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[Treatment] Using T mode on Bi pap ST machine after 2 months
#1
Using T mode on Bi pap ST machine after 2 months
Before trying to get a ASV machine for my complex sleep apnea, and not being satisfied with the ST mode getting rid of the central apneas, I set up The T mode to use tonight after some trial and error. Settings will be 18 ipap, 10 epap, RR 13, Ti max 1.5 ( I:E 1:2.0 ) and rise time 650. Seems very comfortable - resting RR is 14. As always, I'm hopeful it will work.  Thinking-about Anyone else ever try this?
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#2
RE: Using T mode on Bi pap ST machine after 2 months
Rick, you could get a lightly used ASV from Suppler #2 for $1699. It's a bunch of money, but will solve your problem once and for all. T-mode will simply give you a mechanically timed switch between EPAP and IPAP, while S/T mode allows for spontaneous trigger and uses a timed backup. I honestly don't think it will work out. Why are you not on ASV already? How can we help?
Sleeprider
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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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#3
RE: Using T mode on Bi pap ST machine after 2 months
I’ve had problems with my one and only doctor that prescribes settings and machines for me, and I haven’t talk to her for a couple of months. I have also had problems with the supplier and getting a mask that is comfortable because my initial settings were 19 / 15. I do lots of reading and understands how everything works, but wasn’t aware until recently that this ST machine was not the correct one for my issues. My treatment is covered under Medicare, so hopefully I should be able to get the correct machine from my doctor. If not I’ll get another doctor, and possibly the equipment supplier if I can’t get the mask issue worked out. Thanks for reaching out, I’ll post my results tomorrow, wish me luck :-) PS-Thanks for sending me the information to allow access to the clinical menu, without that, I’d definitely be up the creek without a paddle :-)
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#4
RE: Using T mode on Bi pap ST machine after 2 months
Of course, we wish you good luck and good comfort, but I can spot a new member with a clueless doctor pretty quickly by now. Your problems will be resolved immediately with the ASV, and because the ASV is so automatic, a titration is a waste of time. Depending on your deductibles and copays, I hope you will consider just buying out of pocket and proving it works, rather than paying for endless doctor visits, arguments, clinical sleep tests and an over-priced machine. $1700 and done, and you will change doctors anyway.
Sleeprider
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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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#5
RE: Using T mode on Bi pap ST machine after 2 months
Thank you for all the links, they will be very helpful. I already learned I have a mild case of palatal prolapse.

I thought you would be interested in the outcome of my experiment using the T mode...it never happened. Turns out, it was too out of sync at the start, so I changed some settings and used the ST mode.

First, a brief history: 68 yr old male with history of snoring and arrested breathing at night. I had 2 previous sleep study's done 10 yrs & 5 yrs ago, diagnosed as OSA, with nothing done. This summer I had 2 done within 1 week, because the first was inconclusive. In the second one, CSA showed up as well. My AHI was 15.7 - mild, but enough to start treatment that was covered my insurance. Orders were 19 / 15 with back up rate at 9, and a few other settings I can't remember.  AHI's have been 4 - 8. I had the pressure lowered twice because of pressure and leaks, only to go back up because AHI's went back up and still tired in the morning. So, after 2 months experimenting with all the settings and not being happy with the numbers, I posted this thread.

Settings; pressure settings 19 / 14, back up rate (RR) 13, Ti max 1.5, Ti Min 1.4, rise time 500, trigger & cycle set at H. After 2 hrs, RR changed to 14, rise lowered to 250, and both trigger & cycle changed to M.

Results; After 7 hrs: Leak 10, Vt 720, RR actual 13, Mv 10.3, Ti 1.5, I:E 1-2.0, Spon trig 45, Spon cyc 9, AHI total 1.0 and Ai 0.1 . 

 BEST AHI and AI numbers to date, and I feel somewhat rested.  Smile  Unusual  Ti min / max settings resulted in ideal I:E of 1:2.0.  Smile FYI, my resting awake RR is 14. I'll keep and use these settings for a week. Might be on to something. What do you think?
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#6
RE: Using T mode on Bi pap ST machine after 2 months
The recommended ST titration protocol calls for a backup rate 2-4 BPM lower than resting awake respiration rate. If the rate of 13 is comfortable, that's fine, but don't hesitate to try out 12 BPM. Once we look at some Oscar data, we can hopefully find some lower pressures that work well and are more comfortable. Your tidal volume and minute vent are unusually large and suggest you are over-ventilated. This can contribute to central apnea. Here is a link to the Resmed Clinical Titration Guide that you can use to learn more about your ST and alternatives. The ST section starts on page 37 and you will note that this device is intended for pulmonary and neuromuscular diseases, not central and complex apnea. https://document.resmed.com/en-us/docume...er_eng.pdf
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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#7
RE: Using T mode on Bi pap ST machine after 2 months
Thank you for your response. I’m 6 foot two and have unusually long lungs. Sometimes they have to take two x-rays to get the whole thing visible. No respiratory diseases that I am aware of of according to my lung doctor. I do have a chronic cough that I am trying to mitigate that’s been ongoing for 20 years. It usually only happens in the winter up here in Alaska. I will try some lower settings on the respiratory rate and also the pressure settings although I’ve been there and haven’t had a lot of success with that. Probably because I changed too many things at once every night. If my AHI‘s stay stable and low, and then I might try the lower respiratory rate first. Then  I will try some lower settings on the pressure settings. I’m going let my settings set for a few days to see if they’re stable first. One thing at a time and give it a few days to check for stability before proceeding. Again thank you for your time and response.
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#8
Pressure support of 3 on bipap machine.
4 is factory minimum, but 3 seems to work much better at keeping my airway open on my bipap machine. The c-flex setting of 3 does the same thing on a pap machine. Current setting is 10-7 for a PS of 3. Any comments?
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#9
RE: Pressure support of 3 on bipap machine.
Not much to comment on. Please post OSCAR charts so we can see what is going on.

Flex of 3 might deliver the equivalent of PS of 2 some of the time since flex is variable based in part on how hard you are breathing.
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#10
RE: Using T mode on Bi pap ST machine after 2 months
Rick, I merged your two threads because they both pertained to your therapy using a VPAP ST to treat your complex apnea. Keeping posts in a single thread helps to preserve the background, history and settings to keep things more coherent.

PS 3 is probably insufficient pressure to trigger a breath when a central event occurs. We really need to see an Oscar chart to see what is really going on with your therapy and the effect any setting changes is having.
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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