[Equipment] Longtime BiPAP w/ centrals needs new machine advice

[memeuro]

Thanks for replying guys. Really appreciate it. I have a call in to Supplier #2 who will call me when they get a ResMed ASV with lower blower hours. Just waiting until next month for my FSA card to kick in.
I saw my sleep doc on Friday and told him I changed the PSMin to 3 and he said everything looked fine.
Thanks for the great advice. I will move the EPAP min to 7 and try that for a week or so.
Many thanks again for your patience.

[memeuro]

Hi Guys,
Just waiting on getting my unit and hope it will be able to get me to a better place in my sleep.
I pulled out my polysomnogram from 2014 just to see what the prescribed values were and something struck me as worrying, which I did not see before seeing my sleep doc. My stage 3 sleep was at 0% (range 20-25%). This is the deep restful sleep one needs to feel refreshed. This really concerns me but I don't really know what to do next other than reach out to my sleep doc.
Any advice please?

I also noticed a recommendation to NOT sleep supine. Guess I missed that one because I have never heard that. My fault for not reading the report. How are people sleeping upright and not having their necks collapse? Using a cervical collar? Please say no!

There is another component I haven't shared, just because this is the Internet & privacy & HIPAA. I have severe chronic pain from major trauma when I was younger that resulted in failed back surgery "syndrome" after multi-level anterior and posterior spinal fusions, along with femur broken in 4 places and right hip sheared off and broken pelvis. This leaves me in a lot of pain that really exacerbates in the day when I am not getting rest. I really need deep restful sleep so I'm not in so much pain I cannot function the next day. The specialist I see was the first person who understood this and verbalized it when I met him 10 years ago but few other MDs understand this.
In any event, I am probably sharing way too much and may regret that and have to delete this post.
But I'm basically reaching out to the sleep gurus on this board to see what they would do and if it's even possible to get N3 above 0%.
Sorry for the long post.
Latest OSCAR from change in EPAP min to 6.

[SarcasticDave94]

The pressure gurus may wish to have modified OSCAR charts, but I'm not going to try guessing what they may want. What I see is a lot of CA and even more Hypopnea than CA relatively speaking on this chart. I would tend to consider increasing EPAP Min up to 7 and view results. And turn all Ramp settings OFF.

[Gideon]

Strong pain medication, especially those with opiods often have a negative effect on Central Apneas. Are you taking anything similar to these. It is important to know because we need to also look at the advanced charts to see if we see any other breathing issues.

[memeuro]

Thanks. I see ramp settings listed in the side bar of OSCAR but I think unless I turn the physical button red I thought the ramp function is off.
I will change up to 7 for EPAP min. Honestly thought I had done that but I see it at 6. Thanks for that.
What would I need to do to get the gurus the modified data? Any particular things they need?
I just used the OSCAR Wiki to highlight what they list as typical items for display.
Thank you so much for helping.

[SarcasticDave94]

I think best practice is to show 1 standard view OSCAR chart and then if needed, other views can be asked for as needed. There's a setting within OSCAR to reset it to default which is probably what you want to present first. No to pie chart and minimize calendar on the left and no to the right panel area.

[memeuro]

Okay. Get that. But the image I posted doesn't have the pie chart or calendar and follows the guide from you signature.
Am I doing something wrong or need to include other views?
Appreciate your willingness to help.

[SarcasticDave94]

OK let me redo the answer. The chart setup you posted in #22 above will in most cases get the job done unless directed to post specific advanced OSCAR charts.

[Gideon]

2 things increase min EPAP, I'd say to 8 which is high for ASV

Dave, can you talk a bit about your back pain.

and second, Two sets of charts please
1. The Standard charts, what you are doing now.
2. The Advanced charts which are more breathing centered. in OSCAR View / Reset Graphs / Advanced (or Standard)

[SarcasticDave94]

Sorry for the delay, OK back pain can be a big pain.

I don't remember all the medical names for all the back issues I have. I do know this, I have chronic lumbar nerve damage, have had ruptured disks with ongoing degenerative disk disease, was on Prednisone for about 4 years which setup osteoporosis, have broken all 5 lumbar vertebrae and at least one in the thoracic area, weaned off Prednisone and did the diagnostic to prove medical necessity for Ablation - a medical surgery to burn the nerves in the lumbar that sense pain, and then I went for a Spinal Cord Stimulant implant. I also had Kyphoplasty done on lumbar vertebrae L2 and L4 to reshape the bones that were otherwise crushed. I needed psychiatry doctor interview to permit the SCS and then a trial twice for the SCS due to request for a different brand. The second SCS trial lesser invasive failed as T10 thoracic vertebra was invading epidural space. New and invasive trial included laminectomy of T10 and implant of the electrodes. A week later was the SCS implant part 2.

Sorry for thumbnail sketchy info. Anyway, all the stuff that occurred had me at a back pain level of 10+++++++++ for over a year. Opioid style pain meds were of zero effect. I once was stuck on the couch where I had slept overnight for about 6 more hours because I could not move off the couch myself. The ambulance crew picked me up to transfer to the stretcher, rode to ER. The SCS implant does work well as my pain is a manageable 4-6 of 10. I do have a rollator/4 wheeled walker I use every day as my left leg may collapse at any time, dumping me on the floor. I have a massive rehab power wheelchair insurance bought if I need it. I am on no pain pills with the SCS doing its job well. Normally, I must sleep in my hospital bed with air mattress at the house. And yes absolutely, back pain can disrupt sleep and interfere with PAP therapy.

Back pain is a real pain.