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#11
Thanks, Sleeprider, for the links, especially to the American Heart Association site on ejection fraction. I earned a few things and I have an EF of 40-45 since it was discovered in 2004--thankfully it hasn't changed. That explained it for old82 much better than I could have done!
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#12
Glad that link helped. I was trying to avoid anything too technical

Old82, your profile shows you are using an auto pressure of 4-6 and I don't know if you are using any exhale relief. What I would like to you to consider doing, is to experiment with some "fixed" pressure. Choose any pressure between 4 and 6 cm, and set that as both the minimum and maximum on your machine settings. Make sure EPR is OFF. Try that for a couple nights, then let me know if your AHI is reduced. I'd rather look at your graphs, but this trial will give us both answers.
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#13
(05-22-2017, 12:14 PM)Sleeprider Wrote: Glad that link helped. I was trying to avoid anything too technical

Old82, your profile shows you are using an auto pressure of 4-6 and I don't know if you are using any exhale relief.  What I would like to you to consider doing, is to experiment with some "fixed" pressure.   Choose any pressure between 4 and 6 cm, and set that as both the minimum and maximum on your machine settings.  Make sure EPR is OFF.  Try that for a couple nights, then let me know if your AHI is reduced.  I'd rather look at your graphs, but this trial will give us both answers.

Roger that sleeprider.  I do have EPR on 2 and when I experiment with a higher pressure I use EPR  on 3 .   Isn't that what gives me pressure relief and is a GOOD thing? 
I will start tonight with a fixed pressure as you suggest and get back in a few days.  Thanks for your interest.
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#14
In a word, no. Pressure relief in your case can cause the centrals you are seeing. Your pressure is incredibly low anyway and pressure relief should not be necessary. If your current pressure range is 4-6 then with EPR at 2, your EPAP pressure is always 4.0. 4/4, 5/4, 6/4. That's it. I'm suggesting setting pressure at 5.0 min and max or 5.0 CPAP, and no EPR. Try it and see what you get. If it doesn't cut your CA in half, I'll let you go right back to the old setting.
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#15
Ejection fraction is not a concern for most VPAPs. The only machine that currently has some concerns regarding ejection fraction is the ASV.

PaytonA
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#16
To answer the original question, the supplies for all models of the Airsense (including ASV and bi-level) are the same - the same heated hose, the same humidifier, the same filters. Medicare does not require a sleep study for replacement supplies unless you have never been actually diagnosed with sleep apnea ever. Even then, they don't care because all they require for SUPPLIES is the doctor's face-to-face notes and a prescription for them to be covered.
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#17
(05-22-2017, 02:48 PM)Sleeprider Wrote: In a word, no.  Pressure relief in your case can cause the centrals you are seeing. Your pressure is incredibly low anyway and pressure relief should not be necessary.  If your current pressure range is 4-6 then with EPR at 2, your EPAP pressure is always 4.0.  4/4, 5/4, 6/4.  That's it.   I'm suggesting setting pressure at 5.0 min and max or 5.0 CPAP, and no EPR.  Try it and see what you get.  If it doesn't cut your CA in half, I'll let you go right back to the old setting.
Hi old82 - I'm about 4 years younger behind you and had the same problems - left on CPAP with no one watching what was happening.  I had similar problems which the wonderful people on this forum have helped to get much better under control.

Was running AHI = 9+ for 2 years on old PAP with CAs 50%+ and multiple PBs every day as well.  Started checking results when I switched to Airsense 10 Autoset and with the help of this forum now running well under AHI 4.0 with CAs less than 30%.  In my case turning EPR off and working the max./min. pressures plus getting rid of leaks with FFM + soft collar made all start to come together.  Give it a try as I'm sure you will find good results when you get the settings adjusted to your specific needs.

Good luck and hope this all works out well for you.
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#18
(05-22-2017, 10:56 PM)Mosquitobait Wrote: To answer the original question, the supplies for all models of the Airsense (including ASV and bi-level) are the same - the same heated hose, the same humidifier, the same filters.   Medicare does not require a sleep study for replacement supplies unless you have never been actually diagnosed with sleep apnea ever.  Even then, they don't care because all they require for SUPPLIES is the doctor's face-to-face notes and a prescription for them to be covered.

Thank you Mosquitobait for the answer to my original question. The reason I asked it was because at one time I bought a different mask over the internet and when I called my DME for suppllies  I was questioned about it not being the mask of record and it was suggested I needed to make an appointment with my DME to be fitted and approved for it. I convinced them that I had a good fit and had already conferred  with my DME and they said it was OK. I don't know what would happen if I had called for supplies for a different brand of machine. 
Old82
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#19
(05-23-2017, 12:20 AM)TexasTiger Wrote:
(05-22-2017, 02:48 PM)Sleeprider Wrote: In a word, no.  Pressure relief in your case can cause the centrals you are seeing. Your pressure is incredibly low anyway and pressure relief should not be necessary.  If your current pressure range is 4-6 then with EPR at 2, your EPAP pressure is always 4.0.  4/4, 5/4, 6/4.  That's it.   I'm suggesting setting pressure at 5.0 min and max or 5.0 CPAP, and no EPR.  Try it and see what you get.  If it doesn't cut your CA in half, I'll let you go right back to the old setting.
Hi old82 - I'm about 4 years younger behind you and had the same problems - left on CPAP with no one watching what was happening.  I had similar problems which the wonderful people on this forum have helped to get much better under control.

Was running AHI = 9+ for 2 years on old PAP with CAs 50%+ and multiple PBs every day as well.  Started checking results when I switched to Airsense 10 Autoset and with the help of this forum now running well under AHI 4.0 with CAs less than 30%.  In my case turning EPR off and working the max./min. pressures plus getting rid of leaks with FFM + soft collar made all start to come together.  Give it a try as I'm sure you will find good results when you get the settings adjusted to your specific needs.

Good luck and hope this all works out well for you.


Thank you Texas Tiger for your encouraging words.  Our situation sounds similar ...it may be that older people have the same problems due to age?  I'm going to try the one pressure without EPR as suggested by Sleeprider for a few nights and see what happens.  I agree that this blog and the wonderful advisors in it are a great source for help.  I'm really turned off by sleep doctors that won't spend the time to dig into the details of their patients problems even when, for example,  you can show them meaningful details from the ResMed program and they disbelieve it. 
I'll be a fellow Texan as soon as I can sell my house.  Moving to Wichita Falls and if there's anyone out there who knows a good sleep doctor there pleeeese give me his/her name.
Old82
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#20
(05-22-2017, 02:48 PM)Sleeprider Wrote: .  Pressure relief in your case can cause the centrals you are seeing. Your pressure is incredibly low anyway and pressure relief should not be necessary.  If your current pressure range is 4-6 then with EPR at 2, your EPAP pressure is always 4.0.  4/4, 5/4, 6/4.  That's it.   I'm suggesting setting pressure at 5.0 min and max or 5.0 CPAP, and no EPR.  Try it and see what you get.  If it doesn't cut your CA in half, I'll let you go right back to the old setting.


From old82 to Sleeprider
Well...what do you know? I took your advice and essentially turned my machine into a brick by turning off most of the automatic features and going to a straight CPAP pressure with no EPR or RAMP or AUTOSET and had a pretty good night! Who would have thunk it!

Last night, in spite of an unusual high leak of 29 (usually in the teens) and low hours used of just 4.4 due to my usual awakening about 4am , I had the following numbers according to the ResMed program.

Pressure set 5.0 straight CPAP
Hours used  4.4
Total AHI.     2.3
Total AI.       1.2
Central AI.    1.2
# of centrals     6
# of obstructive 0
# of hypopneas. 5

I did get a little extra sleep without the machine and mask on after the 4am wake up and overall I felt More rested than usual . I thank you for your input and suggestions . I'm going to build on these new settings and see if I can improve even more. 

Now why can't a sleep doctor come up with suggestions like yours?  I thank you .

Old82
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