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I'm very new to CPAP. Not new to Apnea. I recognized central apnea over 7 years ago. A major car accident 1 year ago made it worse and hard to ignore. Did an in home SS showing severe obstructive. I convinced a pulmatologist the study was wrong. Did an in lab study showing 3 out of 10 events/hr were central. Told the doctor that was still wrong because the technician insisted, I spend two hours on my back of my only 4 sleep hours which I know causes my obstructive. My first CPAP a Luna G3 with doctor settings of 8 and 20 could not be tolerated. After minor test adjustments with the distributor's RCP and no help, it was decided I needed to switch to a ResMed AirCurve 10 VAuto with settings of 20.0, 8.0, and PS: 10.0 I could not take the pressure. With the RCP's help I adjusted it down to 12.0, 5.0, and PS: 4.0 and can now sleep. My results show 15 to 20 events per hour with 95% being central. I asked my RCP if the ResMed AirCurve ASV is what I needed, and got agreement but said call the doctor. I told the doctor all of the above who said call me in six weeks after full use of the AVuto. My RCP agreed and said I need 31 four hour days on the VAuto for insurance to cover a change. Neither the doctor nor the RCP suggested numbers to try. my doctors settings are: Max IPAP: 20.0 Min EPAP 8.0 PS: 10 HELP!
We give suggestions on pressure with the use of DATA. That data is from OSCAR - it is a totally free download (everything on this site is free). You will need a card in the cpap machine and transfer the information in OSCAR. With that data we can see what may help. Please download oscar and post we would be happy to help any way we can.
I'm not sure how to attach the Oscar file. I can see the results in Oscar. The only way I see to save the file is .cvs format but that is not acceptable to attach to my reply.
Richard, I have some bad news about your medical team...they are incompetent. Your initial settings of 20.0/8.0, and PS: 10.0 were doomed to failure and anyone subjected to PS 10 without a backup rate would have suffocated from the induced central apnea. The ASV is indeed the correct answer, so I'll excuse your RCP from my previous condemnation. I'm going to suggest some settings for you to try tonight, and hopefully you can give me some feedback tomorrow.
EPAP Min 4.0, Max pressure 10.0, PS 3.0, Trigger sensitivity: Very-high. I really need to know what kind of events this results in to fine-tune it, and I do not expect efficacy, but you should be able to survive it. Do you know how to change settings?
Here is a link to the Resmed Clinical Titration Guide https://document.resmed.com/en-us/docume...er_eng.pdf It will help if you read the section on ASV at page 28 and understand how it differs from your Vauto. I don't think anyone, including myself, could tolerate a Vauto with PS 10. Ask your doctor what the hell he is thinking to go along with this. He should know better.
There are links in my signature for Organize your OSCAR Charts, and Attaching Files. These tutorials should get you the information needed to post a chart.
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.
Thank You Thank You Thank You. I ran and collected the Oscar data but can't for the life of me figure out how to save the file other than .cvs which I can't attache for your review. It is so refreshing to hear someone say I'm not loseing my mind. I thought my lungs would explode at those settings.
As I had mentioned, the doctor had them set at at Max IPAP: 20.0 Min EPAP: 8.0 and PS: 10.0 and the trigger and cycle at Med which made me hyper ventilate and get dizzy and my ears plugged up. I could only take it for 5 minutes.
I have them currently set at Max IPAP:13.0, Min EPAP: 5.0, PS: 4.0 Trigger: Med Cycle: Med. Which I can tolerate.
I'll attach a screen shot of some of the settings I've tried.
Well, there it is. I expect with the settings I suggested you will be under 8 AHI, but still not acceptable. My hope is you will tolerate the Vauto long enough to persuade your doctor to move you to the next step of ASV. I already linked the titration protocol, and you can see that the AutoASV initial settings are very standard and fully automated. You should be able to demonstrate efficacy on ASV without a lab titration, but I'm sure that won't make the boat payments, so unlikely. Still, if you had the ASV setup with EPAP min 4.0, EPAP max 15.0, PS min 3.0, PS max 15.0 it would kick your central apnea and any obstructive events out of the way and we could easily optimize it.
I think you are on your way to getting the ASV covered, so just keep pestering the doctor with messages that you need appropriate therapy for CA and to please initiate the process to accomplish that. Send along images like the one you just attached, and it should expedite your request. For now EPAP Min 4.0, Max pressure 10.0, PS 3.0, Trigger sensitivity: Very-high. The trigger sensitivity is very important to improvement as it will take less spontaneous effort to trigger IPAP and this often stimulates the user to take a spontaneous breath. Leave cycle and the Ti settings at defaults and ramp off.
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.
Last night was my best night on the AirCurve so far. Thanks so much. I used the settings: EPAP Min 4.0, Max pressure 10.0, PS 3.0, Trigger sensitivity: Very-high.
I’ve attached the Oscar screen shot, and my independent Oximeter readings which are the best so far on the AirCurve.
Glad to see you overperformed my predictions. Keep up the good work. You still have some events that cause desaturation. The only bad news is that results like this will undermine your argument that ASV is medically necessary. You are optimized to avoid CSA, but the ASV would cut the event rate to near zero. My concern is that by being "too good" your doctor will conclude the Vauto is just what you need. We can discuss this further, but it is the classic "Catch-22" of optimizing therapy for someone that needs ASV. Still, I bet you enjoyed the sleep.
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.
Hey Sleep Rider. I'm really starting to think that my lower nightly apnea numbers on the ResMed relate to my being awake much of the night. Even with the adjusted settings I did to the ResMed when I'm dozing off and I recognize a central apnea event happening it makes me so nervous I can't fall asleep. And while I'm awake at night my O2 numbers and lower events will always look great. The ASV CPAP may be the answer, but I have another 3 weeks on the AirCurve 10 VAuto before my doctor will even talk to me. I've also been researching the remedē implant system.
I'm very new to CPAP. Not new to Apnea. I recognized central apnea over 7 years ago. A major car accident 1 year ago made it worse and hard to ignore. Did an in home SS showing severe obstructive. I convinced a pulmatologist the study was wrong. Did an in lab study showing 3 out of 10 events/hr were central. Told the doctor that was still wrong because the technician insisted, I spend two hours on my back of my only 4 sleep hours which I know causes my obstructive. My first CPAP a Luna G3 with doctor settings of 8 and 20 could not be tolerated. After minor test adjustments with the distributor's RCP and no help, it was decided I needed to switch to a ResMed AirCurve 10 VAuto with settings of 20.0, 8.0, and PS: 10.0 I could not take the pressure. With the RCP's help I adjusted it down to 12.0, 5.0, and PS: 4.0 and can now sleep. My results show 15 to 20 events per hour with 95% being central. I asked my RCP if the ResMed AirCurve ASV is what I needed, and got agreement but said call the doctor. I told the doctor all of the above who said call me in six weeks after full use of the AVuto. My RCP agreed and said I need 31 four hour days on the VAuto for insurance to cover a change. Neither the doctor nor the RCP suggested numbers to try. my doctors settings are: Max IPAP: 20.0 Min EPAP 8.0 PS: 10 HELP!
