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Yet another newbie - I'm clueless... - Printable Version

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Yet another newbie - I'm clueless... - RandyR - 03-07-2017

After years of listening to my wife tell me that she has to poke to me keep me breathing through the night, I had a sleep test done in Mid-January and based upon the results, I picked up new Bi-PAP equipment On Friday, Feb 17.  I've used it every night, except once when I had a red-eye flight.

Good news is that my Apnea events are down from 70 (as measured during the sleep test) to around 12 to 13.  Per "myair.resmed.com" daily updates, I'm performing well with daily scores in the range of 90 to 96, with most scores between 94 and 96.

So, could I be doing better?  My sleep seems a bit better from a "feeling" point of view, but am I getting the full benefits of this equipment?  Can my Aircurve 10 Auto be tweeked to give me better results?

I've downloaded sleephead and formatted the output per the instructions...
I've downloaded ResScan...

But I'm clueless as to what it all means, how to interpret this data, and what actions I can take to get the most out of my investment.  Hence, my first post.

Thanks,
Randy...

(I'll see of posting 3 more replies gets me to the magic "4" number)

Post 2...

Post 3...

Post 4...


RE: Yet another newbie - I'm clueless... - RichardVT - 03-07-2017

Welcome!
I would think you should be able to fairly-easily get your index down to 5, then try to tweak from there to get lower than that down the road. Others will come on to help you out a lot!


RE: Yet another newbie - I'm clueless... - RandyR - 03-07-2017

Sleepyhead pic attached (?)...
[attachment=3260]


RE: Yet another newbie - I'm clueless... - RichardVT - 03-07-2017

I would say you could increase your pressure, others will help more than I can.


RE: Yet another newbie - I'm clueless... - justMongo - 03-07-2017

Yes, we can offer suggestions that may get better results.
Of course the graphs from software tell the story.

To slow down the occasional spammer, we make a new member get to 4 posts before they can post a ink.
We also, slow the rate at which a new person can post. Now, it appears you edited your original post -- still only counts as one.

Post your screenshots from Sleepyhead or ResScan to a photo sharing site like imgur or photobucket.
For new members we will permit a "broken link" to imgur or photobucket for CPAP data only.

Be sure to redact any personal information from your screenshots (real name, et cetera).


RE: Yet another newbie - I'm clueless... - justMongo - 03-07-2017

@RandyR: You have a lot of central events. More centrals than obstructive.
The Aircurve 10 Vauto is a good machine. It will raise pressure on obstructives; but not on centrals.

There are 3 pressures set for Vauto: IPAPmax, EPAPmin, and PS (Pressure Support).
The split between IPAP and EPAP is set by PS. In your case at 4 cm-water.

Your centrals seem to cluster after the machine advances pressure in response to obstructive events.
You're sort of walking a wire between obstructive and central events.

I'd like to see a summary of your sleep study. You might do better with a little less PS; but let's see what your sleep study concluded.


RE: Yet another newbie - I'm clueless... - ajack - 03-07-2017

well, when you answer me that's 2.

I'm new as well, I went from a resmart auto to a resmed s9 auto for the first time last night, 2 very different machines in how the breath feels. It was worth getting the resmed


RE: Yet another newbie - I'm clueless... - Sleeprider - 03-07-2017

With respect to RichardVT...no. don't increase pressure. Your current prescription is 20/8 over PS 4.0. You got a bilevel machine because you had central apnea during your diagnostic test or because you failed CPAP during titration testing. The reason is that you have what is called complex apnea, and once you fail bilevel, you will finally get the machine you need, which is an ASV (adaptive servo ventilator) which will finally resolve the central apnea and hypopnea. We can try to optimize your current machine to reduce events, but you need to know that you got the bilevel because insurance requires you fail that before it will approve the higher level machine.

As you can see from the data, you have both obstructive and clear apnea events. I also see pretty strong inidcations there is periodic breathing. The good news is there isn't much hypopnea. I don't see a clear path to reduce both OA and CA in your case, so the best advise is to bear with it for a month pending your first follow-up. It's obvious your treatment falls far below demonstrating efficacy for bilevel, and after a month, you will be scheduled for a titration study for ASV /ST therapy. Meanwhile you need to demonstrate a diligent effort to use the bilevel machine, and give it a fair chance. It may get a bit better, but I don't expect you will achieve less than 10 AHI.

Please understand we are here to support your efforts and make this as easy as possible, but the insurance and medical system is going to extract its pound of flesh before giving you the machine you need. I think you will find you do better with less pressure support (difference between IPAP and EPAP pressure, currently 4). Anyway, hang in there.


RE: Yet another newbie - I'm clueless... - RandyR - 03-07-2017

Thank you, Sleeprider, for your quick reply.  I hope to see my sleep Doc in a couple of weeks for the initial follow up...

From ResScan (Statistics Tab) Viewing Range = Feb 17 (day one) to Mar 6 (last night), I see this:

Respiratory Indices (events/hour)
Apnea Index:  13.0
Obstructive: 3.4
Central: 9.8
Unknown: 0.0
Hypopnea Index: 0.3
AHI: 13.3

I assume the above are summary/average numbers.

Time to go google "adaptive servo ventilator"...


RE: Yet another newbie - I'm clueless... - RandyR - 03-07-2017

ajack, My Doc told me, "Don't waste your time researching which is the best Bi-PAP machine.  I've already done that for you."...

Good luck on your pursuit of quality sleep!