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Switching machine questions/advice - Printable Version

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Switching machine questions/advice - bekkih - 10-22-2021

OK, short history - started with a dreamstation that DME said was 'brand new' - found out later that it had 600 hours on it when I took it home. Yeah, I let them get away with it. Started with pillows - they said that was THE mask I had to get. Found out later that there were actually 3 different mask s listed on my script. Yeah, I walked away and never went back. I only used that machine for a month or so regularly and then very sporadically for a few years - it wasn't helping much and no matter the settings, I couldn't make it be very helpful as far as not feeling like I got run over by a truck in my sleep. Fast forward 5 years and along came the recall. I bought a new Aircurve 10 Vauto. I have COPD and based on what I have read, I felt it would work better for me. 
I did have a sleep study 5 years ago but I can't recall the results exactly, only that they said I had mild OSA and very fragmented sleep. I am including screen shots from the first use of the dreamstation and then a recent one with the aircurve, just because they are amazingly different. My question would be - is there any setting(s) that y'all would suggest I change? With the dreamstation, there was no real change in how I felt in the morning. With the aircurve, I feel a little more rested, but still fall asleep during the day if I sit still too long...

[attachment=36574][attachment=36575]


RE: Switching machine questions/advice - SarcasticDave94 - 10-22-2021

Welcome to the Apnea Board, our little odd Apnea funny farm

The older Respironics chart looks to have had areas of Positional Apnea, signified by the big blocks of time with many event flag clusters. That isn't the Positional state the medical teams discuss about an Apnea test, back, side, stomach sleeping. This is the neck position that promotes airway kinking and is corrected by a thinner flat pillows instead of a stack, or by a soft cervical collar.

The newer ResMed chart didn't show that, and appears to be better suited to treat you. But if you see that flag clusters again, chalk it up to Positional Apnea.

The VAuto timing set may be useful as well with COPD. Lack of timing is why I can't use ASV any longer with my COPD. For myself, I'm headed to ST-A due to the combo of CA and COPD.

As you've noticed yourself, your ResMed is likely more comfortable than the Respironics. Most will say the same. I'd say you're better setup to succeed with ResMed than Respironics, especially with the COPD mixed in.


RE: Switching machine questions/advice - bekkih - 10-22-2021

(10-22-2021, 12:58 PM)SarcasticDave94 Wrote: Welcome to the Apnea Board, our little odd Apnea funny farm

The older Respironics chart looks to have had areas of Positional Apnea, signified by the big blocks of time with many event flag clusters. That isn't the Positional state the medical teams discuss about an Apnea test, back, side, stomach sleeping. This is the neck position that promotes airway kinking and is corrected by a thinner flat pillows instead of a stack, or by a soft cervical collar.

The newer ResMed chart didn't show that, and appears to be better suited to treat you. But if you see that flag clusters again, chalk it up to Positional Apnea.

The VAuto timing set may be useful as well with COPD. Lack of timing is why I can't use ASV any longer with my COPD. For myself, I'm headed to ST-A due to the combo of CA and COPD.

As you've noticed yourself, your ResMed is likely more comfortable than the Respironics. Most will say the same. I'd say you're better setup to succeed with ResMed than Respironics, especially with the COPD mixed in.

Thanks! 
As far as the apparent positional apnea from the older device, I sleep the same way now as I did then - left side, pillows stacked in a ramp under my upper body and behind me to prevent rolling onto my back due to lower back issues. My neck is at the same angle, more or less, every night for the last 20 -something years. I am sure something was going on, but it isn't really apparent what it was so I'm not even going to worry about it now. Lol Aside from that, I am not seeing the periodic breathing so much now - what about the new machine might have caused that to decrease?
What can the Vauto timing set do?


RE: Switching machine questions/advice - SarcasticDave94 - 10-22-2021

Timing...
If your breath pattern is similar to mine, a slower respiratory rate and long exhale, the time controls can help keep it that way by limiting how long inhale is active before switching to exhale either by Ti Min and Max and/or the trigger setting. Best just to try defaults first before edits though.

I do find a quick inhale then elongated exhale feels more natural to me.

Good on the Positional clusters, if they don't appear no issue and no action.


RE: Switching machine questions/advice - bekkih - 10-22-2021

OK, so I've zoomed to a spot I wanted to ask about anyway - what is actually happening here?

The first part is most of what my curve looks like, but I have a fair number of those funny spikey sections and some up-and-down action that looks like it is approaching periodic breathing. Does it look like something adjusting the timing settings could help smooth out? Maybe I shouldn't worry about it? I have no idea...lol

I have been using it for about 2 weeks at the same settings at this point


[attachment=36577]


RE: Switching machine questions/advice - SarcasticDave94 - 10-22-2021

I'm not the greatest chart reader, but the first thing I think of is maybe this is an arousal (the spikey stuff) or other disruption, then it ends with the Obstructive event.

Check back for better answers.


RE: Switching machine questions/advice - bekkih - 10-22-2021

Thanks for all your help/info!


RE: Switching machine questions/advice - Gideon - 10-22-2021

Dave nailed it