Issues with Respironics Trilogy/Specialists

[Madalot]

Interesting. Per the Trilogy, my resting rate is usually around 23-25. If I lay perfectly still and stop concentrating on breathing it goes down to 18-19. Then again, we are actively thinking about the respiratory rate and how we breathe when we are monitoring the screen, so that effects it as well.

Thanks for the explanation on backup rate, I will ask when I go to see the Dr. what an appropriate backup rate would be, if any.

I really wish the Trilogy allowed the patient to monitor their therapy, although it's understandable since it's not a very common machine.

You and me both. I mean, the respiratory information is nice, but I would love to have the Trilogy give the standard OSA data that the cpap/bipap/asv machines do. But you're right -- it's not a very common machine and most people that DO have it aren't doing what we are. They are just using it the way the RT sets it up and that's it. My DME inherited me and the Trilogy and I had to train them on how to use it!!

[Matt00926]

Interesting. Per the Trilogy, my resting rate is usually around 23-25. If I lay perfectly still and stop concentrating on breathing it goes down to 18-19. Then again, we are actively thinking about the respiratory rate and how we breathe when we are monitoring the screen, so that effects it as well.

Thanks for the explanation on backup rate, I will ask when I go to see the Dr. what an appropriate backup rate would be, if any.

I really wish the Trilogy allowed the patient to monitor their therapy, although it's understandable since it's not a very common machine.

You and me both. I mean, the respiratory information is nice, but I would love to have the Trilogy give the standard OSA data that the cpap/bipap/asv machines do. But you're right -- it's not a very common machine and most people that DO have it aren't doing what we are. They are just using it the way the RT sets it up and that's it. My DME inherited me and the Trilogy and I had to train them on how to use it!!

That is my experience as well, my sleep doc is unfamiliar with the trilogy (to be fair, the majority of sleep disorder patients suffer from OSA or something similar). My RT seems familiar with the machine but not with my specific needs. Then again, I'm a harsh critic and I've only met him once. It's hard to be objective when you feel miserable and just want things to work!

[Madalot]

Interesting. Per the Trilogy, my resting rate is usually around 23-25. If I lay perfectly still and stop concentrating on breathing it goes down to 18-19. Then again, we are actively thinking about the respiratory rate and how we breathe when we are monitoring the screen, so that effects it as well.

Thanks for the explanation on backup rate, I will ask when I go to see the Dr. what an appropriate backup rate would be, if any.

I really wish the Trilogy allowed the patient to monitor their therapy, although it's understandable since it's not a very common machine.

You and me both. I mean, the respiratory information is nice, but I would love to have the Trilogy give the standard OSA data that the cpap/bipap/asv machines do. But you're right -- it's not a very common machine and most people that DO have it aren't doing what we are. They are just using it the way the RT sets it up and that's it. My DME inherited me and the Trilogy and I had to train them on how to use it!!

That is my experience as well, my sleep doc is unfamiliar with the trilogy (to be fair, the majority of sleep disorder patients suffer from OSA or something similar). My RT seems familiar with the machine but not with my specific needs. Then again, I'm a harsh critic and I've only met him once. It's hard to be objective when you feel miserable and just want things to work!

Once again, I hear you! I'm no expert, but I've been using the Trilogy since February 2010 and have been through Hell and back trying to get settings that at work for me. Please do not hesitate to ask me questions. I may not know the answer, but maybe between the two of us, we can figure it out!!!

[JDS74]

I believe you are going to need a very special software program from Respironics called Direct View to see any data on that SD card.
SleepyHead and/or Encore aren't compatible with the Trilogy machines.

Yes, Pugsy is correct. And Direct View does NOT track any sleep related data (other than apneas but the data makes no sense). It WILL track your averages including Vte, IPAP/EPAP, PTB, Minute Ventilation, etc.

Here is a link to Phillips description of DirectView but not how to get a copy.
http://www.healthcare.philips.com/main/ ... efault.wpd

[Matt00926]

Had a tough time sleeping last night, but even with maybe 3-4 hours of sleep today I feel better. My goal is to NEVER fall asleep without the mask and machine on. Eventually I assume I will start sleeping more and more as time goes on.

[Madalot]

Had a tough time sleeping last night, but even with maybe 3-4 hours of sleep today I feel better. My goal is to NEVER fall asleep without the mask and machine on. Eventually I assume I will start sleeping more and more as time goes on.

I'm sorry you had a rough time last night. As you said, hopefully things will settle and it will get better over time.

Have you thought about adding a stand-alone humidifier to the Trilogy? I had tried cpap & bipap (both with humidifiers) before ending up on the Trilogy and found I missed it. A forum member had one and gave it to me and I've been using it ever since. I got my doctor to write the order for humidification so my DME had to provide me with a humidifier which I have as my backup for when this one bites the dust.

Oh -- question for you! Are you using an antibacterial filter? If so, how often do you change it?

I ask because my first DME had one on it, but never said squat about it needing to be changed (idiot RT). By the time the owner realized it, about 9 months had passed and that thing was BLACK!!! It was disgusting.

The recommendation is monthly, but I have cats (lots of hair and such) so we change mine twice a month.

[Matt00926]

Had a tough time sleeping last night, but even with maybe 3-4 hours of sleep today I feel better. My goal is to NEVER fall asleep without the mask and machine on. Eventually I assume I will start sleeping more and more as time goes on.

I'm sorry you had a rough time last night. As you said, hopefully things will settle and it will get better over time.

Have you thought about adding a stand-alone humidifier to the Trilogy? I had tried cpap & bipap (both with humidifiers) before ending up on the Trilogy and found I missed it. A forum member had one and gave it to me and I've been using it ever since. I got my doctor to write the order for humidification so my DME had to provide me with a humidifier which I have as my backup for when this one bites the dust.

Oh -- question for you! Are you using an antibacterial filter? If so, how often do you change it?

I ask because my first DME had one on it, but never said squat about it needing to be changed (idiot RT). By the time the owner realized it, about 9 months had passed and that thing was BLACK!!! It was disgusting.

The recommendation is monthly, but I have cats (lots of hair and such) so we change mine twice a month.

I have thought about a humidifier, I do tend to wake up with a really dry lips/mouth and throat. I will probably ask for one soon. The RT showed me the filter, he said I can just clean it once a month or so. The RT said for the first six months or so they will be visiting semi-frequently to make sure things are going smoothly.

I have been reading up on target tidal volume and it seems the new target values are between 6 - 8mL/kg as part of the new trend toward lung protection strategies. Right now i am using 8mL/kg but I don't think I can reach the target amount with my current IPAP/pressure support setting. However, I seem to recall on the BiPAP averaging about 320 with the same PS which would be between the 6 - 8 mL/Kg range so I think it should be okay.

I am going to load up Sleepyhead and take a look at my old BiPAP data to check out the data averages.

I am slowly creating a list of solid questions to ask when I see my new Dr. soon.

[Madalot]

Had a tough time sleeping last night, but even with maybe 3-4 hours of sleep today I feel better. My goal is to NEVER fall asleep without the mask and machine on. Eventually I assume I will start sleeping more and more as time goes on.

I'm sorry you had a rough time last night. As you said, hopefully things will settle and it will get better over time.

Have you thought about adding a stand-alone humidifier to the Trilogy? I had tried cpap & bipap (both with humidifiers) before ending up on the Trilogy and found I missed it. A forum member had one and gave it to me and I've been using it ever since. I got my doctor to write the order for humidification so my DME had to provide me with a humidifier which I have as my backup for when this one bites the dust.

Oh -- question for you! Are you using an antibacterial filter? If so, how often do you change it?

I ask because my first DME had one on it, but never said squat about it needing to be changed (idiot RT). By the time the owner realized it, about 9 months had passed and that thing was BLACK!!! It was disgusting.

The recommendation is monthly, but I have cats (lots of hair and such) so we change mine twice a month.

I have thought about a humidifier, I do tend to wake up with a really dry lips/mouth and throat. I will probably ask for one soon. The RT showed me the filter, he said I can just clean it once a month or so. The RT said for the first six months or so they will be visiting semi-frequently to make sure things are going smoothly.

I have been reading up on target tidal volume and it seems the new target values are between 6 - 8mL/kg as part of the new trend toward lung protection strategies. Right now i am using 8mL/kg but I don't think I can reach the target amount with my current IPAP/pressure support setting. However, I seem to recall on the BiPAP averaging about 320 with the same PS which would be between the 6 - 8 mL/Kg range so I think it should be okay.

I am going to load up Sleepyhead and take a look at my old BiPAP data to check out the data averages.

I am slowly creating a list of solid questions to ask when I see my new Dr. soon.

The filter I am talking about is NOT the gray, washable one. I'm talking about a big, round filter that is disposable. It goes on the Trilogy before you attach the hose. It is an extra precaution against bacteria. Look up antibacterial filters on cpap.com and you'll see what I mean.

Definitely ask about humidification, especially if you have a dry mouth. It made a world of difference for me. Cpap.com sells them as well, but if you can get your doctor or ORDER it, the DME will provide it and bill your insurance (if applicable).

[Matt00926]

Had a tough time sleeping last night, but even with maybe 3-4 hours of sleep today I feel better. My goal is to NEVER fall asleep without the mask and machine on. Eventually I assume I will start sleeping more and more as time goes on.

I'm sorry you had a rough time last night. As you said, hopefully things will settle and it will get better over time.

Have you thought about adding a stand-alone humidifier to the Trilogy? I had tried cpap & bipap (both with humidifiers) before ending up on the Trilogy and found I missed it. A forum member had one and gave it to me and I've been using it ever since. I got my doctor to write the order for humidification so my DME had to provide me with a humidifier which I have as my backup for when this one bites the dust.

Oh -- question for you! Are you using an antibacterial filter? If so, how often do you change it?

I ask because my first DME had one on it, but never said squat about it needing to be changed (idiot RT). By the time the owner realized it, about 9 months had passed and that thing was BLACK!!! It was disgusting.

The recommendation is monthly, but I have cats (lots of hair and such) so we change mine twice a month.

I have thought about a humidifier, I do tend to wake up with a really dry lips/mouth and throat. I will probably ask for one soon. The RT showed me the filter, he said I can just clean it once a month or so. The RT said for the first six months or so they will be visiting semi-frequently to make sure things are going smoothly.

I have been reading up on target tidal volume and it seems the new target values are between 6 - 8mL/kg as part of the new trend toward lung protection strategies. Right now i am using 8mL/kg but I don't think I can reach the target amount with my current IPAP/pressure support setting. However, I seem to recall on the BiPAP averaging about 320 with the same PS which would be between the 6 - 8 mL/Kg range so I think it should be okay.

I am going to load up Sleepyhead and take a look at my old BiPAP data to check out the data averages.

I am slowly creating a list of solid questions to ask when I see my new Dr. soon.

The filter I am talking about is NOT the gray, washable one. I'm talking about a big, round filter that is disposable. It goes on the Trilogy before you attach the hose. It is an extra precaution against bacteria. Look up antibacterial filters on cpap.com and you'll see what I mean.

Definitely ask about humidification, especially if you have a dry mouth. It made a world of difference for me. Cpap.com sells them as well, but if you can get your doctor or ORDER it, the DME will provide it and bill your insurance (if applicable).

Oh my, thanks for the heads up on the filter! I will make sure to ask the RT the next time he comes to the house. The RT mentioned he can bring a humidifier next time he comes if I feel I need it. Hopefully they are cheap and easily replaceable. If so I will probably just order them in bulk and take a look every 3 months or so to see if it needs to be changed.

Not looking forward to humidifier maintenance, I tend to be very lazy.

[Madalot]

Not looking forward to humidifier maintenance, I tend to be very lazy.

If you get the same humidifier I have, the tank is DISPOSABLE. It needs to be changed monthly. I get supplies every quarter and I get 3 antibacterial filters (I buy extra myself since I change it twice a month) and 3 water tanks. Use distilled water and there shouldn't be any maintenance other than changing the tank once a month.

[Matt00926]

Not looking forward to humidifier maintenance, I tend to be very lazy.

If you get the same humidifier I have, the tank is DISPOSABLE. It needs to be changed monthly. I get supplies every quarter and I get 3 antibacterial filters (I buy extra myself since I change it twice a month) and 3 water tanks. Use distilled water and there shouldn't be any maintenance other than changing the tank once a month.

Interesting. Your DME sends you the disposable tanks and filters on a regular basis? Hm, I had no idea the antibacterial filter needed changing so often. Live and learn.

[Madalot]

Not looking forward to humidifier maintenance, I tend to be very lazy.

If you get the same humidifier I have, the tank is DISPOSABLE. It needs to be changed monthly. I get supplies every quarter and I get 3 antibacterial filters (I buy extra myself since I change it twice a month) and 3 water tanks. Use distilled water and there shouldn't be any maintenance other than changing the tank once a month.

Interesting. Your DME sends you the disposable tanks and filters on a regular basis? Hm, I had no idea the antibacterial filter needed changing so often. Live and learn.

I can get any normal supplies that I need every quarter, including a new mask, hoses, filters, etc. The only things I get every time are a new mask, antibacterial filters & water tanks. I have enough washable (gray) filters and hoses.

Remember that the gray filters are the regular filters to keep dust/link out of the machine. I wash these monthly with my mask & hoses. I have 2 sets of hoses (regular 6' cpap hose and a shorter hose from the Trilogy to the humidifier) that I rotate.

The antibacterial filters are the larger, clear with white filter inside, that are disposable and should be changed monthly (unless you have reason to change them more often like I do).

[Madalot]

Checking in with you Matt00926 -- How's it going?

[Matt00926]

It's going okay, I feel better and have more energy overall. I was able to finish the work week relatively well without feeling like I needed to go home. I was able to socialize on Friday and Saturday!

I was actually so tired last night that I fell asleep without my mask on and woke up like 8 hours later. I am going to get back on the grind tonight. I think it threw me off because during the week I was trying to keep a somewhat normal sleep schedule. And then on some weekends I go out with friends and come home late...

Until I see my new Dr. I am going to keep the same settings on the trilogy:

AVAPS-AE at rate 2.0 (i debated 1.0 but I think tidal volume is pretty important)
Max IPAP: 20
Max Pressure support: 15
Min Pressure Support: 10
EPAP min/max: 5 (i debated keeping this at 4 but I figure a little extra oxygenation and also a little more help in eliminating any apneas should they come up, can't hurt)
Rise time: 600
Ramp: 45 mins

[Madalot]

It's going okay, I feel better and have more energy overall. I was able to finish the work week relatively well without feeling like I needed to go home. I was able to socialize on Friday and Saturday!

I was actually so tired last night that I fell asleep without my mask on and woke up like 8 hours later. I am going to get back on the grind tonight. I think it threw me off because during the week I was trying to keep a somewhat normal sleep schedule. And then on some weekends I go out with friends and come home late...

Until I see my new Dr. I am going to keep the same settings on the trilogy:

AVAPS-AE at rate 2.0 (i debated 1.0 but I think tidal volume is pretty important)
Max IPAP: 20
Max Pressure support: 15
Min Pressure Support: 10
EPAP min/max: 5 (i debated keeping this at 4 but I figure a little extra oxygenation and also a little more help in eliminating any apneas should they come up, can't hurt)
Rise time: 600
Ramp: 45 mins

I thought you had switched to regular AVAPS. Maybe when you see your doctor, you can switch if the pulses were bothersome, which I think you said they were.