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+--- Thread: JKemp's UARS Therapy (/Thread-JKemp-s-UARS-Therapy)
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JKemp's UARS Therapy - JKemp - 11-11-2020
Hey folks,
Posted a little while back with a bunch of random history which I think is only vaguely relevant to the task at hand. At this point I'd rather not merge those threads just to keep this tidier, if that is all right.
I did a home study a couple of nights ago (finally) with the following results:
Total sleep: 6 hours 40 min (nerves about the test kept me a up a little)
pAHI = 2.3 (15 total)
pRDI = 12.7 (85 total)
O2 Nadir of 72% (considering that I'm still alive, I'm guessing I just briefly slept on the arm with the O2 sensor. Average was 95%)
This seems consistent with other folks who have UARS, and from what I've been reading, the smart move is probably to look at the AutoCurve 10 (probably used, probably out of pocket). Any other thoughts or recommendations?
RE: JKemp's UARS Therapy - Sleeprider - 11-12-2020
When we see flow limitation and hypopnea as the main expressions of a sleep test, then the best therapy will include some degree of pressure support. The Resmed Airsense 10 Autoset provides up to 3-cm difference between inhale and exhale pressure and has worked well for many of our members. The Aircurve 10 Vauto is far more capable in producing the needed pressure support and has some other controls that can fine-tune therapy. As you know, there is a significant difference in cost. You seem to have the luxury of taking time to find a deal as your AHI and problems are not urgently in need of therapy. This article in our wiki might be worthwhile reading as you consider your options. http://www.apneaboard.com/wiki/index.php/Flow_Limitation/UARS_and_BiPAP
RE: JKemp's UARS Therapy - JKemp - 11-12-2020
Excellent information, thank you so much!
Being that my RDI isn't catastrophic (bearing in mind that I have 1 data point only), would the Aircurve 10 Vauto be "overkill" in comparison to the Airsense 10 Auto? My assumption is that there isn't really a firm correlation between RDI number and the type of machine one should use. I always like saving money, of course, but the added cost isn't devastating (unlike my daily brain fog...)
RE: JKemp's UARS Therapy - Sleeprider - 11-12-2020
Technically, the medical system would have you on CPAP with your results. The Airsense 10 Autoset happens to include up to 3 cm of pressure support in the form of EPR (exhale pressure relief). Like most problems, we actually documented the experience of members using the Airsense 10 EPR feature and its effect on flow limitation. It's probably not the best solution for severe UARS or flow limits, but the results we have seen are pretty impressive. http://www.apneaboard.com/wiki/index.php/Flow_limitation So the answer has to be, "it depends". EPR is sufficient for most cases, but others have found they need the higher pressure support from the Aircurve. It's usually easier to find a deal on the CPAP, but if you run across the Vauto in your search, I sure would not turn it down.
RE: JKemp's UARS Therapy - Sleeprider - 11-12-2020
I'm seeing some good choices in the Madison, WI Craigslist (I use SearchTempest using the search term Resmed or CPAP Machine). There is a new Airsense 10 Autoset at $350 and a very used Aircurve 10 Vauto that probably has many hours, but is available for $100 and would give you a low-risk chance to try the Vauto.
RE: JKemp's UARS Therapy - JKemp - 11-12-2020
Thanks so much for the extra help on this. After a chat with my partner, we determined it made the most sense to proceed with a device offering the greatest flexibility in therapy, and a little before your Craigslist dive (again, seriously you have no idea how grateful I am), I put in an order with Supplier #2 for the Vauto.
It'll be a few days before it gets here, but in the mean time, I've seen other threads with some starting recommendations for settings, but naturally I have now misplaced those browser tabs. What are some good settings to get started with?
RE: JKemp's UARS Therapy - Sleeprider - 11-12-2020
Considering mild apnea and the hypopnea:
Mode: Vauto
Min EPAP pressure: 5.0
PS: 4.0
Max IPAP Pressure 12.0
We can cleanup the settings once we see how you respond.
RE: JKemp's UARS Therapy - JKemp - 11-14-2020
Got my equipment very quickly; I was fortunate that Supplier #2 is located quite fairly close, and even without expedited shipping, I got the next day. Couple observations:
- These things are weird, but I was never horribly uncomfortable.
- My sleep was okay; I definitely got a few solid chunks in throughout the night, but was also awake for maybe about 2 hours total throughout just because of the strangeness of the equipment. Obviously there is some adjustment to be expected.
- The times that I did sleep, I woke up in the same position, which is exceedingly rare for me; probably points to me not having my sleep fragmented?
- A bit of air leakage; I noticed my mouth was open when I woke up a couple of times.
- Are "Clear Airway" events what y'all refer to as "Centrals"?
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RE: JKemp's UARS Therapy - Sleeprider - 11-14-2020
Actually nothing unusual for the first night. Let's back off the PS to 3.0 and see where that puts the flow limitation and if it reduces the CA events. I think the higher PS is a bit much for a new user.
RE: JKemp's UARS Therapy - Sleeprider - 11-14-2020
What value do you find in the "total time in apnea" statistic? I am far more concerned with the number and pattern of events, as well s the conditions under which they occur. Total time in apnea was something the original Sleepyhead generated, because it could be done, but who knows what the value of that metric is?