Can't get AHI below 38

[OSAHell]

FitLife has a ton of deadspace:

Morbius have an interesting point here about the mask deadspace. You should also see lower CSR% in your Sleepyhead daily data.

Does your cardiologist suggested any new heart exam? What about the EF in your previous heart exam, any talks on that?

[clearyt]

Is dead space a good thing or a bad thing? The ef was 40-50 for the last test which was Nov 2013. Can't do another till this November

[OkyDoky]

Is dead space a good thing or a bad thing? The ef was 40-50 for the last test which was Nov 2013. Can't do another till this November

I will try to explain what I understand about the increased dead space with the Fit Life.
When you have more space you are able to retain more CO2. And since it is the balance of CO2 and O2 that triggers our brain to take a breath, it may have played a part in the better report from July 7th.
So in this case it appears to be a good thing.
I'm sure others can explain it more but I didn't want your question left hanging and for you to worry about the term dead space.

[Morbius]

The ef was 40-50 for the last test which was Nov 2013.

That might be a problem. There's great concern about prescribing ASV if EF is <45%:

http://www.fda.gov/Safety/Recalls/ucm450858.htm

[OSAHell]

The ef was 40-50 for the last test which was Nov 2013.

That might be a problem. There's great concern about prescribing ASV if EF is <45%:

That was my first thought when I read the EF answer...

clearyt, have you been diagnosed with CHF? Sorry, maybe I don't recall or missed something in the previous posts... :/

[clearyt]

CHF?

[clearyt]

I just looked it up. No, that has never been mentioned. A Fib, controlled, is the main thing. Chronic bronchitis, also controlled at the moment. Usually flares up in winter.

[OSAHell]

Thanks for the answers and for those who are still woundering CHF stand for "Congestive Heart Failure".

Let us know when you meet with your pulmonologist. I just hope your won't be the "ping pong" ball between your pulmonologist and cardiologist...

At least you seem to have better AHI with your new mask. If you saw improvment with a AHI of 38 you should certainly seem more with an AHI in the teens!

[Pugsy]

Ahhh...the cardiologist didn't want to "handle" making the referral to a real sleep doctor. Can't say as it didn't surprise me but I am disappointed.

So just put your foot down at the pulmonologist office that you want to get a second opinion on the therapy and you want that second opinion to be from someone whose primary medical practice is sleep apnea stuff and understands centrals and Cheyne Stokes and periodic breathing along with possible alternatives.
It's a complicated (and potentially harmful) situation that is going on here. We don't know if the centrals were present in the original at home sleep study or if they have popped up because of the cpap pressure and this is something that really should be followed closely by the experts.

Using the FitLIfe mask probably helped with the oxygen/carbon dioxide balance and thus lessened the periodic breathing so that the respirations were more normal. I would definitely keep using that mask until more information is gleaned from a second opinion. The borderline cardiac EF factor complicates things a little in terms of possible ASV machine usage to remedy the problem but there may be other alternatives that could be explored. This is where the doctor with sleep apnea expertise gets to earn his big bucks.

[clearyt]

Yes Pugsy, you are right. Another opinion is needed, and especially someone with expertise in these more complicated cases. Another echo will be conducted in November, but I don't expect the number to improve. I would like for you to take a look at the charts since using the big mask to see if there is any news there aside from the AHI. If you wouldn't mind. Glad you are back from your trip.

[sickwithapnea17]

maybe the different CO2 balance motivates respiration? I'm not sure if you have a smaller more focused full face mask doesn't the column of air help to splint open your airway for OSA events.
I don't like the amara since the gel tore in a couple of months, don't buy any masks with thin gels. anyway I was travelling and now I'm in a terrible mess because the amara gel tore and I tried to crazy glue the hole and instead the other part tore now.
the thing about the Fit Life is that it leaks at the top unless you really tighten the mask and then it puts a lot of pressure on my eyeballs.

[sickwithapnea17]

I left a leak at the top and tried max ipap 18, epap 7-12 min ps 3cm or so and and around 11am I was really terribly foggy and exhausted, it didn't work maybe because of the leak.
now I changed to max ipap 25, epap 6-13 and min ps 2.5 and I feel a bit better today. but it wasn't as rested as the amara I think

[metsfan302]

Noob here to the group and Cpap kind of.... I just want to say after reading this entire thread, you guys are great and i'll actually feel comfortable posting and not feeling weird. I am going to go make a thread when I get home from work - so I can post exactly what equip I have/ ahi etc its over 50. Sorry did not mean to hijack this thread. I hope your doing better!

[sickwithapnea17]

can anyone say that fit life is better than an amara type mask? I'm disappointed and it's difficult to sleep on since it puts pressure on my eyeballs.