Pokey49 - Therapy Thread

[Pokey49]

One final question for the day. I just got home and changed the mode to VAuto as you advised. When I did that it now says the minimum epap changed from 6 to 4. Does this sound correct or is something else not checked as it should be. I don’t think the DME dotted her Is and crossed all her Ts 
Thanks.

[SarcasticDave94]

I would then change EPAP min to 6. Possibly changing modes reset the pressure.

[Sleeprider]

You don't need to accept the default settings. Vauto mode, EPAP min 6.0, Max Pressure 14.0, PS 4.0 are my suggestions. I think you may need a high or very-high trigger sensitivity, but start with the medium so we get a baseline.

[Pokey49]

Attached below is my first night with the Vauto Bipap. I think one view says it all. Its not very pretty looking, but qualitatively I woke up feeling like it was the best nights sleep Ive had in weeks. Breathing was easy, felt gentle & normal!! Like the machine was accommodating me rather than me accommodating it which was consistently the case with the AS11. I slept almost 9 straight  hours. The past few weeks on the AS11 Ive been waking up 2-3x per night, usually feeling awful.  Often couldn't get back to sleep, but that was not the case last night. In the early am I woke up feeling OK, calm & restful in fact and fell back to sleep. So why the ragged tracings and the multiple CAs?? Looks like I had numerous leaks and some pressure spikes, I assume due to the leaks???..............this pap therapy is perplexing stuff.

[SarcasticDave94]

You had some moderate leaks. It's up to you if you want to diminish them.

If needed, you can try Trigger High to address the CA flags.

Besides those, you said yourself you're sleeping better with the VAuto. Don't go looking for something to fix if it's not broke. The graphs will not be perfectly flat. It's fine.

Other than this, try to build a few good nights sleeping with the VAuto to build a trend.

[Sleeprider]

Pretty much what I suggested in previous post, EPAP 6, Max pressure 14, PS 4, trigger sensitivity high, and TiMax 2.6. I think your qualitative comment says the most important thing, and look at the time in therapy! You had 9:23 in therapy which is about a 3-hour improvement over CPAP.

[jdougc]

Congratulations on a big achievement.
"I woke up feeling like it was the best nights sleep Ive had in weeks. Breathing was easy, felt gentle & normal!"

This is what therapy is about.

[Pokey49]

Im going to leave well enough alone for a while and see if I can repeatedly get more good nights of sleep and then worry about the CAs later. Maybe I will try a high trigger later once I learn more what that means...........I just listened to 2 Mayo Clinic presentations about central sleep apnea. It can occur due to a variety of causes, the majority of which I don't have. The two most likely for me: treatment emergent or medication caused, although the medications discussed were none of which I am taking. Another possible cause heart valve issues. I have a leaky mitral valve, known about it for 20 years and done fine with it. CA has never appeared in any sleep study that Ive ever had. I had AFIB that I had an ablation for which was very successful. So at this point no idea why Im having them, hopefully they are not serious and will go away in time.

[super7pilot]

One way to look at it pokey. If you had that sleep wake junk breathing and DID NOT have any event flags. It would have the same effect on you.

Sleep wake junk is a sleep disruption. Full stop. You may or may not have any events with SWJ.

In my therapy. If i have a low Co2 CA. i just ignore that. It has no effect on me.

[super7pilot]

Pokey, why are you assuming those Clear Airways are Central Apnea’s?