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(08-11-2021, 09:42 PM)SarcasticDave94 Wrote: Ok for now you may want to drop EPR to 1. View the OSCAR data, CA should diminish but the Obstructive Apnea and Hypopnea events will likely increase. Welcome to the PAP treatment teeter-totter. Acting to diminish CA makes OA go up and vice versa.
Dropped epr to 1 last night, went okay. I recall more arousal and half waking up more often, CAs didn't change much.
I also noticed a flow rate pattern that looked odd to me. Kinda rounded and low amplitude inspiration, and a higher amplitude with a point in the expiration. I have it attached.
Oh and one of my mask straps decided to unvelcro so one of my nasal pillows was half off for a little bit.
Machine: Needing iVAPS but QUACKS refusing to help but they love testing Mask Type: Not using mask Mask Make & Model: F&P Vitera on shelf Humidifier: None/nada CPAP Pressure: 0-0 pressure set CPAP Software: Not using software
Other Comments: SCS PVC K9D** Untreated CA Asthma Dr. Donothings
08-12-2021, 03:42 PM (This post was last modified: 08-12-2021, 03:44 PM by SarcasticDave94.
Edit Reason: clarify
)
RE: New CPAP User, Trying to Reduce CA's
I'm thinking sooner than later you're getting a ticket to ride on the ASV approval path. Your current CA aren't responding much to differences in EPR. ASV will kill off all Apnea events that currently cannot be handled by the Avoidance Game your current PAP plays.
Unless you have loads of cash, getting the doctor to schedule you for the Titration with ASV is your best bet to prove its necessity.
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.
(08-12-2021, 03:42 PM)SarcasticDave94 Wrote: I'm thinking sooner than later you're getting a ticket to ride on the ASV approval path. Your current CA aren't responding much to differences in EPR. ASV will kill off all Apnea events that currently cannot be handled by the Avoidance Game your current PAP plays.
Unless you have loads of cash, getting the doctor to schedule you for the Titration with ASV is your best bet to prove its necessity.
Gross, from all the reading I've done here on AB so far suggests it's quite a feat to get one. I wonder if the process is much different up here in Canada.
Machine: Needing iVAPS but QUACKS refusing to help but they love testing Mask Type: Not using mask Mask Make & Model: F&P Vitera on shelf Humidifier: None/nada CPAP Pressure: 0-0 pressure set CPAP Software: Not using software
Other Comments: SCS PVC K9D** Untreated CA Asthma Dr. Donothings
Canada would have its own rules and pathway. I fought to get ResMed's ASV in 2017 in the US. But after I got it I developed COPD and ASV wasn't the right choice any longer. Having taken the hard road to get it via insurance, I can tell others how to get their own, but what I mention will be US based. Hard? Yes. Doable? Yes. It takes one willing to work and not accept no as the answer.
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.
(08-12-2021, 06:31 PM)SarcasticDave94 Wrote: Canada would have its own rules and pathway. I fought to get ResMed's ASV in 2017 in the US. But after I got it I developed COPD and ASV wasn't the right choice any longer. Having taken the hard road to get it via insurance, I can tell others how to get their own, but what I mention will be US based. Hard? Yes. Doable? Yes. It takes one willing to work and not accept no as the answer.
So I obtained my sleep study results. Definitely has some central, but overall seem pretty low overall? I'm not sure if central under 5 ahi are just considered normal or not? I've attached them for reference. The hypopneas seem quite positional.
The thing is, the hypopnea which makes up the majority of your AHI is not classified. It's pretty typical for hypopnea events to be central. It takes some analysis to tease it out from the flow rate data, and no algorithm does this automatically, it's a lot of work. We can analyze a flow rate (respiration wave) and pretty easily determine if it is obstructive (flat-tops limiting flow) or central (natural waning of breathing effort), but the sleep medicine industry hasn't caught up to us yet.
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.
(08-12-2021, 07:26 PM)Sleeprider Wrote: The thing is, the hypopnea which makes up the majority of your AHI is not classified. It's pretty typical for hypopnea events to be central. It takes some analysis to tease it out from the flow rate data, and no algorithm does this automatically, it's a lot of work. We can analyze a flow rate (respiration wave) and pretty easily determine if it is obstructive (flat-tops limiting flow) or central (natural waning of breathing effort), but the sleep medicine industry hasn't caught up to us yet.
Oh interesting, I didn't know hypopneas could be non obstructive. Thanks for the info!
So I tried no epr last night and it went less than ideal. I leaked like a sieve! Experienced the dry mouth people have talked about. I think I'll be keeping it at 1 for now since it didn't do anything to reduce my CA's.
Attached summary and a zoom of last night just in case it shows anything useful.
Your charts do not show that you had EPR active. Your pressures displayed on the left are the same for inhale and exhale. While you could have the EPAP pressure plot turned off, because it is now being displayed in the pressure graph, this graph is not showing any pressure difference.
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.
(08-13-2021, 11:52 AM)Crimson Nape Wrote: Your charts do not show that you had EPR active. Your pressures displayed on the left are the same for inhale and exhale. While you could have the EPAP pressure plot turned off, because it is now being displayed in the pressure graph, this graph is not showing any pressure difference.
Sorry if I wasn't clear, last night I tried with EPR turned off, vs the night before I used epr 1. I found I leaked a lot more with no epr and with no benefit of any reduced CA's. Therefore it seems like epr at 1 is a better setting for me (at least with my current mask).
