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[Equipment] UARS diagnosis - Which machine should I get?
#71
RE: UARS diagnosis - Which machine should I get?
Regarding a titration test from CPAP to ASV, the CNP who oversaw my two sleep studies recently said "Your insurance will not likely pay for a PAP Titration without a sleep apnea diagnosis." When I tried to send her some Oscar data (she couldn't open the links) and told her what settings I was using (Vauto mode, Min EPAP =6 Max IPAP =15 PS =0), she said "Your machine may be blowing off too much carbon dioxide and causing the central events." Without looking at the data, does that sound like a reasonable interpretation to anyone?


Regardless, when I finally get an AirCurve 10 ASV, what should my initial settings be after a factory reset? I know on 06/08 Sleeprider said "EPAP min 6.0, EPAP max 8.0, PS min 3.0, PS max 12" -- is that all I need to know for my first night? Should I set it to ASV or ASVauto?
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#72
RE: UARS diagnosis - Which machine should I get?
If you're going to consider something like the example Sleeprider mentioned, it must be ASV Auto mode. The difference between modes ASV and ASV Auto is an EPAP range. Mode ASV is a static EPAP, single pressure, ASV Auto mode is EPAP Min/Max. range.

You could try that pressure set or a slightly modified ResMed ASV titration, 6-15 EPAP and 3-15 PS. Keeping 6 as min EPAP so you're not air starved.

I myself didn't like or use ASV mode, but ASV Auto mode due to that significant difference.

ResMed AirCurve 10 ASV titration protocol shot

   
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#73
RE: UARS diagnosis - Which machine should I get?
Thanks for the great info (as usual). Have you used both the Vauto in addition to the ASV? What were your experiences like with one compared to the other? I hope I can acclimate myself to the machine breathing for me when I'm apparently not doing it myself. I hope it doesn't repeatedly wake me up when it's trying to help me...
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#74
RE: UARS diagnosis - Which machine should I get?
I've never had a VAuto as my CA and COPD combo would never play well with one.

My take is the ASV responds faster than others. And I'd say that's by design to kick your lungs when a CA occurs. You'll need to be aware of an occasional miscue from the ASV, typically soon after you've started ASV rather than later on. The ASV will kick right as you drift off, blowing your socks off. OK, when you calm down a bit, just Blow Back. Literally blow back moderately forceful into the mask and Mr. ASV will get back in line.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#75
RE: UARS diagnosis - Which machine should I get?
Lets step back for a second. What symptoms are you hoping will be treated by treating your UARS? What makes you think that sleep disturbed breathing is your main cause of these symptoms?

Also if you haven't already tried it try increasing trigger sensitivity to very high to see if that has any effect.
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#76
RE: UARS diagnosis - Which machine should I get?
(06-17-2021, 09:15 PM)Geer1 Wrote: Lets step back for a second. What symptoms are you hoping will be treated by treating your UARS? What makes you think that sleep disturbed breathing is your main cause of these symptoms?

Also if you haven't already tried it try increasing trigger sensitivity to very high to see if that has any effect.

Symptoms I'm experiencing include unrefreshing sleep, waking up frequently during the night, daytime fatigue, difficulty concentrating, and irritability throughout the day.

More often than not I'll wake up in the morning and just feel like garbage. I can't remember the last time I woke up feeling like I had a good night's sleep. I think UARS might be a significant contributing factor.
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#77
RE: UARS diagnosis - Which machine should I get?
OK as mentioned, let's exhaust all VAuto options then we'll cross the bridge to other devices.

Have you tried other Trigger settings, high or very high? There's a few other timing settings that can be discussed if needed.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#78
RE: UARS diagnosis - Which machine should I get?
ASV is not guaranteed to fix your UARS. A number of users have found relief using vauto but from what I have seen the ones that fail vauto often fail ASV too. In your case your body doesn't appear to want more flow hence the central apneas. You are still early in treatment and this could go away with time as your body adapts. If you want to try ASV you can, if you want to wait a bit there are a couple other things you can mess with to see if/how they effect your data.

The recommendation to try very high trigger sensitivity setting is something that has worked for a few UARS patients. Although thinking about that recommendation again it will only work if you start using PS, with PS off that setting won't affect anything.

Although your OSCAR results indicate central apnea you could try a few different things that would help obstructions to see if that has any effect. Stuff like trying a higher EPAP (just small jumps to 8 then maybe 10 if you think it helped a bit) to see if that makes any difference. Addressing any positional things (removing large pillows etc that can cause chin tucking, trying to sleep on side vs back to see if that affects centrals) might help understand if there is a hidden obstructive side of things.

Reading your sleep study details the one thing that caught my eye was how low your low heart rate was both when asleep and awake, there was also notes of PVCs. Is this something that was ever discussed or looked into? Might be worth a couple questions to doctor as it may have been glanced over originally. Not sure that there is any actual issue with those findings but imo worth asking about.
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#79
RE: UARS diagnosis - Which machine should I get?
FWIW heart PVCs... for me they tend to create palpitations, harder and faster beats not due to exertion. They tend to make me fatigued and hard to breathe in attempting to keep up with the heart.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#80
RE: UARS diagnosis - Which machine should I get?
I never thought anything suggested here was guaranteed to fix my UARS. I can't try anything with the Vauto now because I don't have it anymore. I was told eleven days ago I had exhausted my options. I wish the high-trigger sensitivity option had been mentioned before I gave it up.

I'll agree that I am still early in treatment. I'm not used to breathing through a mask while I sleep yet, and I'm still in the process of finding one I'm completely comfortable with. I think the Oscar data may be suggesting my body might not want more flow because I've only used the machine for one week and none of this is second nature yet.

PVCs were never brought to my attention by a doctor or anyone else as far as I can remember.
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