SH analysis

[thibaulthib]

How tall in cm and how big are you in kg ?

[Dyinginmysleep]

How tall in cm and how big are you in kg ?

180 cm / 5"11

106 kg / 235 lbs

[thibaulthib]

Your tidal volume IBW with 6ml/kg would give 450ml, so right now 400-420 is ok.

However, I have faced almost a similar situation with a Dreamstation CPAP, and had to move to BiPAP.
I'm just a user, but that sounds to me it looks like panic attacks during your sleep. I don't know if it is a sufficient reason, but I would recommend you to try out a BiPAP for few days if you are able to do so.

While using Dreamstation, I have tried CFlex 1, 2 and 3 as well as AFlex 1, 2 and 3. AFlex 1 was for me the best mode. Maybe you should give it a try?

Is there anyone sleeping next to you able to confirm or not about the anxiety attacks?

Thib

[Sleeprider]

Ahead of the arousal, your actual tidal volume was about 360 mL and minute vent was near 6.0 L/min which is below your median and probably your requirements. I can only speculate that you are gradually increasing either hypoxia or hypercapnea and during sleep you are not responding to this low respiratory rate as most of us would with an increased volume or rate of respiration. You appear to suddenly arouse with dramatically increased breathing volume or what appears to be recovery breathing which compensates for the low oxygen or high CO2 that has previously built up. In other words, I agree with the thoughts Thibaulthib posted above.

This pattern has been consistent, and it's not something we see very often, if ever, because the autonomic respiration system works on a feedback loop that usually prevents this. I have no doubt that it would be fully resolved by a bilevel machine where pressure support would enhance your respiratory volume. The problem is not that you "can't breath", it is that you are waking up in an oxygen debt and having a panic reaction complete with hyperventilation and probably an adrenaline shot. If you want to see this, an inexpensive recording oximeter would tell the story, or confirm if SpO2 is gradually dropping, then suddenly recovering during the arousal.

Your fixed pressure Philips CPAP may do better if you increase the pressure to 9 or 10. Even though you don't have many events, the higher pressure would improve oxygenation. It's worth a try. If we continue to see this slow desaturation or panic reaction even with higher pressure, I think you should consider upgrading your machine to at least a Resmed Airsense 10 Autoset where EPR could provide 3-cm of pressure support, or better to an Aircurve 10 Vauto which could provide even more pressure support. Let's try some higher pressure first.

[Dyinginmysleep]

Thank you guys for the responses. I talked to the place that sold me the cpap while waiting for my visit with the sleep doctor but their knowledge stops a being able to press the on button and telling me the machine works as intended. Anything further and they look at me like im an alien...

This wednesday i have my visit with the sleep doctor and will print out what you guys said and bring it to him and see what his take is.

As for upgrading to another machine, the place where i got my current machine said to get a Dreamstation, does this have the features i need? Or do i specifically need a Resmed Airsense 10 Autoset or Aircurve 10 Vauto?

What is the best machine, with money not being an issue? I know very little about this, and would greatly appreciate your advice.

As for the oximeter, will this do?
Commercial link removed.  Search Amazon for Superior Measuring Oximeter.


I really really appreciate your help, it's not a good feeling being terrified of going to bed and i have no one to turn to currently but you guys

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To maintain our status as an educational organization, the only commercial links allowed in this forum are to CPAP-related manufacturer websites.  This is stated in the Apnea Board Rules with details given in the Commercial Links Policy section.

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[Dyinginmysleep]

Also, i changed the pressure on my machine from 7 to 9. Hope this works

[Sleeprider]

Only the Resmed machine provides pressure support like a bilevel, with up to 3 cm pressure difference between IPAP and EPAP. This pressure support can improve ventilation and might avoid some of the respiratory arousals you are experiencing. An Auto CPAP rather than fixed level CPAP can also increase and decrease pressure automatically to better meet changing needs through your night and you life for that matter. Auto CPAP can be setup as a fixed pressure, and insurance covers them both at the same cost to you under HCPCS code E0601. So we prefer auto CPAP, and would recommend the Resmed Airsense 10 Autoset over the Philips Respironics Dreamstation Auto. Both are considered good machines, and the medical community does not recognize any difference between the two, however the pressure relief on the Resmed actually has a potential therapeutic application that the Philips does not.

We do not know what causes your sudden arousal, but if it is due to a slow onset of hypoxia, then bilevel may be more helpful. I think the best explanation to your doctor would be, "I have used the Philips Respironics machine for many years and still have this problem, so I'd like to try the Resmed Autoset and see if that helps". Also, "I think an auto machine like the Resmed Autoset will help me to get better results and avoid a future sleep test". You doctor is NOT going to want to read a bunch of forum hacks suggesting therapy alternatives. Keep it simple. It's your right to request what you want.

[pholynyk]

Aside from the impropriety of posting a commercial link, the oximeter you referenced is NOT suitable for recording overnight. Many suppliers use the same or similar case, but only the Contec CMS50D+ will record overnight. However, this style of oximeter is clunky and can slip off the finger overnight.
I would recommend spending (a little?) more and getting a Contec CMS50 F or I model, which has a separate sensor which fits snugly over a finger.

[Sleeprider]

Take a look at Supplier #19 for Contec CMS 50F or 50I. SleepyHead is currently compatible with Contec CMS50D+, CMS50E, CMS50F and CMS50I serial oximeters. It's worth getting one that is less bulky and will be more comfortable and reliable. Whatever you linked to is not a useful device.

[Dyinginmysleep]

Last night had no issues with the cpap turned up to 9.

As for the oximeter, the CMS50D+ is 55 bucks and looks like maybe the one i'll be getting. The Contec CMS 50F or 50I seems to have horrific reviews on amazon.

Another one that i noticed was this one, supposed updated version of the cms50f/i  on Amazon.
Link removed.

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Moderator Action: Link Removed

To maintain our status as an educational organization, the only commercial links allowed in this forum are to CPAP-related manufacturer websites.  This is stated in the Apnea Board Rules with details given in the Commercial Links Policy section.

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