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+--- Thread: Need assistance please. (/Thread-Need-assistance-please)
Need assistance please. - Phaleronic - 10-03-2022
My mother is 72 years old and knows she snores so I set her up with my cleaned/defoamed DS2. She has sleep apnea from what I see in the charts. I can also see that she needs more pressure, but if I raise max to 12 she feels it is too much pressure.
I'm thinking I should look for an autobipap for her, or get her a cervical collar as she is sleeping on pillows in an elevated position. Any input would be greatly appreciated.
The date is wrong.
Thank You
RE: Need assistance please. - mesenteria - 10-03-2022
It might be worth finding out how your mum sleeps. Does she wake up often gasping for air, or does the current pressure arouse her, maybe due to blow-by around the mask?
I see a lot of what I suspect is positional apnea, most often caused by head position relative to the chest. We find similar results and event patterns in people who tend to tuck their chins toward their chest, or whose pillows are too high for them, or too stiff maybe. My own wife, a sure apnea sufferer, sleeps on her back about 85% of the time, and she likes her chin down toward her chest on her back.
Your data, or hers, show that she is maxed out in the upper limits most of the night. That might be because of the chin tucking, but it might simply mean she needs 'more.' The answer might be another mask, but it seems to me that she does need probably another three or four cm of H2O.
I see a lot of central apnea, but that might only be what we call 'treatment emergent' CAs. Once she is properly treated by her machine and maybe another better mask, those centrals are likely to reduce considerably or fall off altogether. If not, then she would need an auto-bipap at the very least, and quite possibly she won't be served well unless she uses an adaptive servo-ventilator (ASV).
RE: Need assistance please. - Phaleronic - 10-03-2022
Thank you very much, and yes she sleeps elevated on two pillows and I've told her that it increased chintucking and OA events. I have tried upping the pressure, but that was with the old mask (F20) and I have her on the dreamwear full face now...
RE: Need assistance please. - KeepSmiling - 10-03-2022
If using a full face mask, I would use minimum pressure of 7.
Why is your mother using elevated pillows. Does she choke, trouble breathing etc.
Is she allowed to and can she sleep on her side instead of her back.
Different Machine are used for different Medical Condition: Lung conditions being one of them need bilevel. But there maybe contraindications for it.
Congestive Heart failure of some kind, or heart failure should not use ASV.
From Resmed website, available to the general public - Titration Guide . (I was looking up stuff and itpopped up.
Consider using bilevel when:
• Patient is not tolerating high pressure settings1
:
- Pulling at mask
- Experiencing arousals or microarousals
- Can’t progress to REM sleep cycle
- Feels bloated or has a sensation of swallowing air
- Saying pressure is too high
- States it’s difficult to exhale despite EPR feature
• Events persist at 15 cm H2O2
• Women may need to be switched at a lower pressure due
to their increased pressure sensitivity
• Patient has history of ventilatory insufficiency such as
chronic obstructive pulmonary disease (COPD), restrictive
lung disease, or obesity hypoventilation syndrome (OHS)1
• More than 3 cm H2O is required between IPAP and EPAP
---
The machine your mother is using, have you tried the Aflex. According to your info you have a bilevel machine, have you tried using that for your mother
You mention pressure of 12 being to high, what about less then 12 and more than 9.5 max shown in the scan.
CPAP (Autoset) is ok for people without some specific medical conditions.
The scan looks like the machine is ran like a straight CPAP. Increase the pressure by one and put Aflex to 1.
You need to know what is causing the periodic breathing.
Is her tongue causing issues.
RE: Need assistance please. - Phaleronic - 10-03-2022
I will raise max to 12 and min to 7 and try aflex. Thank you for the feedback and I will ask her those questions you posted.