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how do i slow down the surges?
#11
RE: how do i slow down he surges?
sleeprider  Thanks for the details.  It's a nuisance to remove the SD card every day and stick it in the computer so OSCAR can download the info, then go put the card back.  They should make a WiFi connection!

Also I am somewhat alarmed.  My doc says my main problems are OSA now, based on sleep study 9/1/2020.  The prior was CSA.  Could it be possible that one sleep study could mask the CSA?  The risk is that I may get a new ResMed but not the version that supports CSA therapy, when I might need it.

I put the machine on CPAP 11cm mode because of the diagnosis.
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#12
RE: how do i slow down he surges?
It would be helpful if I could see a definition of the acronyms "EPAP" and "ASV".
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#13
RE: how do i slow down he surges?
You were diagnosed with CSA in a sleep study and OSA in another study. We would need to look at the results of those studies. You should request copies of all sleep studies and keep them on file. It is extremely unlikely that if you had CSA it would be spontaneously resolved and become OSA unless it was induced by a condition such as taking opiates that you have discontinued. What kind of events did you have when using CPAP mode the other day? According to the chart you posted, you had 0.00 obstructive, 1.03 hypopnea and the other 4 events per hour would be central. Sure doesn't sound like OSA to me. It's possible we could clean that up with lower pressure than the 11.0 you used. You might want to try CPAP mode at 8.0 cm.

If you click on the link for our Wiki at the top of the page, there is a list of terms and acronyms there.
EPAP is the "expiratory positive air pressure". This settings establishes the pressure that occurs during exhale. In ASV we set the EPAP at a pressure high enough to prevent obstructive apnea, then use the pressure support to treat hypopnea and central sleep apnea events. It also can even out the respiratory volume in individuals with periodic breathing or Cheye-Stokes respiration.

ASV is the "adaptive servo ventilator". Your machine is capable of adjusting pressure support on a breath by breath basis. It "adapts" or adjusts pressure to help you maintain a steady respiration rate and volume (minute vent).

As far as downloading new data, we can use any data already recorded on past days to look at what is going on.
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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#14
RE: how do i slow down he surges?
deleted because I can't edit for some reason.
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#15
RE: how do i slow down he surges?
sorry, edits won't save. I'll try some other way.
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#16
RE: how do i slow down he surges?
one mistake doctors seem to make is to ignore history. mine ignored 5 previous sleep studies and a diagnosis of central sleep apnea. he said let's just see what's happening now. that test produced nearly equal numbers of obstructive and central apnea but he ignored that too and prescribed an apap that won't treat central apnea.

one problem with depending on the result of a single night is that central apnea presents inconsistently. I suppose it's possible your earlier diagnosis was mistaken or you might have changed somehow; more likely, the night of your latest sleep study might not have been typical for you. personally, I'd want to be sure your current diagnosis of obstructive apnea is accurate before committing to a different machine.
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#17
RE: how do i slow down he surges?
I was more or less coming to the same conclusion.  I may schedule an appointment with a respiratory therapist to program my current S9 VPAP Adapt.  I probably messed it up.  And consult again with my current doc and ask him how confident he is that I am clear of  CSA. He said something I did not completely understand, sometimes OSA presents as CSA or CSA evolves into OSA, or something like that.
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#18
RE: how do i slow down he surges?
could be, idk. 30 odd years ago I was in my early 30's when first diagnosed with central apnea. with age and weight gain I developed obstructive apnea as well, but I have no reason to think the central evolved into obstructive as I continue to have both and as far as I'm concerned the the age and weight adequately explains the newer obstructive apnea.

you may have reasons to want your RT to adjust your settings but you can easily accomplish that on your own with less expense, more quickly and more often if necessary as you hone in on your optimal settings. ask here if you don't know how it's done. then, when you post oscar charts, folks here will help you optimize your settings to get the best results.
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#19
RE: how do i slow down the surges?
I submitted a request for settings manual per the protocol on this board.  Not received it yet.  I can see my previous settings for ASVAuto on OSCAR, set by my previous doc.  I can use them as a starting point.

I will try to upload some data from OSCAR when I figure out how to organize it.  I have OSCAR v 1.1.1+2d69049c.

Thanks for the help.
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#20
RE: how do i slow down the surges?
Here is the titration protocol and default settings for the S9 VPAP Adapt.  With ASVauto mode, the recommended settings are EPAP min 4.0, EPAP max 15.0, PS min 3.0, PS max 15.0.  In ASV mode the EPAP is fixed at 5.0.  We can optimize these settings on the forum for any events you might see, and that usually results in a smaller ranges in EPAP and PS settings.  The VPAP Adapt and Aircurve 10 ASV have no settings that allow for timing of the time of inspiration or trigger sensitivity which are features on the Vauto.  I'll be the first to say that I think this is something Resmed should revisit to improve their machine, however most users adapt pretty quickly.  Here is the titration protocol.  I think if you post some of the daily detail charts reqested earlier, you might be able to avoid a clinical titration.  Your choice.

[Image: attachment.php?aid=4210]
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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