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please review seeing my Doctor soon
#1
please review seeing my Doctor soon
I have recently switched to a Resmed airsense 10 for her from a PR system 1. As others have said the Resmed is more aggressive. My PR would rarely get above 12 where as the Resmed goes up to 16. My results are better with the Resmed. I have been noticing that at times (to many) my respiratory rate has gone very high (34 instead of 20) and at the same time my tidal volume has gone very low (280 instead of 420), which has me concerned.  I will be seeing my pulmonologist (also a sleep Doctor) on Wednesday and I want to discuss this. I have life long asthma and allergies and my lung function is about 30% below normal.

Any input would be appreciate.
Thanks, Car54

normal 

[Image: ibgd89z.png]


abnormal

[Image: RI34Qlx.png]









p
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#2
RE: please review seeing my Doctor soon
Car54, you seem to bed doing great on the Resmed machine at these settings, and I notice that the improved tidal volume coincides with greater EPR. I think your doctor will focus on how you're feeling and will likely compliment you on the very good results. You can discuss your respiratory volume and rate concerns with him and see if he has an opinion. Bilevel could potentially improve those metrics, and is a fairly common thing to use with COPD and asthema, but you seem to be doing well, so it's going to be a pretty tough case to make.
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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#3
RE: please review seeing my Doctor soon
Just out of curiosity, is there a thread on the forum that explains how to read these charts?
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#4
RE: please review seeing my Doctor soon
Sleeprider, I just lowered the EPR for that night, I have other nights with the full EPR and the same low results. Is the respiratory rate so high because I am taking shorter breaths? Also, how does the higher pressure affect my breathing, is that what is causing it? My PR would never go above 12 and my respiratory rate and tidal volume were almost always what I would consider normal.

Car54
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#5
RE: please review seeing my Doctor soon
Paulag1955 - Sleeprider's sig lines, in the post before yours has a useful collection of links. The one you want first is Robysue's Guide to SleepyHead : http://www.apneaboard.com/wiki/index.php...SleepyHead - which has lots of useful information about SleepyHead's charts.
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#6
RE: please review seeing my Doctor soon
Pholynyk, thank you!
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#7
RE: please review seeing my Doctor soon
While on CPAP I had similar problems with my resp rate and tidal volume and I think it was directly related to the amount of pressure I was trying to exhale against, I was basically fighting it.  I was given the BiPAP titration study and had horrible results all related to central apnea, but concerning my resp rate and tidal volume, the BiPAP made me feel good that night, but I feel even better after two nights on ASV.
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#8
RE: please review seeing my Doctor soon
Car54, I know we have done a number of trials of alternative pressure, but I don't recall the results. Both of the charts above have a maximum pressure of 16, and due to flow limitations, you stay pretty close to that maximum. The biggest difference between the two nights is that in the better graph, your median EPAP is 10.8, while on the one with lower tidal volume it is 12.8. That is pretty significant for someone with primarily flow limitation without apnea. I'm sure we have suggested bilevel might be a better option, but without getting into that, what were your results at a lower maximum pressure? I recommended the higher EPR to you for exactly this reason, and I think you do better when you use it.

You might want to update your profile (USER CP) and correct the machine you are actually using.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
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Optimizing Therapy
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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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#9
RE: please review seeing my Doctor soon
Sleeprider ,

Here is a screen shot when I was using the PR Pressure which is set at 9.5 to 13 but the 95% only goes to 10.20. My respiratory rate is 17 with a tidal volume of 460. That is drastically different then the Resmed. The Resmed is treating me better but with a high respiration rate and low tidal volume, I am concerned.

[Image: ABHDxYt.png]
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#10
RE: please review seeing my Doctor soon
As noted above, you seem to have chronic flow limits, yet find breathing easier at lower pressures. We've seen this in other members. You might want to try some lower pressures and see how you feel, and what you tolerate before events increase. I don't really see APAP as an effective tool to address volume and respiratory rate issues, and any concerns about that would be better to discuss with your doctor.
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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