VPAP ST Help

[delaserna]

Hi
Two months ago, sleep apnea was diagnosed. vpap s / t was given by the doctor two weeks ago. EPAP 4 IPAP 15 settings have been made. Medicalist breathing rate was 12 trigger medium, cycle medium, rise time 150 ms Ti min 1 Ti max 2 adjusted. First night results AHI 8.9 / UA 5.4 H 3.5
By reading the comments from the apneboard, I changed the settings to high trigger, breathing rate 10 Ti min 0.5 Ti max 2.5. My best result is AHI 3.04 . But another night at the same setting was AHI 10.
I request your help with the settings.
I am writing from Turkey, and unfortunately I do not know English. I write with Google translation. There may be spelling mistakes. I'm sorry in advance.

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[jaswilliams]

It looks like you have central apnoea and have been given an ST machine with ivaps function. It does not seem to be working for you. If you don’t have any other health problems then an ASV machine is best

[delaserna]

Unfortunately they don't give ASV. The value appeared below 5 in titration (4,8). For this reason, Bipap ST was given.

[delaserna]

AHI values for 9 days are in the table. I would like your help. 

[Gideon]

Hi
I made some changes on my own device according to what you wrote in the forum, but I was not successful. I opened a new topic in the forum. Please can you help me?  

This thread is the only thread that you have here at AB so nobody here has given you advice. The settings and machine that you have are those that are, or should be provided for pulmonary insufficiency (poor lung function).

1. It is important to know if you have any other lung or breathing issues other than apnea.
   
2. Is this your first machine?
   
3. Do you have results from another machine, if so can you post them. 
   

[delaserna]

I don't have any lung disease. Vpap ST is my first machine. I add my polysomnography report. Thanks

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Diğer sayfalar

[Sleeprider]

I received your PM requesting help, and suggesting that you had used my recommendations to help setup your machine. As Bonjour said, I have never recommended that someone setup an BiPAP ST with EPAP 4, IPAP 15 (PS 11.0).  The problem with your current settings is that the large pressure support (difference between IPAP and EPAP) will cause central apnea, and make you reliant on the timed trigger to IPAP. It is a very very poor choice for therapy! I actually think you should have received an auto CPAP or Auto bilevel (Vauto) rather than the ST.  We can help you get the best therapy from your current machine which has many features of an ASV. Please clarify if your diagnosis included central apnea or just obstructive, and be sure to download a copy of the Resmed Aircurve 10 ST-A manual (I have included instructions below).

Go into your settings, and change the mode from ST to iVAPS. Use the following settings:
Mode: iVAPS
EPAP: 5.0
PS Min 4.0
PS Max 15.0
Enable iBR (intellegent breath rate)
Set Target PT Rate: 12.0
Target Va: 500 or use the Learning Mode below
Ti Min: 0.7
Ti Max 2.0
Rise Time: 300
Trigger: High
Cycle: Medium
Height: Set your actual height in cm
Mask: Full
Ramp: Off

Instead of setting the Target pt Rate and Target Va (breath rate and alveolar minute vent), you can use the following Learning Procedure.  (This is from the clinical menu that you can obtain by sending an email to: apneaboard@gmail.com and put Setup Manual in the subject line. Then, write Resmed Aircurve 10 ST-A in the body of the email.)




This settting will provide dynamic pressure support to resolve your central apnea.


This is the titration protocol we will follow:

[delaserna]

The doctor gave ASV and BIPAP ST to try. AHI 2.7 on ASV device appeared. 4.8 appeared on the BIPAP ST device. Paying only contribution to the state apparatus in Turkey. We need to pay about $ 3000 for Aircurve 10 ASV. And for ASV, first, BIPAP wants us to document that the ST device does not work. And this is very difficult.

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Thank you very much, I will carefully apply what you say and write the result.

[Sleeprider]

You clearly should have gotten a ASV machine. The ST-A that you have is equal or more in expense to ASV and I think they meant to dispense the ST which has strictly fixed pressure. If you can get a prescription for ASV, you can purchase a new or lightly used ASV from Supplier #2 for $1749 to $2250 (new) USD plus shipping. It might be less money to go that route. You have a very very expensive machine with the ST-A and could probably negotiate an exchange of ASV for your ST-A with Supplier #2, however you will need a translator.

[delaserna]

unfortunately I paid about $ 1000 for this machine. But the state owns this machine because it contributes. I need to return it when I'm done or not using it.