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Can someone help me make sense of my Therapy Numbers?
#1
Can someone help me make sense of my Therapy Numbers?
Good afternoon everyone -

Roughly 2 and a half years ago I took an at home sleep test and was diagnosed with complex apnea at 36 AHI 34 being obstructive and hypopneas and 2 being Central apneas.

Based on this information I was recommended ASV by the doctor (it was an online clinic who administered the test and sold the DME - which my current pulmonologist agrees it was an overprescribed machine that was not necessary for me, but possibly financially motivated. 

All that said it is fine and I have used the ASV for 2 years.

That said we tried Auto Bipap first, only for 4 weeks and my pressures (copying straight from the prescriptions) and results were as follows:

1st - Auto BiPAP10/5-25/20cwp - 2 weeks of this only got my AHI to 17.

Doc said he would take a look at my pressures and make 1 more adjustment before going to ASV at my recommendation and 2nd pressures and results were as follows:

2nd - Auto BiPAP:EPAP min 5cwp, IPAP max 25cwp, PS 5cwp - 2 weeks of this only brought my AHI down to 12.

After that I moved forward with buying the ASV out of pocket from said clinic and for 2 years my AHI has never been over 1.

Now here is my question. About 10 days ago my ASV motor went out and I shipped it to a supplier on here to have it repaired and it is coming back this week.

I had a family member let me use a loaner (they have apnea just choose not to use the machine) and it is as follows:

ResMed AirCurve 10 VAuto and clinical settings are: 

Mode: VAuto

Max IPAP 20

Min EPAP 4

and PS of 0.

I was curious to see how this machine would work and in 10 days with these settings my AHI has been below 1 every single night. 

Can anyone explain in beginner's terms how this could be? I have not made any drastic medication or weight changes that would reduce my AHI since starting the ASV and this machine seems to be very similar to the 1st BiPAP I tried and failed. Is it all just in the pressures? Or is the VAuto mode something I probably could have used from the start? 

It would just be nice for this to make sense, and if you respond I appreciate it. Thanks for reading.

kc
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#2
RE: Can someone help me make sense of my Therapy Numbers?
If you could post some OSCAR charts showing a typical night on your previous machine and the borrowed one, that would help to make sense of things.
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#3
RE: Can someone help me make sense of my Therapy Numbers?
KC90, the charts would help a lot, but I see no point in using a Vauto machine with no pressure support. There is so much we can do with the settings. I'll give you some settings, but they are only a slightly better guess than your doctor's settings, and will only cut your AHI by 50% from current. Give me a chart, and we can take it the rest of the way. Try this:
Mode: Vauto
EPAP min 5.0
IPAP max pressure: 14.0
PS 3.6
Trigger sensitivity: High
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#4
RE: Can someone help me make sense of my Therapy Numbers?
(02-21-2024, 07:53 PM)Sleeprider Wrote: KC90, the charts would help a lot, but I see no point in using a Vauto machine with no pressure support.  There is so much we can do with the settings.  I'll give you some settings, but they are only a slightly better guess than your doctor's settings, and will only cut your AHI by 50% from current.  Give me a chart, and we can take it the rest of the way.  Try this:
Mode: Vauto
EPAP min 5.0
IPAP max pressure: 14.0
PS 3.6
Trigger sensitivity: High

Hi Sleeprider, what I was saying if it made sense were those 1st 2 sets of settings were tried on my 1st autobipap machine 2 years ago, they got me to 17 then 14 respectfully at those levels, I returned said machine and bought an ASV out of pocket which has always had my AHI below 1.

While my ASV motor was being replaced this week from a supplier you recommened (thank you btw) I was using my Mom's ResMed VAuto at 4 EPAP 20 IPAP PS 0 and Mode: Vauto.

With this different bipap machine and 2 years later, somehow my AHI has not been over 1 the past 10 days. I'm just trying to understand why this would be, basically it is as effective as my ASV machine is and the first time I tried BIPAP it didn't work at all like that. Hope that makes sense.
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#5
RE: Can someone help me make sense of my Therapy Numbers?
(02-21-2024, 08:17 PM)kc90 Wrote: Hi Sleeprider, what I was saying if it made sense were those 1st 2 sets of settings were tried on my 1st autobipap machine 2 years ago, they got me to 17 then 14 respectfully at those levels, I returned said machine and bought an ASV out of pocket which has always had my AHI below 1.

While my ASV motor was being replaced this week from a supplier you recommened (thank you btw) I was using my Mom's ResMed VAuto at 4 EPAP 20 IPAP PS 0 and Mode: Vauto.

With this different bipap machine and 2 years later, somehow my AHI has not been over 1 the past 10 days. I'm just trying to understand why this would be, basically it is as effective as my ASV machine is and the first time I tried BIPAP it didn't work at all like that. Hope that makes sense.

So to simplify for clarification if it helps, i appreciate any response 

Oct 2021 - Auto BiPAP10/5-25/20cwp - 2 weeks of this only got my AHI to 17.

Nov 2021 - Auto BiPAP:EPAP min 5cwp, IPAP max 25cwp, PS 5cwp - 2 weeks of this only brought my AHI down to 14

Jan 2022 - Auto-ASV: Auto mode, EPAP min 4cmH2O, PS min 0, PS max 15 - AHI always less than 1

Feb 2024 - last 10 nights on loaner machine - ResMed AirCurve 10 VAuto - VAuto mode min EPAP 4 MAX IPAP 20 PS 0 - AHI always less than 1, hovering around .5 mostly.

No weight or medical changes but for some reason this machine works as good as my ASV and I just dont understand why, this is all foreign to me though.
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#6
RE: Can someone help me make sense of my Therapy Numbers?
Well, I clearly got lost in the forest on this one, and it may be because you started a new thread from where we were working before. Anyway, settings on your Vauto currently are very wide, and it would help to know where the device settled in. PS 0 is simply CPAP, so it appears you don't really need ASV if CPAP from 4-20 pressure is working. Even though this seems like a different question from your therapy thread, It would have avoided a lot of confusion if you would have asked it there.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#7
RE: Can someone help me make sense of my Therapy Numbers?
(02-21-2024, 08:54 PM)Sleeprider Wrote: Well, I clearly got lost in the forest on this one, and it may be because you started a new thread from where we were working before. Anyway, settings on your Vauto currently are very wide, and it would help to know where the device settled in.  PS 0 is simply CPAP, so it appears you don't really need ASV if CPAP from 4-20 pressure is working.  Even though this seems like a different question from your therapy thread, It would have avoided a lot of confusion if you would have asked it there.

Thank you for your response, my apologies for making another thread. I just have 10 nights under my belt with the loaner machine and was really curious why it was working so well is the reason I made the new thread. I appreciate your response and I clearly do not need ASV, and my new pulmonologist indicated I never did in the 1st place only having 2 central apneas per hour. 

I just found it strange that this Cpap mode or whatever it is works as effectively as my ASV, and it just didn't make sense why the 1st BIPAP didnt work. Must just be the settings he gave me is all I can guess uneducated.
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