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help [complex sleep apnea, AirCurve 10 settings]
#1
help [complex sleep apnea, AirCurve 10 settings]
Hi guys,can anyone look at my sleepyhead figures to see where im going wrong?
I have been on therapy since Feb (complex sleep apnea) but still struggling.
The headaches I suffered from almost daily are nearly gone ,which is a huge bonus but I am still feeling tired all  the time and feel like Im actually
being awoken by my aircurve 10 machine constantly throughout the night.
Although the sleep clinic (nhs) are really nice I just dont feel tht they realy know whats going on with me.
I am also waiting on an ENT appointment as I cannot breathe through my nose due to a deviated septum.Could this be a factor even although 
I have a full mask?
The neurologist started me on a low dose of Mirtazapine to help me drift off which is great but I just cant stay sleeping 
I am awaiting a titration study so finger crossed that that helps :-(
Any advise would be great
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#2
RE: help
Please feel free to attach Sleepyhead charts to your posts. The forum software allows attachments to be made regardless of post count. The tutorials for chart organization and posting attachments are links in my signature below. We have many members that use ASV for complex apnea. If you are using an Aircurve 10 S or Vauto, you probably need to get upgraded therapy using an adaptive servo ventilator (ASV). As far as nasal congestion, you might be surprised to find a nasal pillows mask provides more relief than a full face mask. Nasal pillows direct the air pressure directly into the nares and open the nasal passages. Many of us are chronically congested but can breathe freely at night using a nasal pillows mask.
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#3
RE: help
cheers sleeprider,I am on way out the door but will post the info tomorrow.I forgot to add I have tried the nasal pillows but couldnt tolarate as I felt like I was suffocating .
Thanks for the quick reply
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#4
RE: help
not sure if this worked properly :-)


Attached Files Thumbnail(s)
   
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#5
RE: help
Your image shows you are using a Resmed Aircurve 10 ASV in ASVauto mode, with a minimum EPAP pressure of 4.0, Maximum pressure of 22.0 and PS min 3.0, PS max 15.0. The AHI is only 0.88 and appears to be all hypopnea. The machine pressure support stays busy managing your breathing.

There are some scale problems with the image, so it's hard to interpret everything going on, and I think the problem is you are showing too many graphs like everything below the Flow Limit. It appears you are using a very long ramp period of 45 minutes, and this is where most of your event occur. You really need to turn that to auto or shorten the ramp to somewhere between off and 10 minutes. Ramp is not recommended for ASV.

Based on what I'm seeing here, I would like you to reduce the PS max from 15 to 12. This might help with the sleep disruption, and I don't anticipate a significant impact on your therapy. I think you should also use a EPAP min of 5.0 to help avoid hypopnea, and based on your machine's behavior when ramp is not on. You really need to kill the ramp.
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#6
RE: help
Cheers Dleeprider will give that a go tonight ?really appreciate the advice.Will try what you have recommend and get back to you ?
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#7
RE: help
Starting in Feb is still early days. The pressure does take a while to get use to, especially with an ASV. One tip after you turn the ramp off. When you are falling asleep and it's increasing, unwanted high pressure. Is to blow back hard, this resets the machine pressure. Your brain will soon get use to breathing steady and not upsetting the machine.

If the column on the left is right and not picking up a false reading. It's hard to tell with the chart set up you have. It could be a glitch but the median 820 tidal volume and 8.8 breaths a minute is out of the norm. Do you normally have a slow breath rate and have counted it while awake?
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap from machine data, or software. Set the min pressure at 'med' median pressure or 90% OR 2cm below 95% pressure. max pressure at 20cm for now. Forum will help you fine tune settings
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#8
RE: help
I think I breathe quite fast and hard due to blocked nose,Will try and get a better picture uptonight cheers
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#9
RE: help
If you provide a zoomed image of your flow rate over about a 2-minute period, we can tell much better what is going on. Any period that does not include ramp will be fine. This lets us see the individual respiration wave form and count the breaths per minute. Your statistics suggest a respiration rate of about 9 breaths per minute. We normally expect to see in the range of 12 to 18 with the median being right about 15 BPM. The statistics show your minute vent is healthy at over 7 L/min due to the high volume per breath of 820 mL. A zoomed image lets us verify.
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#10
RE: help
At last ,people that seem to know what they are talking about :-) As I said ,I have little faith my sleep nurse
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