Very long obstructive apneas
I'm new to the Apnea Board and I have been on a ResMed AirCurve 10 VAuto for about a month and all the settings are the ones that come from the factory. One thing I have noticed is that in a random fashion an obstructive apnea will be flagged and the pressure increases but only after 50-60 seconds. During this time it shows that I'm not breathing at all. This seems like a long time before the pressure is increased. Do I have the settings wrong to catch this or is this just the way the machine works? Also, I found the TiControl page 6 which has a table that I can't understand. This is for the Clinician Manual Ver 6.0 and lists several patient breath rates from 10-40 with accompanying Sufficient inhalation times and Secure exhalation times. What am I supposed to do with this table? Thanks for any help you may be able to provide. If this is covered in a previous post please specify the post.
foxmt58
08-08-2018, 12:53 PM
(This post was last modified: 08-08-2018, 01:04 PM by Stom.)
RE: Very long obstructive apneas
(08-08-2018, 12:45 PM)foxmt58 Wrote: I'm new to the Apnea Board and I have been on a ResMed AirCurve 10 VAuto for about a month and all the settings are the ones that come from the factory. One thing I have noticed is that in a random fashion an obstructive apnea will be flagged and the pressure increases but only after 50-60 seconds. During this time it shows that I'm not breathing at all. This seems like a long time before the pressure is increased.
PAP machines, to my surprise, do not work like a toilet plunger to blast open obstructive apneas when you aren't breathing. It turns out that more pressure when your airway is already completely closed isn't going to help. You have to start breathing on your own before the machine can do anything about obstructive apneas.
Your machine has to increase pressure
before the airway is fully closed by monitoring partial flow restrictions and increasing pressure in response, hoping to
prevent full apneas. The minimum pressure your machine is set to also plays a part in preventing full apneas.
RE: Very long obstructive apneas
So I think you are saying that only the rise in CO2 due to complete blockage of the airway can cause breathing to begin. Thanks for your input.
RE: Very long obstructive apneas
or raise your minimum pressure?
08-08-2018, 01:25 PM
(This post was last modified: 08-08-2018, 01:27 PM by Stom.)
RE: Very long obstructive apneas
(08-08-2018, 01:02 PM)foxmt58 Wrote: So I think you are saying that only the rise in CO2 due to complete blockage of the airway can cause breathing to begin. Thanks for your input.
I'm still learning about this stuff, so anything I say is subject to correction.
When you sleep you relax the muscles holding soft tissues from restricting your airway. An apnea is when your muscles are relaxed and gravity allows the soft tissues to block your airways, keeping you from breathing for 10 seconds or more. When you stop breathing from obstructed airways, your body will try to breathe in, your chest and abdomen will try to expand to suck air into your lungs, but they can't because your airways are blocked. Eventually, the CO2 build up and struggle for breathing will wake you up enough to contract the soft tissue and/or change your body position enough to open your airways again, allowing you to breath in, then the machine can increase pressure to try to prop the airway open when your muscles relax again, a bit like putting a wedge in a door to keep it from closing (probably a bad analogy, but it's all I can think of at the moment :-) )
RE: Very long obstructive apneas
Foxmt58, if you are using default settings on your Resmed Airsense 10 autoset then the pressure is in the range of 4 to 20 cm. Most of us require higher minimum pressure in order to control obstructive apnea. As mentioned earlier, the apnea must be prevented, as the machine cannot clear an obstructed airway. The best way for us to help you is to see a #Sleepyhead chart from your machine. The software is free and the instructions for organizing and posting an image is in my signature links. At the very least, you can increase the minimum pressure on your machine to 8.0 cm, and we can give you instructions for getting into the settings menus.
Please download and install #Sleepyhead, set your minimum pressure to at least equal your current median pressure, and things should get better pretty quickly.
