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questions to my new apap
#1
questions to my new apap
Hello guys,
this was my first night with my apap and i have some questions. I have a Resmed airsense 10 autoset.
My doctor was absolutely against the usage of bipap since he thiniks that it worsens UARS. He claims that he is the leading sleep Physician in germany since he dealt with the most patients (germanies health care system seems kinda thrash honestly). My questions are the following :

1)I cant remove the plastic in place of the humidifier its kinda stuck. Any idea how to remove that ?
2)Normally i wake up multiple times a night. With the apap i only woke up once in 8 hours of use. After the 8 hours i removed it and slept for another 6 hours, and am still tired. Any ideas where to go from here ?
I have to add i went in for titration but the doc and his team were incredibly lazy. They just put the pressure at 5-15 and said the APAP automatically does the rest lol.
I will include an Oscars of my first night and a pic of the APAP and the part which i need removed.
I would really appreciate your guys help.


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#2
RE: questions to my new apap
As I guess since I don't have the cover plate. Press down on the center ribbed section and pull it out and pull off the cover plate.

As a general rule your doc is wrong about UARS and BiLevel. BiLevel is the medical treatment of choice for UARS in the CPAP family though it is more expensive than the CPAP.
In your case your doc may be correct in that you have a fair amount, not a critical amount of Central Apnea and it is ok to assume that an increase in PS or EPR on your AutoSet, may, ONLY MAY, increase your Central Apneas. The only way to know for sure is to try it and if too many central occur then back off and reassess.

Also you are talking UARS. UARS is all about the flow limits, the hard part is to know when you have chased them enough, this is mostly a subjective choice. We like to see your 95% Flow Limit Stat at 0.03 or lower and rely on how you feel for a subjective analysis. UARS is best treated by increasing EPR or PS on a biLevel.

Therefore
Set Min = 7
Set EPR = 3
Try over night and repost
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#3
RE: questions to my new apap
(07-19-2022, 12:35 PM)enzo1 Wrote: With the apap i only woke up once in 8 hours of use. After the 8 hours i removed it and slept for another 6 hours, and am still tired. Any ideas where to go from here ?

Stop doing the part where you sleep with it removed. That's the fastest way to get yourself feeling better again. It's likely not going to happen in a day or even a few days.
Sleepster

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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#4
RE: questions to my new apap
This is my second night. I think the flow limits are better now, but subjectively i dont feel better yet.
Let me know what you guys think. I think i woke up more today than yesterday tho.

Is there any way to control in which stages of sleep i have been, since my deep sleep phases were so low?


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#5
RE: questions to my new apap
Not specifically. Minimizing disruptions is our goal. This means minimizing, within reason, not shooting for zero, events.
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#6
RE: questions to my new apap
Your flow limits are better, your central apnea is not worse with the increase in EPR. That is proof, that for you BiPap is not worse. Not me or anyone else saying it, but concrete physical proof based on your charts.

I don't see a need for an ASV, but the trigger function available in the VAuto may reduce your centrals.


You will not feel better overnight
I'd actually keep these settings for a while and expect a very gradual change in how you feel.
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#7
RE: questions to my new apap
What exactly is the trigger function ? And why are my central apneas with the mask at home 3.2/h but in the sleep lab 0.5/h ? Is it possible that those are other apneas but are missinterpreted by the machine or the software?
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#8
RE: questions to my new apap
Is my Leak rate normal ?
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#9
RE: questions to my new apap
(07-20-2022, 08:54 AM)enzo1 Wrote: And why are my central apneas with the mask at home 3.2/h but in the sleep lab 0.5/h ?

That's not a clinically significant difference. It can fluctuate like that for no reason. Sometimes you have to look at several days or sometimes weeks of data to draw conclusions.

(07-20-2022, 09:00 AM)enzo1 Wrote: Is my Leak rate normal ?

There are are large chunks of time where your leak rate is elevated. Most likely mouth-leaking. You can try a full face mask or a chin strap. Both are available from your equipment supplier and most likely covered by your insurance. Or you youu can buy a soft cervical collar.
Sleepster

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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#10
RE: questions to my new apap
Your APAP algorithms via analysis of the flow rate picks when to shift from exhale to inhale. Trigger adjusts the timing/sensitivity of that shift. This can literally trigger you to breathe at the onset of a central. A higher setting so you trigger with a smaller change is we would be trying to accomplish. While not designed to do that it is effective for a number of people.
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