[Symptoms] No relief with multiple machines

[apneapt]

Hello everyone,

I hope you are all well.

Here's my story:

I am 39 year old, slim bodied but severe nasal allergies. I have had multiple turbinate reduction surgeries but to no avail.
I got diagnosed with sleep apnea using home sleep study in Feb 2017. I suspected I had sleep apnea because I started waking up with severe fatigue.

I was started on Resmed Airsense CPAP by my Kaiser sleep doctor. Initially I used nasal mask which worked for less than a month but then I realized my turbinates swell up and cause complete blockage of my nose and thus the nasal mask doesnt work. So then I started using full face mask. I titrated pressures upto 13. I told my sleep doctor that I was still not feeling well so he recommended Bipap. So, I ended up buying Resmed VAUTO. I am using this Bipap now but I am still feeling fatigued and my AHIs are climbing up.

I am not sure whats going on. Now my pressures are upto 16 (avge). 

I seem to prefer breathing through my nose. So, what I do is I block my nose at night time so that my mouth can stay open. I use full face mask.

If anyone can, offer any advice I would greatly appreciate it.

Thanks!
apneapt

[srlevine1]

If anyone can, offer any advice I would greatly appreciate it.

Welcome to the forum.

I would strongly suggest that your download the #Sleepyhead software and provide a few screenshots so that forum members might review your "numbers" and make appropriate suggestions. You may also wish to purchase a pulse-ox unit and see if you might be desaturating during sleep. I recommend speaking with Kevin Cooper - Vendor #19 -- who is my go to guy for pulse-ox equipment. I have a CMS 50-F unit that will record data overnight which can be synced to your Sleepyhead reports.

I also suggest that another call to your sleep doctor might be appropriate as it appears that a closer look at your therapy -- on an individualized basis -- would be a better solution that continuing to guess by trial and error.

Best of luck.

[Gideon]

Welcome to the forum.

Obviously you are having issues with your therapy.  The machine that you say you are using is the "ResMed AirCurve™ 10 VAuto BiLevel" which is a very good machine.  Please update your profile to indicate this.  You can do things with this machine that you cannot do with am Airsense CPAP machine.  

Data is THE key to understand what is going on so please download SleepyHead software and upload your daily charts,  see my signature for a link to understand how to and how to organize the charts.  Select those that are suggested for inclusion in your chart.  With Sleeoyhead we can view, on a breath by breath basis if necessary, in detail every breath you took through the night.  

Also post the Home study that you took.  It will help us to understand your apnea.

The issue you stated deals with your nasal passages so let's start there.
Adjust your humidity, both up and down, what you need and your body desires is different from everyone else.   There is also a heated hose (ClimateLineAir™ Heated Tube) which I find very comfortable.

I'm sure others will jump in with their thoughts too, but try adjusting the humidifier and see if that makes a difference.


Fred

[Gary1of2]

As far as allergies you might consider acupuncture. I do it and it works for about 2 to 3 months. You never know I had allergies. She was using some kind od red solution on the needles. She did not leave them in just a prick with them.

[srlevine1]

Data is THE key to understand what is going on so please download SleepyHead software and upload your daily charts,  see my signature for a link to understand how to and how to organize the charts.  Select those that are suggested for inclusion in your chart.  With Sleeoyhead we can view, on a breath by breath basis if necessary, in detail every breath you took through the night.  

Fred,
I just read your guide and wanted to thank you for a well-explained, well-written guide to the organization and posting of Sleepyhead data.
I noticed that you said, "1. If using a Philips-Respironics machine, turn off the VS2 flag. (Toggle is in the lower-left drop-box)." Do you feel the same way about ResMed's UF1 and UF2 flags?

Steve

[Spy Car]

Welcome to the forum apneapt.

I also see a Kaiser sleep doctor for treatment of sleep apnea. While I generally like Kaiser, this system works best for people who are on top of their own situations, as the doctors and technicians seem busy and it is possible for solvable issues to go unaddressed without a patient informing herself/himself and self-advocating.

It is critical that you figure out how to load data from the SD card inside your AirCurve to your computer using "Sleepyhead" software, and then posting the chart here using the Imgur photo hosting service. Links on how to accomplish this are in Gary's signature above (see post #4) among other places on this forum.

Seeing the charts will allow experienced members to advise you on what's going on with the therapy, so you can go back to your doctor with information.

If your AHIs are going up and you are feeling worse on Bi-level, I'd particularly like to see what percentage of CA events you are having. I'm not among the most sophisticated of analysts here (and generally like to leave that advice to others), but I have walked this path and know that *if* your problem is CAs, where you
just stop breathing (instead of more common Obstructive apneas) that a Bi-level can make matters worse.

We need to make sure you have the right machine. If you do, others will be able to help customize the pressure settings. If it is a problem with CAs (as it was with me) you would need a different type of machine, called an ASV. We don't know this--but worsening on Bi-level raises my suspicions--so seeing charts is imperative.

Also, at my Kaiser sleep clinic they have some brilliant Pulse Oximeters that are re-branded as ResMed products. srlevine1 owns one (and has written about them) and I got to borrow one. These are neat because they plug right into ResMed devices, have a comfortable sensor, and import Pulse Ox data directly with regular Sleepyhead imports. Once you load Sleepyhead you might ask to borrow one from the Kaiser Sleep lab to check your Oxygen levels. If they are concerning then you can figure out if you need your own Pulse Ox device.

Do heed the advice to load Sleepyhead charts. This is the key to improving your therapy.

Best,

Bill

[apneapt]

Hey guys

This forum wont let me post pics or links until I have 4 posts...??

---

May be this time it will work.

---

Thanks

[apneapt]

How can I show you guys the data?

This forum wont let me post!!!

You guys are so great.
Thanks

[Gideon]

Until you get "Member" status, add a space to the URL "htt p://IMGUR/xxxxx.png"

UF1 and UF2 are user defined flags.  Normally they should be off. 

Fred

[apneapt]

since I cant post pic. I will just type it up for all of you. Bill I think you were so right. Take a look:

AHI, Clear airway, obstructive, Unclassified apnea, Hypopnea
10/25/17: 7.3, 6.23, 0.89, 0.18, 0
10/24/17: 13.86, 11.43, 2.29, 0 , 0.14
10/23/17: 7.3, 3.07, 3.8, 0 , 0.44
10/22/17: 6.27, 4.17, 1.37, 0, 0.2
10/21/17: 6.2, 4.3, 1.6, 0.15, 0.15
10/20/17: 7, 4.9, 1.5, 0, 0.5
10/19/17: 9.77, 9.1, 0.6, 0, 0


Thank you

---

htt ps://i.imgur.com/QqmrfD3.jpg

(I put a space in htt ps)