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hookedonstitch - Therapy
#41
RE: Angela P Therapy
The full name of the machine you want is the Resmed Aircurve 10 Vauto, however the Aircurve VPAP S would be suitable and a bit less expensive. The only real difference is the S has fixed pressures while the Vauto is capable of auto-titration like your Autoset.
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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#42
RE: Angela P Therapy
(07-22-2021, 07:35 AM)Sleeprider Wrote: The full name of the machine you want is the Resmed Aircurve 10 Vauto, however the Aircurve VPAP S would be suitable and a bit less expensive. The only real difference is the S has fixed pressures while the Vauto is capable of auto-titration like your Autoset.

Thanks Gideon and Sleeprider for the full name of the machine that I will be looking towards in the future.

I hope someone here can explain what happened to me last night because it was a very scary feeling!  I was on the verge of falling asleep when all of a sudden I got really dizzy, felt like I wasn't/couldn't  breathe and my heart skipped a beat with a force I haven't felt before (I do get palpitations/have had a full Cardiac workup that gave an all clear).  It passed in a few seconds but it was so unusual that I screenshot the time on my phone.  As I suspected it did coincide with an event.  Is this what a central apnea does when I am asleep?  It happened at the exact same time as my first CA event.

Since my machine and OSCAR are not talking to one another again, this was in the APAP for her mode, pressures 6.6 to 8.8, when this event happened I had EPR on 2 with the intention of trying something different but after that I set EPR back to 3.


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#43
RE: Angela P Therapy
(07-15-2021, 08:48 AM)Crimson Nape Wrote: First, my observation is based on your most recent screenshot and I haven't read the thread's history.

Using an EPR of 3 in an attempt to reduce flow limitations, is not reducing them to a low enough level.  This is causing your CPAP to increase its pressure in an attempt to overcome these restrictions.  Based on your flow limit value, your CPAP will probably always go to the highest set pressure.  At the same time, the EPR's pressure difference is also inducing CAs.  This is akin to a double-edged sword, which do you want to reduce the FLs or the CAs?  It would appear that you have hit the best medium.

Unfortunately, an event is reported as a binary value.  Either you have one or you don't.  In reality, it is a little more gray.  Yes, you have an event, but how long did it last?  If the few CAs that you are experiencing are of minimal time, then that's the best trade off with flow limitations that you can make.   However, as the CA's event duration increases, so should your concerns and a decision to decrease your pressure would be in order to help reduce the CAs.  The CAs could be pressure induced and may subside as your body becomes acclimated to the pressure.

I realize that I have provided a bunch of definite maybes, but based on your last results, I would look more to how you feel.

Hi Crimson Nape, I'm going back through this thread and had a couple of questions.  My CA events are still unpredictable (as I have come to understand they will be) but how long for each event is too long?  Mine are not around 15 seconds long or under.  As I am increasing the pressure, the CA events are getting longer :Sad   

I still feel exhausted every morning and it's been 7 months of APAP therapy now.  I do have insomnia and PLMD that I am dealing with too but even after getting 7 hours or more of sleep I wake up yawning and spend the rest of the day in a complete daze.
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#44
RE: Angela P Therapy
I don't think you ever fell asleep and experienced a brief pause in breathing at the end of some deeper awake respiration. After that flow limitation increased to the break in therapy. I have no explanation for it, but this looks like a transition to light sleep and it may be that you arose from that as a result of increasing respiratory effort. With EPR at 3, I encourage you to set the minimum pressure to 7.0 to get full advantage of the pressure support available.
Sleeprider
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____________________________________________
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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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#45
RE: Angela P Therapy
Thanks Sleeprider, this is what I have done with the minimum pressure.  Am I right in thinking turning down the EPR will further increase the flow limits?
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#46
RE: Angela P Therapy
How many times are considered the norm for waking up and/or changing positions per hour using CPAP?  Also, how long is it before a CA becomes too long?  Mine have now increased to 13 seconds.
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#47
RE: Angela P Therapy
Couple of comments from an Ontarian here

Angela, you could try talking to your GP. Explain to your GP that your current sleep clinic doesn't "get it" in terms of your quality of sleep and see if you can be sent elsewhere. Explain to your GP that you have flow limitations that are not being addressed and see if they can recommend you to a sleep clinic that is knowledgeable about this. That it is more subtle than an apnea event, but equally disruptive to quality of sleep.

Sunnybrook Hospital has a sleep lab, and while I know nothing about the lab particularly, Sunnybrook, in general, seems to have good equipment. Other hospitals may also have sleep labs which may have better equipment. Just a thought.

Question: is this flow limit situation called UARS?

If it is, Dr Stephen Parks seems to be a Dr. Who writes a lot about UARS. He also has a website with info. His books can be borrowed at the library. If Mississauga library doesn't have it, the books can be borrowed via the TPL. Sometimes having a "authority " to back a discussion with a doctor can help.

Also, Angela, if you do decide to go rogue and pay for your own AVS, you will be able to sell your APAP if you want. I see a lot of machines on Kijiji. Not lately, only old stuff ... really old stuff. So your machine would stand out like a winner.

Another alternative....your GP should be able to write a Rx for an AVS at least to support a rental trial. That's assuming you have a responsive GP
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#48
RE: Angela P Therapy
This wiki on Apnea Board explains UARS and the use of bilevel therapy well. I am not a fan of using ASV for flow limitation and UARS, although it is being done by the doctor that wrote the article in our wiki, it just isn't usually the first choice. http://www.apneaboard.com/wiki/index.php..._and_BiPAP
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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#49
RE: Angela P Therapy
Angela -- I get that "don't know the settings" in red thing when OSCAR loads up data without being able to find the SETTINGS directory or the STR.edf file when it does the load. Depending upon what went wrong, you can go to the OSCAR Data->Advanced->purge current selected day and purge any that have the funky message, and then reload data.
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#50
RE: Angela P Therapy
Sleeprider, ah Dr. Krakow .... I forgot about him. Yes that is an excellent article. He makes many good points, like what you don't look for you won't see.

So flow limits and UARS, he said are interchangeable.

I think this helps Angela indirectly.

Angela, when you talk to your doctors about your issues maybe you could bring them a copy of this wiki article. Ask your doctor if they know about UARS and discuss how it impacts your sleep and energy levels.

Years ago, a doctor I knew said being a good doctor was like being a good Detective. The patient comes in with a bunch of clues or symptoms and the doctor then sorts through them to determine what is relevant to come up with a diagnosis.
Sleep-well
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