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Help with settings - Printable Version

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RE: Help with settings - Sleeprider - 01-20-2019

I will just say your respiratory rate is not something I have experience with, but it looks like central apnea. ASV would probably intervene and creat a breath where you are flat-lining. The AHI is not bad, but there are a lot of questions I can't answer at this point. Let's just continue to look at what is going on.


RE: Help with settings - Hamish McTavish - 01-20-2019

Thx. Sleeprider, I will be discussing this with my respiratory specialist early next month. In the meantime I will keep an eye on my Sleepyhead reports.


RE: Help with settings - Hamish McTavish - 01-21-2019

Here are a couple of screenshots from last night...looks a little better at lower pressure of 7?

[attachment=9940][attachment=9941]


RE: Help with settings - Sleeprider - 01-21-2019

It's hard to say if the reduced pressure or turning off EPR or both are responsible for the reduction of of CA events. The closeup still shows 7 BPM and very poor volume. It helps us if you include the respiratory and machine data in the left column.

Your original chart showed a minute vent of only 4 L/min and some pretty extraordinary inspiration time average of nearly 5-seconds with expiratory time close to 3-seconds. If you get a chance to ask your doctor "what's up with that?" I'd be interested in hearing the answer. It's nice to see a lower AHI, but the numbers are not the problem in my opinion, and your case is more complex than simple apnea. A home sleep test was not appropriate in your case, and I'd like to see you return for a real polysomnography (PSG) or clinical titration. Let me impress upon you how rare that recommendation is from me. I can only think of 2 or 3 other people I have ever reviewed therapy for on this forum that I have said, get back to your doctor because something is sufficiently unusual, I can't help resolve. It's possible that your deviated septum and sinusitis causes sufficient resistance that using a nasal pillows mask is not going to work out. It might be interesting to look back at your results with the other mask where your respiration rate was higher.


RE: Help with settings - Hamish McTavish - 01-21-2019

[attachment=9942]Here you go Sleeprider...I will definitely bring this up with my respiratory guy in February...thx.


RE: Help with settings - Sleeprider - 01-21-2019

Well, your resp rate and minute vent are up on this one, so I feel quite a bit better with these results.


RE: Help with settings - Hamish McTavish - 01-21-2019

That was from last night with the pillows. This one is from December 28 with the full face mask and you can see the amount of leaking that was going on.
Do you think turning off EPR would help at all?

[attachment=9943]


RE: Help with settings - Sleeprider - 01-21-2019

I missed that you had EPR at 3. Usually this helps with improving volume but can make centrals worse. I suspect it may be better using EPR than not, but it would be interesting to see the difference. With EPR at 3, your pressure is 7.0/4.0 (IPAP/EPAP), but your event rate here is pretty good. I think it's best to keep your current settings for a while and we can observe the variation for a while before getting into changes.

The leak rate from the full face is so high that the data can't be relied on.


RE: Help with settings - Hamish McTavish - 01-21-2019

Yes, very high leak rate. I am hoping the Airtouch mask with the memory foam will work for me as I don't mind full face masks...although the pillows are quite comfortable. I wore a headband with the pillows last night and loosened the straps a bit and it was really comfortable with only minor leaking and very little movement on the headgear.


RE: Help with settings - Hamish McTavish - 01-22-2019

Good morning Sleeprider...
Here are a few screen shots from last night. AHI was not bad but not sure if you'll like the numbers again
I took one screen shot of when I was awake and I think everything looks ok there but as soon as I fall asleep my breathing rate goes down quite a bit so this is only happening when I'm asleep. Not sure what to think of it.

[attachment=9962][attachment=9964][attachment=9963]