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UARS
#11
RE: UARS
Your numbers are good, there is nothing that needs changing number wise. You had 1 RERA, this is evidence of having some Flow Limitations, nut nothing number-wise that needs changing.  The basis of future changes should be based on how you feel.  

Your closeup does show some Flow Limitation, low enough that it does not require chasing.  You state that you wakeup all the time is no good, it is also a very poor measure.  If you wake up all the time then you get no sleep.  There is nothing in the charts indicating what is doing this.  If you can define what is waking you, I know, easier said than done, it will be a lot easier to help you.  The next obvious thing to attack is sleep hygiene
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#12
RE: UARS
I am near Portland, Oregon.
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#13
RE: UARS
Thank you for your reply.  Do you not believe, as others, that UARS should be treated with bi-level?

I feel, many days, absolutely horrible.  I lived 35 years of my life feeling fine, clearly UARS was developing as the teeth grinding got worse.  But suddenly, I started gasping for air hundreds of times as I was falling asleep.  I did CBT, therapy, saw a psychiatrist, got on meds, yadda yadda, NOTHING did anything until I was finally diagnosed with UARS and started using APAP.  It worked well after an adjustment period and I slept normally (woke a few times a night for a few mins) until about the last year, as sleep has deteriorated again.  I am seeing a naturopath and taking hormone replacement therapy, as I know that is an issue and it appears to be helping.

I go to bed at the same time, only try to go to sleep when sleepy, I don't use screens in the evening, I read relaxing books, wakeup at the same time, exercise vigorously every day, chase 2 young kids around, meditate nearly every day.  I'm not really sure what else I can be doing.  Do you have suggestions??

I thought that the flow limitations should be eliminated on the graphs?  No?
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#14
RE: UARS
They should be driven down to roughly the level that you have them now. Eliminated? No, that is an extreme, and extremes are rarely good. Striving for zero's is an extreme, good if you get them easily, but not to the point of chasing them. Multiple awakenings need to be identified and addressed. UARS is best treated with PS and as such a BiLevel, but assumes that you cannot get sufficient PS with a CPAP. CPAP's do not deliver PS, thus the need for a BiLevel. In the real world I know that you recognize that ResMed CPAP devices can deliver up to 3 cmw of EPR/PS. Further attempts to treat flow limitations for you would call for a BiLevel.
Specifically identify your awakenings and you may have a reason to get a BiLevel, maybe even one that will convince your doctor.
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#15
RE: UARS
How do I specifically identify awakenings?  How can I know what is waking me up, if it's a breathing problem waking me up?  I just don't know what the next steps are.

Is not possible that the flow limitations that I am still having are enough to wake me up?
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#16
RE: UARS
If you are waking, take 5 breaths then turn the machine off, then restart. Then view the detail (3-minute view) and identify "disturbed" sequences in your charts. Video yourself and take a similar action.

And yes, it is possible, but let's prove it to justify further action.

All that said your purchasing a BiLevel (VAuto) will not hurt your therapy.
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#17
RE: UARS
Great, thank you!  I will do it and report back.
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#18
RE: UARS
There is an Aircurve 10 Vauto advertised in your Craigslist but located in Olympia for $275. The seller reports 2658 hours. This is an exceptional deal if you want to experiment with higher PS and inspiratory timing and sensitivity.
Sleeprider
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#19
RE: UARS
(10-18-2019, 09:34 PM)Sleeprider Wrote: There is an Aircurve 10 Vauto advertised in your Craigslist but located in Olympia for $275.  The seller reports 2658 hours. This is an exceptional deal  if you want to experiment with higher PS and inspiratory timing and sensitivity.

This would make, at worst, a great backup machine.  I would get it for that reason alone.
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#20
RE: UARS
(10-18-2019, 06:45 PM)Sleeprider Wrote: ... Meanwhile, like me, you may have to buy your first bilevel to prove it works.  I would guess nearly half of all members you see on this forum with bilevel, had to procure their first BiPAP machine without their doctor's or insurance support.  I still have my Philips System One 760 as a backup, but insurance bought my Aircurve 10 Vauto. 

@sleeprider - have you explained this (how you demonstrated medical necessity for bilevel via use) somewhere on the forum, or can you briefly summarize here?
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