+- Apnea Board Forum - CPAP | Sleep Apnea (https://www.apneaboard.com/forums)
+-- Forum: Public Area (https://www.apneaboard.com/forums/Forum-Public-Area)
+--- Forum: Main Apnea Board Forum (https://www.apneaboard.com/forums/Forum-Main-Apnea-Board-Forum)
+--- Thread: New to Forum (/Thread-New-to-Forum--32087)
New to Forum - rfaircloth40 - 03-21-2021
I have used a Bpap off and on for 2 years, I have tried many settings and I am now back to the original. Any information will be greatly appreciated.
Thank you
Richard
RE: New to Forum - Gideon - 03-21-2021
welcome to the forum.
what we need to do is balance OA and CA events. Since you have essentially no OA events we want to try to reduce your CA events. For that we want to reduce PS and evaluate what happens. What we expect is for the CA events to decrease.
Reduce PS to 3/ set IPAP = 16
RE: New to Forum - Sleeprider - 03-21-2021
The biggest problem in the graphs above is not the event rate, but the mere 3.3 hours of therapy. That's not going to get the job done. Move your Flex level to 2 and stick with it for a night.
RE: New to Forum - mesenteria - 03-21-2021
Agree, halve the range you currently have for flex (it's currently 4.0 according to your charts) for a bold first move, and then bracket. As Sleeprider says, at least one night....a FULL night. Like, 5 hours minimum, and that means asleep if you can manage it. Lying there awake, waiting for the clock to run up to 5 or more hours, doesn't do any of us any good, so please don't subject yourself to that kind of torture. If you have some other problem interfering with your sleep, please let us know and we'll try to help if we can.
If you get a good result on the first night, I would personally advise to let it ride another two or three nights to see if it's a solid change for the better. One night is a bit thin because there is so much variance for most of us from night-to-night. I'd like to seem some reliability to any changes.
RE: New to Forum - rfaircloth40 - 03-22-2021
I feel better this morning, I did not get through the whole night, but close. I did a Performance Test on my machine and it failed. I have an appointment this week to see what is wrong. I do have one other item, I have a place in the mountains, above 8500 feet, while I am there my AHI goes between 30 to 60. I called my Manufacturer and they stated my machine does adjust for altitude. I am not sure if the Performance Test failure is related.
Thank you for the feed back, it is greatly appreciated.
Richard
RE: New to Forum - Sleeprider - 03-22-2021
Your problem with altitude is common, but your central apnea rate is high anyway and will be worse at altitude. The BiPAP you have is not capable of treating central apnea, and I think you probably need a machine called ASV (adaptive servo ventilator). The ASV can treat therapy onset central apnea as well at the centrals that occur at altitude. ASV will treat your apnea with lower exhale pressure to keep your airway patent against obstruction, however when a central apnea occurs and the airway is open, the SV increases pressure support to cause you to inhale. It allows the spontaneous breathing your have most of the time, but also treats central apnea and hypopnea. If you regularly go to high altitude you will need ASV, however we will try to optimize your current machine to minimize the CA events.
You are using a BiPAP but there is not pressure support (difference between inhale and exhale pressure IPAP/EPAP). Normally individuals using a bilevel like myself, use the pressure support function for comfort and to treat inspiratory flow limitations. The pressure support makes breathing easier. In some individuals like yourself, the pressure support increases the number of CA events. It could be that your failure to adapt to your BiPAP is not your fault, but that it is the wrong therapeutic device for you.
RE: New to Forum - rfaircloth40 - 03-22-2021
What ASV would you recommend? I guess I need to go back to the DR, I hate going through another Sleep Study,
Thanks again,
Richard
RE: New to Forum - Gideon - 03-22-2021
Make a case and write it down.
How much time are you at "altitude". This is part of your case. the 4.84 AHI, 3.98 CAI could be OK (only maybe) BUT the higher values at altitude are not.
How consistent is your CAI?
Here is one set of rules, keep in mind that how you feel can override this.
(edit) http://www.apneaboard.com/wiki/index.php/Justifying_Advanced_PAP_Machines
You have been on BiPap for 2+ years and you still have CA events, these are not going away.
Which ASV, Collectively here we recommend the ResMed and many of the users have switched from the PR so are familiar with both/
RE: New to Forum - SarcasticDave94 - 03-22-2021
Agreed, this is headed to Central Apnea diagnosis for cause. For cause here is maybe pre-existing condition or higher altitudes. Mini trainwreck so far. We can attempt to set you up with an avoidance plan as suggested, but your comfort needs consistently documented. Literally write down events, comfort or lack, and all other symptoms, complications. Once we get there, you'll need to present it to doc and request ResMed AirCurve 10 ASV.
RE: New to Forum - rfaircloth40 - 03-22-2021
Thank you, I will start a log, here are charts from the high altitude, I am up there all summer and visit during the winter for a week at a time.
Richard