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[Treatment] New to therapy, not going well
#31
RE: New to therapy, not going well
(03-08-2018, 08:59 AM)mjoereid Wrote: Thanks for the welcome and comments. I'm not concerned with the hypopneas  anymore. Its the CA's that seem to show up more towards morning that I would like to reduce. Not sure why they cluster towards morning but would like to cut them down if its possible.

I'm guessing on these CA events, so I advise to take with a grain of salt: this may be sleep/wake junk that can give you all kinds of wacky, and sometimes false event data. In other words, you may be in that transition of sleeping to waking, and you may not be fully or otherwise aware of this transitional phase.

Coffee
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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#32
RE: New to therapy, not going well
Hello,

The ramp setting is to allow the air pressure to start out slow at a lower pressure as you slowly fall to sleep. It is adjustable both in pressure and the time of the rap up delay. For example, I have my machine set to 5 as the starting air pressure, and the time as 5 minutes.
So as I lie down the timer automatically begins counting and the pressure slowly rises to the level needed to keep me under good control. The pressures then are automatically regulated between the minimum air pressure set point and the maximum, for me it is 6 to 14, the machine will adjust the pressure as it needs to during the night, you need to only have your mask correctly attached and try to avoid leaks.

PS: If you don not have a mask that covers both your nose and your mouth, and during the night you open your mouth, this is a giant leak and will render the cpap treatment useless for all practical matters, so insure you do not breathe thru your mouth OR use a mask that covers your mouth. You can purchase a good chin strap that will wrap around your head and lower jaw to assist in keeping your mouth shut, but the best solution is a full nose and mouth mask if you are a mouth breather, then you are good to go.
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#33
RE: New to therapy, not going well
Generally I am not a mouth breather but once a night once a week I will wake up with a dry mouth and leak rate off the chart. I have tried the full face and have to say it drove me crazy and I ripped it off and went the rest of the night with nothing. I use the P10 and think I have good results with it.
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#34
RE: New to therapy, not going well
Been a few weeks and things seem to be going well except last few nights where I've had some of my highest AHI yet. Mostly CA. Here are the last 5 nights, any ideas/suggestions.
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#35
RE: New to therapy, not going well
For some reason I can't get screenshot of last night but it was AHI 7.02. Mostly CA clustered in first 2 hours of sleep and last 2 hours.
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#36
RE: New to therapy, not going well
Just knocking this up the list. Any comments, suggestions?
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#37
RE: New to therapy, not going well
These results are consistent with the earlier results you posted. I think you should set your machine to a range of 6.0 to 8.0. You have never benefited from pressures above that level. Your CA rate is within reason, and I think most doctors would attribute it to sleep transition or disruption, however it may be real. We know your CSA is worse when EPR or pressure support is used, so the CA may be real. It is really below the threshold where you would likely be authorized for ASV treatment.

I have an idea that might help, although we don't do this very often. You can install a Heat-Moisure-Exchanger (HME) between your CPAP tube and the mask. Just look for "CPAP HME" online. These devices are only about $5.00 and are often used when a machine does not have a humidifier. Its benefit to you is that it slightly increases the dead-space in the CPAP tubing to conserve CO2. This might reduce your events a bit.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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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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#38
RE: New to therapy, not going well
(04-20-2018, 08:09 AM)Sleeprider Wrote: These results are consistent with the earlier results you posted.  I think you should set your machine to a range of 6.0 to 8.0.  You have never benefited from pressures above that level.  Your CA rate is within reason, and I think most doctors would attribute it to sleep transition or disruption, however it may be real.  We know your CSA is worse when EPR or pressure support is used, so the CA may be real. It is really below the threshold where you would likely be authorized for ASV treatment.  

I have an idea that might help, although we don't do this very often.  You can install a Heat-Moisure-Exchanger (HME) between your CPAP tube and the mask. Just look for "CPAP HME" online.  These devices are only about $5.00 and are often used when a machine does not have a humidifier.  Its benefit to you is that it slightly increases the dead-space in the CPAP tubing to conserve CO2.  This might reduce your events a bit.

Thanks, I will try the CPAP HME. I think I have seen them in my internet travels. If my CA is real would I benefit from an ASV machine?
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#39
RE: New to therapy, not going well
You have between 2 and 7 AHI, mostly central. The benefit of ASV is that you would probably have near zero events, however, ASV itself is not without its drawbacks and disruptions. It is also very costly, and you need to have some cardiac screening to ensure your hearth ejection fraction is satisfactory. This therapy is not all about the numbers, and the primary benefit is to resolve sleep disordered breathing to prevent arousals that can cause fatigue, brain fog and other issues related to inadequate, or poor quality sleep. If you are sleeping okay, I'd say stick with the CPAP; if you feel like your life is not under control due to sleep issues, then perhaps ASV is where you go.

Member SpyCar is probably most familiar with this level of AHI/CAI and moving to an ASV.
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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