Night 8, it's already Love - Hate. So glad I found you guys!

[jaswilliams]

I think you need more pressure support when you don’t breath due to the CA’s it would be good to see the flow chart but I suspect the ipap needs increasing to help your periodic breathing I would suggest a value of 13. But you would be better suited an asv machine

[SarcasticDave94]

Hey there FE350. A big welcome to the world of Apnea Board.

You've already been given GREAT advice from others, so I'll be assuming the role of comic relief at some point. Laughter and humor will be needed to combat insanity as we deal with the 3 amigos of Duck (doctor) / DME / health insurance.

I'll try not to be an irritating jerk or other similar Major Payne types. OK well not all the time anyway.

Be assured that, going by the high probability you're headed towards an ASV machine, you and I can make your treatment path loaded with abundant success.

Again I'm assuming you're headed to ASV, try your absolute best effort to get the ResMed unit. I'm not saying Respironics ASV is bad, but I'm certain you'll be pleased with the ResMed and the results it WILL produce.

Mainly, let this post serve as an introduction from this Mixed Apnea patient that happens to have COPD. I don't fit the mold of "normal" by any stretch of any measurable parameters. BTW I've never tried to "fit in" as normal either. FWIW ASV is well suited for ME. And despite COPD should indicate I need the ST, ain't happening here. I skipped that machine, and I'm NOT going there.

Any questions about ASV, just post away and I'll try my best to answer within the limits of my experience of 1 year on ASV.

salute regarding near-future success.

[Sleeprider]

This is really simple. PS Of 4.0 cannot cause a breath to overcome your apnea and hypopnea events. The apnea appear central based on some flow response to the timed breaths. You need ASV, but would not rule out higher pressure support. It normally takes a minimum of 6-8 pressure support to cause a breath. Your ST is not intended to treat this condition because you don't need full time pressure support this high.

[FE350]

Hi Everyone,
I'm on day 12 of my BPAP therapy, and I believe it is NOT working.  Attached is my Sleepyhead report.  The first file is the entire view of last night, the second upload is a zoomed in view of one of my events.  This is all very new to me, please understand I don't yet know even the questions, let alone answers.  Thanks for your help!
JP
FE350

[thibaulthib]

Hi,

I am also using an AirCurve 10 ST, with ST mode enabled. I will try to help you as much as I can. 
I have been using it for 2 months now, and I have reached AHI = 0.0. Here is my thread, this will definitely help you: http://www.apneaboard.com/forums/Thread-...-some-help

In the meantime, I can see you are still having a lot of UA (we will consider them OA) and H.

I would recommend you to move to 13/8 for the following reasons:
- in PS4 (11/7) you still have too many H. So PS5 will help reduce the H
- Using EPAP=7, there are still too many UA. Bringing to 8 will help lower the UA.

Let's start from there and tell us tomorrow :-)

PS: What is your backup rate (RR) set in the machine?

[DeepBreathing]

G'day again JP. It's helpful if you can keep your discussion in a single thread - that way you will have a complete record of all the advice given and how you responded.

Just repeating from the earlier thread, your sleep study showed a huge majority of your apnea was central. You quite likely have the wrong machine, and as it's currently set up it's not doing you any good at all. Basically it's not doing anything more than a basic CPAP with a slightly higher pressure relief. The timed pressure pulses obviously aren't strong enough to overcome your apneas. The changes thibaulthib has suggested might help, but experience of many members here has shown that it's almost impossible to get consistent, stable good results for central apnea using anything other than an ASV.

As mentioned in your other thread, you might be on a path that requires you to "fail" on CPAP then ST before finally getting a chance at ASV. I would raise this immediately with your doctor and ask why you're not already on ASV, and how he thought setting up your machine like a CPAP would overcome central apnea.

[Gideon]

DB nailed it.  I had to review your other thread to properly answer this one. Your UA events are CA events and your charts are showing a classic failure of an ST machine attempting to treat ASV.  The little "blips" in your detailed charts are your ST's failed attempt to cause a breath.  SR has the only possibility listed in his last post, to increase PS to a level that you do not need full time.

When are you getting an ASV machine?  Talk to your doctor about it now.

Your chart says no CA Events and your doctor will note that unless he looks at the detailed charts, so take in several to show him., the UA events are misclassified CA events, you need to look at the detailed charts to see that, but it is obvious.

[thibaulthib]

Guys

Can you give me the link to the other thread please ?

I would like to take a look too.

[Sleeprider]

I have put in a request to merge the threads.
http://www.apneaboard.com/forums/Thread-...d-you-guys
http://www.apneaboard.com/forums/Thread-...me-analyze

[OpalRose]

Threads have been merged.