Respironics DreamStation BiPAP autoSV H/HT/C,DS

[hueyville]

Just switched from a Respironics System One BiPAP autoSV Advanced with Quattro mask to a Respironics DreamStation BiPAP autoSV H/HT/C,DS. Doctor says it's main advantage is he can look at my data at will and make changes to machine from his computer and it has a few improvements in algorithms and features over the previous machine. For those of you that don't remember the mess I was in back in 2013 and earlier following a severe head injury and broken neck I suddenly went from no signs of apnea to actually stopping breathing in my sleep for up to a few minutes till wife or tent mate climbing mountains woke me or I woke up choking and feeling like I was drowning.

First doctor and sleep lab dropped me immediately. I had taken my Ambien, pain pill and a 10mg Diazapam just two hours before sleep technicians demanded I leave the sleep lab after I went "code 4" so went to me vehicle to nap and they came out and demanded I leave their property. Went through a string of doctors and machines before found a good doctor who cares and fought the insurance company till they bought me the ASV after starting on a CPAP then a Respironics System 1 cpap/cflex bipap/biflex where my AHI still hit 135 to 160 some nights. After years of sleep studies, adjusting machine, adding sleeping wedge to actually discovering my AHI is lower if sleep with television on. (Explain that)

Currently my AHI hovers between 35 and 50 with odd nights down close to 10 and some nights still spikes up into the 90 to 135 range even with the ASV. Tonight will be my first night on the Respironics DreamStation BiPAP autoSV. Have downloaded their App to my phone and tablet plus paired both to my new machine. Doctor says it has some minor improvements to algorithms and mainly gives him better access to my data and making changes to the machine. He hopes he can log in weekly and work on reducing my AHI as it seems to vary with weather, seasons and stress. Am in high stress mode lately due to a myriad of factors. Do I still use Sleepyhead software to look at my data when feel a need or will I get enough from the Respironics DreamMapper app? Any oddities or quirks I need to be aware of? I was last patient of the day at my DME supply today and the tech was in a hurry so once she went down the "list" wanted to leave but as I asked questions she responded with a blank stare to more than she could even attempt to answer.

A normal night for me now is to take a Lunesta 3mg about an hour before bedtime then take a 10mg Diazapam just before I lay down and in 2 to 4 hours am wide awake till take a second 10mg Diazapam and will sleep another 1 to 3 hours based on how exhausted I am and how bad my brain and the ASV wrestle with each other over control of my breathing. I am one of those who will eventually wake up dead if don't use the machine but some nights rather die than strap the lobster with an air compressor on my face. After breaking my spine in three places over a period of time and several accidents (mostly people text messaging and driving rear ending me as spend most of my work day on the road) have finally weaned off pain med but without the Lunesta and Diazapam I will go days without sleep just looking at the ceiling as lay in bed.

I have the humidifier, heated hose and full face mask as body will go into mouth breathing mode with any other mask type and block off the machine. If try to mouth breath in full face mask it won't let me even get a start and forces me to breath through nose. It's the central hypopneas that really send my AHI numbers to the statosphere. Since the head injury not only did the apnea start but my my body quit making thyroid hormones, adrenaline and testosterone so have to take all that in pills or injections. Suggest folks try to avoid head injuries. Appreciate any tips on the new machine.

[zonker]

Appreciate any tips on the new machine.

goodness, you've had a heap of troubles. sorry you had to go through that.

the good news is that the technology moves forward. i don't have that machine and thus can't give you any advice. however, several here are familiar with it and will be along shortly to help out.

you may want to get a leg up, however. the free software, oscar, will help you quite a bit. with it, you can make graphs of each of your sleep sessions. those graphs can be uploaded here, where the experts can make helpful suggestions based on the data you show them.

please see my sig. it has a "newbie" thread and while you aren't a newbie, it will give you all kinds of guidance. see also the link to download oscar.

good luck!

[hueyville]

Have been using SleepyHead and only log in here when something changes in my equipment or treatment so guess I need to download what seems to be what others are now using. Last night was my first night on the new machine and first couple hours were tough, woke up after 2.5 hours, went back to sleep again for another two hours then took a muscle relaxer and had the best five hours sleep without even twitching in a decade. Seems like the new machine is an upgrade at least in comfort for me. Hope this does get me down to at least a 10 AHI average as am not unused to seeing nights like these.

[zonker]

Have been using SleepyHead and only log in here when something changes in my equipment or treatment so guess I need to download what seems to be what others are now using.

wish i had the knowledge to help you.

only thing i can advise is setting your charts the way they should be-

wiki/index.php/Oscar:organize

until you get some help from more knowledgeable people who may want to change things for the presentation of charts.

oh and i'm just curious, why do you have the dates blacked out?

[palerider]

Have been using SleepyHead and only log in here when something changes in my equipment or treatment so guess I need to download what seems to be what others are now using. Last night was my first night on the new machine and first couple hours were tough, woke up after 2.5 hours, went back to sleep again for another two hours then took a muscle relaxer and had the best five hours sleep without even twitching in a decade. Seems like the new machine is an upgrade at least in comfort for me. Hope this does get me down to at least a 10 AHI average as am not unused to seeing nights like these.

I'm interested in why you blacked out the dates of screenshots from some other month, with images that aren't even from a dreamstation autosv...

Your apparent attempt at being clever... didn't work very well.

[Jas_williams]

Have been using SleepyHead and only log in here when something changes in my equipment or treatment so guess I need to download what seems to be what others are now using. Last night was my first night on the new machine and first couple hours were tough, woke up after 2.5 hours, went back to sleep again for another two hours then took a muscle relaxer and had the best five hours sleep without even twitching in a decade. Seems like the new machine is an upgrade at least in comfort for me. Hope this does get me down to at least a 10 AHI average as am not unused to seeing nights like these.

I'm interested in why you blacked out the dates of screenshots from some other month, with images that aren't even from a dreamstation autosv...

Your apparent attempt at being clever... didn't work very well.

Sometimes there’s bad screenshots and sometimes there’s awful screen shots.


No indication of what machine your using how it’s configured or any information to actually allow us to help you. If you have an ASV it’s def not configured to work as one. Looks like you have a static pressure BiLevel or a very badly configured Auto.

[palerider]

Have been using SleepyHead and only log in here when something changes in my equipment or treatment so guess I need to download what seems to be what others are now using. Last night was my first night on the new machine and first couple hours were tough, woke up after 2.5 hours, went back to sleep again for another two hours then took a muscle relaxer and had the best five hours sleep without even twitching in a decade. Seems like the new machine is an upgrade at least in comfort for me. Hope this does get me down to at least a 10 AHI average as am not unused to seeing nights like these.

I'm interested in why you blacked out the dates of screenshots from some other month, with images that aren't even from a dreamstation autosv...

Your apparent attempt at being clever... didn't work very well.

Sometimes there’s bad screenshots and sometimes there’s awful screen shots.


No indication of what machine your using how it’s configured or any information to actually allow us to help you. If you have an ASV it’s def not configured to work as one. Looks like you have a static pressure BiLevel or a very badly configured Auto.

Those screenshots were from three different days, in some month NOT January or February of this month, and the pressure traces aren't from an autoSV.

What I see are lies. *shrug*

[hueyville]

Those screen captures were from my Respironics System One BiPAP autoSV and don't remember why blacked out those areas as were years ago. I can't seem to get Oscar to work on my computer at present but what's odd is switching to the new Dreamstation my AHI has been 5.2, 5.9 and 2.9 with 8.2 hours average sleep per night. On the System One my average AHI was 35 with lows 10.0 to 11.0 and highs 90 to 150 and average nights sleep 3.5 to 5.5 hours. I always thought there was something wrong with the System One machine out of the box but my numbers posted on it were consistent with sleep lab studies. Why in the world would someone lie about sleep apnea? That is totally baffling to me? If I remember correctly the top box I blacked out had my name but why the dates don't remember. Am always overly careful with personal info posted to web.

[hueyville]

(Trim)
No indication of what machine your using how it’s configured or any information to actually allow us to help you. If you have an ASV it’s def not configured to work as one. Looks like you have a static pressure BiLevel or a very badly configured Auto.

They are from a autoSV where doctor was changing pressures along with every setting on the machine drastically weekly trying to find a way to make the horrible nights stop. Initially he said was going to get me down to and AHI of 3.0 then 10.0 and finally got to feeling we had made progress any night I was under and AHI of 35. My apnea is so bad I have been asked to never return to four local sleep labs as went Code 4 in two of them and other two freaked out so bad I woke uplease in an ambulance. All of my sleep studies are done at the hospital now where they have the ability to deal with total stopping of breathing and fading heart rate.

[Jas_williams]

I have just been back through all you posts from 2013, it seems the screen shots were from a Resmed BiLevel running in Bipap mode.

You said that your ahi got down to 10 and below when you finally got your ASV but you never posted any graphs.


How are you doing with the new machine ?

[Pugsy]

That was a very old report from a bilevel with fixed pressure only settings. No wonder it looked like crap.

SleepyHead has been known to have problems playing nice with the new DreamStation ASV.
Not sure about OSCAR as it has been a bit iffy. Supposedly there is a newer not yet released version of OSCAR that plays nicer with the DreamStation ASV.
When push comes to shove though you can always get Encore Pro and it will work with the new DreamStation ASV.
PITA to install and use but if you want it you can find instructions on how to get it over at the apneaboard.com forum.
Encore is Windows only though.

[palerider]

Those screen captures were from my Respironics System One BiPAP autoSV 

No, they weren't. The pressure lines are all wrong for an autoSV

[hueyville]

Those screen captures were from my Respironics System One BiPAP autoSV 

No, they weren't. The pressure lines are all wrong for an autoSV

They absolutely were from a few months after I had met compliance on that machine and my AHI had done what it is now trending on the new Dreamstation autoSV. Initially machine was bringing my AHI down near and even into the nine range first week then it just began slowly creeping up without explanation to where better nights were in the thirties and bad nights were nintyish and up to the one hundred fifty range. Doctor started resting machine way outside of its designed parameters to try and see what, if any major changes in how pressure was delivered how my body would react. Pulled me in for another pair of sleep studies, one night on their equipment and a week later using my machine but otherwise all wired up to monitor my sleep.

Nothing they tried was getting any consistent results and by running pressures locked down like a manual machine, automatic mode with some slight variations and my average night settled into the mid thirties with the odd night ten to twenty and odd night ninety to mid one hundreds no matter how machine was forced to do different things to see if a different result could be acheived. What he discovered with his team and consulting other doctors in his specialty was nobody had a clue. By the time I found current sleep doctor had been dropped by two doctors and three labs and told to not come back as I believe they were sure the apnea was going to kill me soon and did not want to be the doctor of record or lab it happened in.

My previous Respironics machine after about a year began to literally drive me nuts. The machine was bouncing around like a pinball machine trying to shut down the events, was sleeping on the steepest sleeping wedge the DME sold which did more than the machine to help. Discovered my best perceived sleep at home was without the machine, sitting in my recliner with legs raised to lap height and recliner back in almost full vertical position. I would wake up every ninety minutes to sometimes three hours choaking, feeling like I was drowning, get normal breathing back and dift off to sleep again in thirty to ninety minutes. Before till someone woke me it was horrible the way I felt when finally forced from sleep and my climbing partners refused to share a tent anymore and wife had to move to bedroom on oposite side of rhe house but my bad episodes would still wake her which in turn she woke me and the cycle repeated getting two to three short sessions of fitful sleep per night usually totalling three to five hours best we could tell.

They put me back in lab and monitored me without any pressure but wired up, mask on and sleeping in a recliner the DME delivered to simulate how I had found I slept best at home. In the recliner woke up three times soon as AHI would start spiking up near triple digits but till the spike was rock solid in the thirties so machine or not my body did what it wanted regardless of any machine and sitting up did more. Continued mountaineering but never slept when higher than base camp and had a camp chair that looked like a sleeping pad with straps that left butt and legs flat on sleeping pad and elevated torso and head using straps to set angle and hold me bent at waist sitting at near vertical upper body position. Could manage this in a separate tent away from the group far enough my wheezing and hacking when woke to about 14,500 feet above sea level. From 15,000 foot to 18,500 foot high camps while others would do their best to get a few hours sleep I would sit up and force myself to always stay awake even if up high three days.

Eventually the fatigue just began to beat me down and when broke my lower spine the second time and heavy packs became an issue to carry totally quit high altitude mountaineering and did day summits in the Rockies during winter where I could sleep in recliners at hotels below 10,000 feet and transitioned to mostly technical ice climbing below 12,000 feet, alpine skiing and even had to stop riding by bicycle competitively at even home elevations from 800 to 3,500 feet as my body could not recover from a hard day of training in a single night or be ready to race a two or three day event and my bike sponsor dropped me and the fresh expensive racing bike wasn't given to me for each season anymore.

Sleep apnea has basically taken over my life and often miss days of work am so fatigued some days from no sleep and make them up on weekends or by working twelve hours the days I feel decent. Got this new DreamStation and took it home setup by the DME and doctor says will not change anything for two weeks and just finished night eleven. Night one slept 6:44 with AHI of 5.5, night two 7:27 at 5.9 AHI, night three slept 12:08 hours with an AHI of 2.9 and woke feeling like I was tripping on LSD. Night four slept 8:36 with AHI of 4.2 and woke feeling good and had a kick @$$ day at work then night five was 13:03 hours with 6.0 AHI but felt good. Night five 10:36 of sleep time and 6.5 AHI, night six 12:29 hours without rolling over at 6.7 AHI, night eight 12:28 hours without a single waking at 6.9 AHI, night nine 11:38 hours without as much as a twitch according to wife at 7.2 AHI. Then it was 7.9 AHI at 12:34 hours of sleep time and was waking lethargic likely from over sleep but my body is a decade starved from a decent nights sleep. Next night was 8:36 hours with 8.2 AHI then 7:05 hours at 7.9 AHI showing the firest night in several had a dip in AHI.

Night before last slept 8:25 hours with 8.1 AHI and last night slept 8:57 hours at 8.9 AHI sending the numbers in a continuous upwards march and doctor talked to my doctors P.A. a few minutes ago. Am going to bed every night within an hour of same time never before 11 pm and never after midnight. Am not setting an alarm to wake and letting my body sleep whatever time it wants but soon as wake and can't go right back to sleep in a few minutes it's time to get up. She said doctor reviewed my numbers soon as they opened while drinking his first cup of coffee. Se relayed a message he was changing nothing and going to let the machine run at the DME settings for first 30 days which all I need with over 4.5 hours sleep per night to make compliance but they want to see a minimum average of 3.5 hours for first 90 days. P.A. said he will likely make a minor adjustment at thirty days and again at sixty days but while in insurance company monitoring use does not want to try anything drastic and may pull me in for a sleep study at ninety days if the upwards climb gets anywhere near the 30 AHI which before was where we called it a decent night for me past several years.

I have believed a theory since my first two machines and especially after they switched me to the third machine which were all thirty days apart meaning I have two machines with thirty nights sleep back in their cases and the first BiPAP autoSV which is several years old but after first year of fighting the dang thing only wore it nights my back hurt too bad to sleep in the recliner and had to sleep in the bed. I think following the head injury where I fell off a tower job fracturing the rear of my skull just above the first vertebrae in the cervical spine in a nice T shaped fracture, bruised the rear of my brain where autonomic functions happen and had a lot of internal bleeding that quit right before they began discussing drilling hole(s) in the skull to allow the blood to drain and relieve pressure. In addition to going from no apnea to sudden complex uncontrollable apnea my thyroid levels went crazy, body quit making adrenaline and testosterone. My thyroid fluctuates from hyperthyroidism to hypothyroidism so requires regular blood tests to adjust which medicine I take and how much. I take the same amount of testosterone by injection every Monday after breakfast which has not changed or wavered since diagnosed with more than "Low T" but basically No T. My adrenal levels are stabile except when work/exercise hard in summer heat my body goes into dehydration no matter how much fluids I drink and if don't increase my intake of Hydrocortisone will go into adrenal shock and pass out. Havery been wearing a Medicalert bracelet for almost a decade now with name, "NEEDS STRESS DOSE STERIODS" in all caps and Complex Sleep Apnea under that. I have a Medicalert necklace size of a military dog tag with more detailed engraving and has a built in USB drive that port slides out with past fifteen years complete medical records including sleep studies, doctors notes, all information on head injury and endocrine system issues plus MRIs and x-rays of all my broken bones from the past injuries so emergency room doctors can be informed on immediate treatment and medications plus able to separate old issues from new.

To date have woken up five times in back of ambulance looking at grinning EMTs, used to be an EMT/Wilderness First Responder/Mountain and Wilderness S.A.R. so often will be at least someone on the radio that knows me if not on the crew that dispatched when someone sees me pass out in the heat. They are well used to it now, all information from past instances documented so call doctor in emergency room radio facility to approve administering a shot of stress dose steroids while hooking me up to an I.V. to get some fluids in me. By time get to hospital doctor usually pronounces me fit as a fiddle and releases me before they recover their equipment and leave so usually give me a ride back to my vehicle. Have learned to adapt and take my hydrocortisone four times a day in cool weather 10mg morning, 5mg after work and hour before bed.

Yesterday had to work after early church and work hard as till past three days has rained five of seven days per week along with a weekend of snow on ground and roads putting me way behind on my outside work. Friend came and helped me yesterday and we had an odd sunny day where temperature shot up above 60° and was dressed for low of 30° and high of 50° so by about 2:30 was sweating on top of a 32' extension ladder with a hammer drill, cordless impact driver and fixture installing in concrete wall when began to break out in a cold sweat, dropped the impact driver as was losing command of my hands arms and legs so went down ladder fast where I had turned white, was soaking wet and shaking so hard it scared my friend to death who wanted to call 911. Told him to wait, opened my medical kit, loosened belt and stabbed myself in hip with a syringe of stress dose steroids, drank a bottle of water while washing an extra hydrocortisone tablet down and was back on ladder soon as finished a small bottle of water. Thus my body is all mixed up from myriad of autonomic functions being off.

I believe (several doctors agree that with my medical knowledge, experience at keeping body functioning at its peak climbing mountains, racing bicycles, high level skiing, cave exploration, competitive running for about a decade, swimmimg, biathlons and triathlons that my internal belief about what is happening has merit and no doctor has been able to reel in the apnea yet which set in within a month of the tower fall early in the 3G to 4G race all the telecoms were engaged in to have nationwide coverage. I think the part of my brain that regulates breathing which works fine when awake goes loopy soon as approach REM sleep which for me due to fatigue is a matter of minutes after fall asleep I go deep sleep and the damaged part of brain is now misprogrammed and starts sending loopy signals to my body as what else could account for both obstructive hypopneas and centrals when had neither before the fall? Believe that when they put me on a machine it initially begins forcing the body to comply but my busted pumpkin decides it does not like what the machine is doing and begins to figure out how to counteract the equipment. Brain just bows up and does what it wants and why the first three machines were like fighting a lobster on my face holding a hose from an industrial air compressor. Drove me nuts and soon slept worse on the machines than sitting in my recliner.

Oddly we are two weeks into the new Dreamstation and am averaging 10:09:58 hours per night sleep with that group of nights that hit me after a few days where slept from ten to twelve hours per night. First few were sevenish hours and last few have been mostly normal eight hours sleep most recommend so seem to be stabilizing on hours slept but the AHI keeps marching up by a few decimal points every night. At most I wake once if need to go to the restroom which before the Dreamstation had to pee a half dozen times per night. Have always had very vivid dreams with regular nightmares since pre-kindergarden age. In second grade they were so bad parents had me see a mix of doctors including a counseler who said some people with vivid dreams they always remember next day and often for years are just wired like that and I learned to actually steer my dreams back when veered into nightmares to happy dreams without waking most times though on occasion I wake coming out of the bed into an offensive martial arts posture and even throwing punches and kicks. Initially it flipped the wife out but have never made a move that even resembled a threat to her she says it like there is an invisible adversary in the room and I go into fight mode with it till she calmly says my name and it's all o.k. to which many times get back in bed without fully waking. Guess twenty years learning a mix of martial arts in multiple dojos sends the body into muscle memory reaction when perceive a threat even in my dreams. Oddly have a pistol on my nightstand next to the BiPAP and have never touched it during such an episode.

Wife, ex-wife, parents and many friends have seen the leaping up into a flurry of punches and kicks from a dead sleep that all stay clear of my normal direction of attack which is the bedroom door whether at home, hotel or visiting someone's house. Have let off friends sofas and fought whatever set me off in my dream half way to their front door before woke up huffing and puffing. Ex-wife and wife actually began to find it comforting once realized the offensive attack was never directed at them or other person I knew if visiting but say they feel like if anything goes down sleeping or awake that I will go not just defensive but offensive before my consious mind has fully processed the threat but hint of a threat hands, elbows, feet and knees go into instant action. Have had friends/aquantences/relatives/coworkers in past that were practical jokers of the type that would hide behind doors, around corners or sneak up on someone distracted by a task and try their best to scare them. Nobody has done it twice to me as luckily when awake while fear has me do whatever to move forward or pivot 180° which fluidly begin a punch or kick and only once have I made contact hard enough to leave a mark and was already pulling the punch or would have hurt that person bad. Another benefit of years in dojo is learn when sparring with new people and kids how to pull strikes and not damage them.

Sure there are at least two regulars that will call B.S. on the entire post but if think I am lying come spend two to three nights at my house. Entire reason for detail is hope someday will encounter that expert or a statement will be shared with one that understands complex sleep disorders from nightmares to sudden onset apnea following a head injury and have some knowledge that will help me improve my life. Whether it's control my apnea or just get my dreams better dealt with a good night's sleep is something have wanted for a long time. Would post some Oscar charts but my laptop is still not operating with it so all I have is the data from my DreamMapper App.

[zonker]

you know what i find most remarkable about you, sir?

it's your ability to hone in on someone you feel is attacking you and ignore people who have asked questions or offer help.

good job.

[palerider]

Those screen captures were from my Respironics System One BiPAP autoSV 

No, they weren't. The pressure lines are all wrong for an autoSV

They absolutely were from a few months after I had met compliance on that machine

A flood of nonsense won't change the fact that those screenshots you tried to doctor were NOT from the machine you claimed them to be from.

Since you're dishonest, and deceitful, you're not worth my time.