minute Vent 8.12 0.12 7.88 13.38 44.12
Resp. 13.01 4.92 13.00 15.60 20.58
Leak Rate 1.79 0.00 0.00 8.00 63.00
Total Leaks 29.05 15.00 29.00 45.00 82.00
Snore 0.43 0.00 0.00 2.00 13.00
Insp. Time 2.53 0.74 2.34 3.94 11.94
Exp. Time 2.19 0.34 2.10 3.50 11.60
Tidal Volume 628.00 13.33 600.00 1080.00 3820.00

Hi kinger62,

I think the incidence of obstructive events (Obstructive Apnea, RERA, Flow Limitation, Snore, some Hypopneas) would probably have been lowered by raising the Min EPAP to 8. Raising the pressure usually helps reduce the number of obstructive events.

I think the high incidence of central events (Clear Airway apnea, Cheyne-Stokes Respiration, Periodic Breathing, some Hypopneas) would probably have been lowered by lowering the Max IPAP to 13 or lower, and the Max PS to 3 or lower. Lowering the pressure often helps reduce the number of Central events.

Basically, the machine was recording mostly Central events when the machine was in AutoB mode. Higher pressure and higher PS often increase the incidence of Central events. Lowering the pressure settings and lowering the Max PS setting often reduce the incidence of Central events.

It would be helpful if you will be able to post a SleepyHead report or image of the detailed data plots (Event markers and Leak and Pressure and Flow and Tidal Volume). In the Member Account Help Forum visible to Apnea Board members there is a "HOW DO I..." thread in the Important Threads section, telling how to add graphs in our posts, or how to add links to images.

On most nights preceding the days you don't feel very clear headed, does SH show primarily Clear Airway apneas (like it does in the data you posted for Thursday night, where the Clear Airway index was 2.22 per hour, which was higher than the sum of the hourly averages of 0.47 for Obstructive Apneas plus 0.82 for RERAs)?

Using your present machine, you might end up needing to make sure you always stay off your back while sleeping. (Flat on our back is usually the worst case position for causing obstructive sleep apnea.) If you can ensure that you are never rolling onto your back while asleep, perhaps your pressures might be safely lowered while still adequately treating your Obstructive Sleep Apnea. Lowering the Max IPAP and Max PS settings would likely reduce the severity of your Central Sleep Apnea, with the possible risk of worsening the severity of your obstructive events.

Although you seem to have both obstructive and central sleep apnea (also called Complex Sleep Apnea), if the Central Apnea Index is less than 5.0 all by itself, most insurance companies will not cover the cost of an ASV machine which is designed to treat Complex Sleep Apnea. But if the cost would not be a problem for you to bear on your own, you may be able to obtain a prescription from any physician (does not need to be a specialist) after explaining that you understand insurance would likely not cover the cost of the ASV machine but you would like to try the therapy, bearing the cost yourself. For example, I think the current cost for a "Gently Used" Respironics System One BiPAP autoSV Advanced DS960 Machine with Heated Humidifier would be about $1,400 from Supplier #2. (A link to the Supplier List is at the top of each forum page.)

Take care,
--- Vaughn




Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
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#20
I agree with Vaughn's last post. A wide open range like that, IMHO, is good only if someone doesn't know what pressure they should be using and once they see where the median, min, max pressure is, then adjust the pressure accordingly.

I think you should try it in auto for a week with a tightening up of your pressure instead of leaving it wide open and see how you do. This way, if there comes a point in your sleep that you need a higher pressure, it is available to you unlike what would be for a set pressure.
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