Newbie w/questions: Vygon/Boussignac CPAP, etc.

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Pugsy
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Re: Newbie w/questions: Vygon/Boussignac CPAP, etc.

Post by Pugsy » Sun Jul 26, 2015 11:36 am

Condensation in the hose or mask is easily eliminated with a heated hose.
Home cpap therapy is miles apart from a titration sleep study with no humidifier at all.
Heated hoses not only prevent rain out but they also allow for greater control over the humidity delivered.

What you are looking for doesn't exist but if you wish to continue searching for it by all means go for it but give regular cpap therapy a try while you are searching.
There is a reason it is considered the gold standard for sleep apnea therapy.

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Re: Newbie w/questions: Vygon/Boussignac CPAP, etc.

Post by Goofproof » Sun Jul 26, 2015 12:03 pm

Unless you are running a marathon in your sleep, you won't be breathing at your full lung. Actually it will be slower and less deeply. Jim
Last edited by Goofproof on Sun Jul 26, 2015 12:35 pm, edited 1 time in total.
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Re: Newbie w/questions: Vygon/Boussignac CPAP, etc.

Post by PoolQ » Sun Jul 26, 2015 12:03 pm

With your 3L capacity and not feeling like you are getting a full breath sounds like you were hitting a flow limit caused by your apnea, I get the same thing and it can be quite disturbing. Increasing the machine pressure will decrease flow limit events or even eliminate them. I just changed to auto start that does not increase to full pressure until it determines that I am asleep. It defaulted to 4, 5 was still not enough, 6 was too high for me. It turns out that 5.6 is perfect, but it has to go to 8 to be effective and currently has a cap of 14 and reduces the pressure by 4 during exhale. BPAP can go to 20 max and you can set inhale and exhale separately instead of exhale = inhale -x. With the new servo systems the pressure can be adjusted during the inhale to mimic your natural breathing pressure curve, on a breath by breath basis.

This is all way, way past constant pressure, there is nothing that could make me use a constant anything system, Why would I want to decrease my options?
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Re: Newbie w/questions: Vygon/Boussignac CPAP, etc.

Post by yaconsult » Sun Jul 26, 2015 12:08 pm

The latest generation of CPAP machines are amazing in their capabilities and nearly silent. Now that you have had a sleep study, they should be contacting you to meet with your DME so you can be provided with your equipment. The important thing is to make sure you get a good data-capable machine so that you can monitor your progress and make adjustments should it become necessary.

Some great info on these topics can be found at:
http://adventures-in-hosehead-land.blog ... -with.html
https://maskarrayed.wordpress.com/what- ... me-part-i/

Please see the very helpful posts that are pinned to the top section of this forum as well.
Severity criteria: The criteria of the severity of OSAS are a combination of the severity of daytime sleepiness and the value of apnea-hypopnea index (AHI).
Mild: 5-15 events per hour.
Moderate: 15-30 events per hour.
Severe: more than 30 events per hour.

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Re: Newbie w/questions: Vygon/Boussignac CPAP, etc.

Post by raven1962 » Sun Jul 26, 2015 1:38 pm

I was hitting some sort of limit in the machine. It was like hitting the limit of a respirator, before they adjusted the flow. I don't know how better to describe it. Just a normal breath and there wasn't enough air. A sort of bump, like popping a valve. I hit it with almost every breath. I'd be breathing in, then there would be this pause where I couldn't get more air, then kind of a bump and there it would let me get more air. Several times it even happened twice, with the first bump just past about half capacity, and the last bump just before the end of a breath. That's why I would think something running straight off a compressor and a regulator would be more effective. No internal valves, or whatever it was, to be such a problem. Like inhaling and putting your hand over your mouth. Maybe a quarter of a second pause in the flow, sometimes it happened twice. That's why I figured it had to do with my lung capacity, vs the typical 2 liters. It was enough of a problem to bother me, is about all I can say for sure. I'm a PADI scuba diver, if out of practice. I know what a constant supply should feel like.

I can't imagine a sleep study center being capable of the eeg battery they ran on me, not having a top-notch C-PAP. It took a long time just for the tech to put all the electrodes on my head. The hose was bad enough, but having to pull on that set of cables to turn over was a royal PITA. Something about seizure disorder testing, above and beyond the normal sleep study, but it may have had to do with my being a multiple stroke survivor. I've had 6 or 7 mini strokes. No real physical issues, but there are definite gaps in my memory.

So far I've had multiple problems with the one machine, as well as problems with 3 different types of masks (nose pillows, then the cup thing over the nose, then the one covering my nose and mouth. I figure I'm going to need something that cups from under my chin, to over my nose, if not the entire face-plate type. I can't sleep with my dentures in, so the bottom edge kept slipping up too high, letting the mask slip out of alignment.

Even with all of those issues, I felt better after the last 15 minutes or so of real sleep, than I have in a long time.

Knowing the problems I had, led me to the Boussignac valve and constant air-supply questions. Fighting the 3 different masks led to other questions. Been fighting fatigue/oxygen-starvation for a long time, and losing. I still think the steady-source, regulated pressure is going to be better. I certainly know the hose is going to be a big problem, including where it sticks out of the mask. Putting a valve below my chin, without fighting a hose, would seem to be better, at least from where I sit.

I am trying to get a couple of those valves, to work with, as well as continuing to look at different masks. Heck, some nebulizer masks appear to be better shaped, than most of the C-PAP designs. Granted, they need a better seal, but they don't stick out 4-6 inches, either.
Later,
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Re: Newbie w/questions: Vygon/Boussignac CPAP, etc.

Post by pettyfan45 » Sun Jul 26, 2015 2:25 pm

raven1962 wrote:I was hitting some sort of limit in the machine. It was like hitting the limit of a respirator, before they adjusted the flow. I don't know how better to describe it. Just a normal breath and there wasn't enough air. A sort of bump, like popping a valve. I hit it with almost every breath. I'd be breathing in, then there would be this pause where I couldn't get more air, then kind of a bump and there it would let me get more air. Several times it even happened twice, with the first bump just past about half capacity, and the last bump just before the end of a breath. That's why I would think something running straight off a compressor and a regulator would be more effective. No internal valves, or whatever it was, to be such a problem. Like inhaling and putting your hand over your mouth. Maybe a quarter of a second pause in the flow, sometimes it happened twice. That's why I figured it had to do with my lung capacity, vs the typical 2 liters. It was enough of a problem to bother me, is about all I can say for sure. I'm a PADI scuba diver, if out of practice. I know what a constant supply should feel like.

I can't imagine a sleep study center being capable of the eeg battery they ran on me, not having a top-notch C-PAP. It took a long time just for the tech to put all the electrodes on my head. The hose was bad enough, but having to pull on that set of cables to turn over was a royal PITA. Something about seizure disorder testing, above and beyond the normal sleep study, but it may have had to do with my being a multiple stroke survivor. I've had 6 or 7 mini strokes. No real physical issues, but there are definite gaps in my memory.

So far I've had multiple problems with the one machine, as well as problems with 3 different types of masks (nose pillows, then the cup thing over the nose, then the one covering my nose and mouth. I figure I'm going to need something that cups from under my chin, to over my nose, if not the entire face-plate type. I can't sleep with my dentures in, so the bottom edge kept slipping up too high, letting the mask slip out of alignment.

Even with all of those issues, I felt better after the last 15 minutes or so of real sleep, than I have in a long time.

Knowing the problems I had, led me to the Boussignac valve and constant air-supply questions. Fighting the 3 different masks led to other questions. Been fighting fatigue/oxygen-starvation for a long time, and losing. I still think the steady-source, regulated pressure is going to be better. I certainly know the hose is going to be a big problem, including where it sticks out of the mask. Putting a valve below my chin, without fighting a hose, would seem to be better, at least from where I sit.

I am trying to get a couple of those valves, to work with, as well as continuing to look at different masks. Heck, some nebulizer masks appear to be better shaped, than most of the C-PAP designs. Granted, they need a better seal, but they don't stick out 4-6 inches, either.
First off again Boussignac value is not something you can get for home use, it is only for hospital use. If you already have a CPAP do you know what the make, model, pressure setting is. Also what mask do you use.

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Re: Newbie w/questions: Vygon/Boussignac CPAP, etc.

Post by PoolQ » Sun Jul 26, 2015 2:44 pm

I have no idea what kind of machine the lab used, but home machines, unless they are the servo types ($4,000+) cannot do what you are concerned about. They blow air period. The can however detect what you are doing. They can tell if you inhale or exhale, or if you should be inhaling and don't. They have no way to limit the airflow, but could decrease it if they for some reason thought you were starting to exhale. If that is the case you just set ERP (exhale relief pressure) to 0 and you will have to breath out against full pressure, but the machine will no long change pressure on you.

Even if you did get a servo machine you can set it for servo, APAP, Bi-level or pure CPAP. Total overkill for most. If the machine you start with is not working your Doc can have it changed until you get the kind you need. The servo is one step short of a full ventilator.

Remember the study has zero idea of what is going on with you when you walk in. Their job is to figure it out and then report it to the Doc, not to fix it that night.
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Re: Newbie w/questions: Vygon/Boussignac CPAP, etc.

Post by HoseCrusher » Sun Jul 26, 2015 3:00 pm

With more information I have to say that I have experienced something similar.

If you are up to it, try this.

Prior to laying down, hyperventilate prior to putting your mask on.

While sleeping, if you experience the machine trying to limit your intake of air, take your mask loose from your face and take a few quick breaths. Then put the mask back into place and drift back to sleep.

This is a royal pain, but it is manageable. Once you get use to the therapy the problem seems to go away, at least it did for me.

If money is no object, you can set up an ambulance style CPAP device and hire a paramedic to train you in how to adjust the settings. It may not be portable, but it would give you a lot to play with as far as adjustments go.

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Re: Newbie w/questions: Vygon/Boussignac CPAP, etc.

Post by PoolQ » Sun Jul 26, 2015 3:15 pm

Also remember that your brain is not used to any of this and while trying to make sense of what you are feeling it may goof and tell you one thing is happening when it is really something else. Jus saying. I did this a lot, I had my humidity set to high and I kept thinking I was congested. I tried all the standard things for congestion with no relief, then I turned down the humidity by one and bingo no more "congestion"
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Re: Newbie w/questions: Vygon/Boussignac CPAP, etc.

Post by BlackSpinner » Sun Jul 26, 2015 3:20 pm

You can not compare titration and sleep study with home use. First of all titration means they are trying different pressures to see what you respond to best - obviously they are not going to hit it spot on the first time. Many people feel like they are O2 starved on the lower pressures even though they re getting air "pushed" at them. But they have to start at the lower levels. They need to have you hooked up to an eeg in order to see if you are asleep - only by looking at bran waves can they tell if you are sleeping and what stages of sleep you are getting to. Also they need to see if the pressure causes other problems - like your brain forgetting to breathe. There are many different kinds of sleep apnea and some are treated differently then others and only by trying different kinds of pressure and breathing can they tell what you need.

Get a copy of your sleep and titration reports.

Oh and for many of us sleeping with filtered pressured humidified air has greatly benefited our sinuses and asthma.

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Re: Newbie w/questions: Vygon/Boussignac CPAP, etc.

Post by palerider » Sun Jul 26, 2015 3:35 pm

raven1962 wrote:The Boussignac valve uses induced airflow, so it doesn't need a source of 100% airflow supplied. It CAN be used with air, not just O2, which can still be added. It's a constant, regulated flow, rather than some compensated flow machine. .
it's huge compared to the mask I use.

there's *NO WAY* to create a reliable calculated pressure with it.

I'll bet you 20$ that my resmed machine is quieter than any rotary vane pump... though I suppose you could leave that in your garage and run an air line, and not care.

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Re: Newbie w/questions: Vygon/Boussignac CPAP, etc.

Post by chunkyfrog » Sun Jul 26, 2015 3:41 pm

De ja yu?

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Re: Newbie w/questions: Vygon/Boussignac CPAP, etc.

Post by M'ohms » Sun Jul 26, 2015 3:53 pm

There are several masks on the market that incorporate a chin support. Check out FP masks or the Hybrid. Whatever your concerns are about mask fit, there is probably one that will meet your needs. Remember, if one size doesn't work, but you otherwise like a particular mask, then try it in a different size.

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Re: Newbie w/questions: Vygon/Boussignac CPAP, etc.

Post by palerider » Sun Jul 26, 2015 4:03 pm

raven1962 wrote:I was hitting some sort of limit in the machine. It was like hitting the limit of a respirator, before they adjusted the flow. I don't know how better to describe it. Just a normal breath and there wasn't enough air. A sort of bump, like popping a valve. I hit it with almost every breath.
you may need a machine that provides separate inhale and exhale pressures, ie, a bi-level machine, if you breath really slow and deep, you'll need a resmed VPAP machine, because they offer adjustments on how long the machine stays at inhale pressure.

as to your 3 liter lung capacity, the resmed vpap auto can maintain 25cm/h2o pressure while delivering 161 liters PER MINUTE of air, using a standard size hose. so as long as you're not breathing more than 53 times per minute, full capacity, it can keep up with you.

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Re: Newbie w/questions: Vygon/Boussignac CPAP, etc.

Post by palerider » Sun Jul 26, 2015 4:13 pm

PoolQ wrote:I have no idea what kind of machine the lab used, but home machines, unless they are the servo types ($4,000+) cannot do what you are concerned about. They blow air period.
Even if you did get a servo machine you can set it for servo, APAP, Bi-level or pure CPAP..
bilevels can be had for under 1000, and that sounds like what he's run into.

most bilevels can't be set to apap, though they can usually bet configured to mimic it, if they're an auto bilevel.

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