Issues with Respironics Trilogy/Specialists

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
Matt00926
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Re: Issues with Respironics Trilogy/Specialists

Post by Matt00926 » Fri Aug 28, 2015 6:46 am

I guess 2 decent nights in a row was too much to ask for. Laid in bed for a while and felt like I was barely getting enough air. Slept for about 2 hours and then woke up. Took the mask off to take a break, fell back asleep and woke up when my alarm went off. Not being able to stay asleep after falling asleep is killing me.

I am going to raise the minimum PS from 6 to 8 to see if that helps.
Machine: ResMed AirCurve 10 ST
Mask: Fisher & Paykel Simplus FFM

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Madalot
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Re: Issues with Respironics Trilogy/Specialists

Post by Madalot » Fri Aug 28, 2015 8:41 am

Matt00926 wrote:I guess 2 decent nights in a row was too much to ask for. Laid in bed for a while and felt like I was barely getting enough air. Slept for about 2 hours and then woke up. Took the mask off to take a break, fell back asleep and woke up when my alarm went off. Not being able to stay asleep after falling asleep is killing me.

I am going to raise the minimum PS from 6 to 8 to see if that helps.
I'm sorry you had a bad night. I know how that is as I dealt with it a LOT during the early phases of this. Even now, I still have trouble from time to time. My minimum IPAP of 18 seems like nothing to me now. I tried upping it but found it was TOO much for me to fall asleep, so back down to 18 I went.

I used the AE for a while and sometimes I could deal with it, but those pulses -- they really started to disturb my sleep so I finally gave up and when with regular AVAPS.

I truly hope you can find settings that will solve your issues and let you sleep at the same time.

_________________
Mask: FlexiFit HC431 Full Face CPAP Mask with Headgear
Humidifier: HC150 Heated Humidifier With Hose, 2 Chambers and Stand
Additional Comments: Trilogy 100. S/T AVAPS, IPAP 18-23, EPAP 10, BPM 7

Matt00926
Posts: 266
Joined: Sat Apr 25, 2015 9:15 am

Re: Issues with Respironics Trilogy/Specialists

Post by Matt00926 » Fri Aug 28, 2015 8:51 am

Madalot wrote:
Matt00926 wrote:I guess 2 decent nights in a row was too much to ask for. Laid in bed for a while and felt like I was barely getting enough air. Slept for about 2 hours and then woke up. Took the mask off to take a break, fell back asleep and woke up when my alarm went off. Not being able to stay asleep after falling asleep is killing me.

I am going to raise the minimum PS from 6 to 8 to see if that helps.
I'm sorry you had a bad night. I know how that is as I dealt with it a LOT during the early phases of this. Even now, I still have trouble from time to time. My minimum IPAP of 18 seems like nothing to me now. I tried upping it but found it was TOO much for me to fall asleep, so back down to 18 I went.

I used the AE for a while and sometimes I could deal with it, but those pulses -- they really started to disturb my sleep so I finally gave up and when with regular AVAPS.

I truly hope you can find settings that will solve your issues and let you sleep at the same time.
Me too. It's also weird that some nights the mask feels more comfortable then others even when I practice the same "sleep hygiene." The first time I tried the F&P Simplus Full Face Mask was in the sleep lab and I loved it. Last night I kept fiddling with it because it felt too tight no matter what I did.
Machine: ResMed AirCurve 10 ST
Mask: Fisher & Paykel Simplus FFM

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Madalot
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Re: Issues with Respironics Trilogy/Specialists

Post by Madalot » Fri Aug 28, 2015 9:11 am

Matt00926 wrote:Me too. It's also weird that some nights the mask feels more comfortable then others even when I practice the same "sleep hygiene." The first time I tried the F&P Simplus Full Face Mask was in the sleep lab and I loved it. Last night I kept fiddling with it because it felt too tight no matter what I did.
You're going to have nights like that. It just happens. I might go weeks where I am just fine, fall asleep almost immediately, sleep well, etc. But I'm in a pattern now where that is NOT the case. Bed bothers me, mask leaks, pain, etc.

Just keep in mind that you DID have a good night so it IS possible. There are so many factors that can influence how well the night goes. Like I said -- I'm losing weight (just shy of 50 pounds since March) and I realized that my face is slimmer, therefore the mask was leaking. I tightened it but then got a sore on my nose bridge. Then THAT hurt for several nights and disturbed my rest.

Some nights the pain is excruciating and I can barely handle being in bed. Other nights, it doesn't bother me much at all.

All these things affect how MY nights go. I'm sure you've got some other things that can affect it too.

_________________
Mask: FlexiFit HC431 Full Face CPAP Mask with Headgear
Humidifier: HC150 Heated Humidifier With Hose, 2 Chambers and Stand
Additional Comments: Trilogy 100. S/T AVAPS, IPAP 18-23, EPAP 10, BPM 7

Matt00926
Posts: 266
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Re: Issues with Respironics Trilogy/Specialists

Post by Matt00926 » Tue Sep 15, 2015 10:54 am

As a trial I set up AVAPS-AE per my sleep studies recommendation but it was unbearably uncomfortable and my tidal volume actually looked pretty low.

From the sleep study they wanted me to do:

Max IPAP pressure: 30
Max Pressure Support: 16
Min Pressure Support: 8
EPAP min - 4
EPAP max - 14
Tidal Volume - 400
Rise time: 3
Breath Rate: Auto trak/sensitive

These settings are INSANE as even while awake I was regularly seeing my IPAP pressure go between 20 - 25 and I wasn't even appearing to get the average target tidal volume of 400 because I think it kept revving up the EPAP which lessens the pressure support unless the IPAP also increases. My full face mask was having a hard time with pressures above 20 and it was very uncomfortable. I basically just laid awake all night.


What I actually use that is much more comfortable and allows me to fall asleep easier. For whatever reason I achieve higher tidal volumes with these settings as well.

Max IPAP pressure: 19
Max Pressure Support: 15
Min Pressure Support: 8
EPAP min: 4
EPAP max: 5
Tidal Volume: 350
Rise time: 4
Breath Rate: auto trak/sensitive


I don't really suffer from apneas much, I think the high pressure support helps eliminate them. When I used regular BiPAP, I used fixed pressures of 19/4 and my AHI was always under 5 with little to no hypopneas and during my 1st sleep study my oxygen saturation remained 92% and above.

I honestly don't understand the AVAPS (AE) algorithm as being more comfortable than fixed pressure support. I guess it is useful when you need the greater EPAP range?
Machine: ResMed AirCurve 10 ST
Mask: Fisher & Paykel Simplus FFM

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Madalot
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Re: Issues with Respironics Trilogy/Specialists

Post by Madalot » Tue Sep 15, 2015 11:29 am

Matt00926 wrote:I honestly don't understand the AVAPS (AE) algorithm as being more comfortable than fixed pressure support. I guess it is useful when you need the greater EPAP range?
That's pretty much the conclusion I came to as well. We finally upped my fixed EPAP and turned the AE off. I was okay on it sometimes, but most of the time, those damned pulses disturbed my sleep.

So, straight AVAPS it is for me.

_________________
Mask: FlexiFit HC431 Full Face CPAP Mask with Headgear
Humidifier: HC150 Heated Humidifier With Hose, 2 Chambers and Stand
Additional Comments: Trilogy 100. S/T AVAPS, IPAP 18-23, EPAP 10, BPM 7

Matt00926
Posts: 266
Joined: Sat Apr 25, 2015 9:15 am

Re: Issues with Respironics Trilogy/Specialists

Post by Matt00926 » Tue Sep 15, 2015 12:04 pm

Madalot wrote:
Matt00926 wrote:I honestly don't understand the AVAPS (AE) algorithm as being more comfortable than fixed pressure support. I guess it is useful when you need the greater EPAP range?
That's pretty much the conclusion I came to as well. We finally upped my fixed EPAP and turned the AE off. I was okay on it sometimes, but most of the time, those damned pulses disturbed my sleep.

So, straight AVAPS it is for me.
The pulses didn't seem to bother me the last few nights but I think they are easier to deal with when the settings are more reasonable (not such a wide open range). I'm just using the EPAP min of 4 and EPAP max of 5 so basically I'm getting a little extra pressure support when the slightly higher EPAP isn't deemed necessary to kill an obstruction.

Kind of funny that I wanted to obtain the Trilogy so badly, yet I'm not really doing that much different than my old BiPAP. I miss how quiet my Resmed Aircurve 10 machine was. It is nice that while awake I can use a lower IPAP pressure though instead of it always being fixed. I usually have an IPAP of 15 - 17 while laying down awake.

When I am sitting up I have a much higher spontaneous achieved tidal volume and then when I lay down it tends to lower. Makes sense since I have restrictive lung disease so the breathing patterns are different for me.
Machine: ResMed AirCurve 10 ST
Mask: Fisher & Paykel Simplus FFM

Matt00926
Posts: 266
Joined: Sat Apr 25, 2015 9:15 am

Re: Issues with Respironics Trilogy/Specialists

Post by Matt00926 » Thu Sep 17, 2015 8:52 am

Last night I pulled out my old Resmed Airfit F10 mask and found the fit to be better than my current F&P Simplus. It's also a lot quieter, it seems less air comes out of the vent holes or maybe just the vent holes are smaller/not as many.

Out of curiosity I put the AVAPS-AE settings back on with the wide range but lowered the target tidal volume from 400 to 300 which for me is 6mL/kg and I had a much better experience in comfort. I didn't really mind the pulses either.

When I woke up my IPAP was around 20 which isn't bad considering while awake it's usually from 15-17. I also feel better knowing that with the EPAP range I am hopefully getting the proper airway and oxygenation support that I need as my respiration patterns surely change throughout the night.

I think I will finally keep these settings so that they can pull some meaningful data from the sim card. I can't believe they still don't support the patient being able to monitor their therapy. My RT told me that most of his patients are old people and they don't really care and aren't curious.
Machine: ResMed AirCurve 10 ST
Mask: Fisher & Paykel Simplus FFM

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Madalot
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Re: Issues with Respironics Trilogy/Specialists

Post by Madalot » Thu Sep 17, 2015 3:58 pm

Matt00926 wrote:Last night I pulled out my old Resmed Airfit F10 mask and found the fit to be better than my current F&P Simplus. It's also a lot quieter, it seems less air comes out of the vent holes or maybe just the vent holes are smaller/not as many.

Out of curiosity I put the AVAPS-AE settings back on with the wide range but lowered the target tidal volume from 400 to 300 which for me is 6mL/kg and I had a much better experience in comfort. I didn't really mind the pulses either.

When I woke up my IPAP was around 20 which isn't bad considering while awake it's usually from 15-17. I also feel better knowing that with the EPAP range I am hopefully getting the proper airway and oxygenation support that I need as my respiration patterns surely change throughout the night.

I think I will finally keep these settings so that they can pull some meaningful data from the sim card. I can't believe they still don't support the patient being able to monitor their therapy. My RT told me that most of his patients are old people and they don't really care and aren't curious.
I'm glad you found settings that work better for you. I know it took me FOREVER to get settled on the Trilogy.

I wish the Trilogy would give more sleep related data. The respiratory data is good and helpful, but I'd like a little more of the sleep apnea data, which Direct View does NOT provide.

_________________
Mask: FlexiFit HC431 Full Face CPAP Mask with Headgear
Humidifier: HC150 Heated Humidifier With Hose, 2 Chambers and Stand
Additional Comments: Trilogy 100. S/T AVAPS, IPAP 18-23, EPAP 10, BPM 7

Matt00926
Posts: 266
Joined: Sat Apr 25, 2015 9:15 am

Re: Issues with Respironics Trilogy/Specialists

Post by Matt00926 » Fri Sep 18, 2015 12:12 pm

Madalot wrote:
Matt00926 wrote:Last night I pulled out my old Resmed Airfit F10 mask and found the fit to be better than my current F&P Simplus. It's also a lot quieter, it seems less air comes out of the vent holes or maybe just the vent holes are smaller/not as many.

Out of curiosity I put the AVAPS-AE settings back on with the wide range but lowered the target tidal volume from 400 to 300 which for me is 6mL/kg and I had a much better experience in comfort. I didn't really mind the pulses either.

When I woke up my IPAP was around 20 which isn't bad considering while awake it's usually from 15-17. I also feel better knowing that with the EPAP range I am hopefully getting the proper airway and oxygenation support that I need as my respiration patterns surely change throughout the night.

I think I will finally keep these settings so that they can pull some meaningful data from the sim card. I can't believe they still don't support the patient being able to monitor their therapy. My RT told me that most of his patients are old people and they don't really care and aren't curious.
I'm glad you found settings that work better for you. I know it took me FOREVER to get settled on the Trilogy.

I wish the Trilogy would give more sleep related data. The respiratory data is good and helpful, but I'd like a little more of the sleep apnea data, which Direct View does NOT provide.
Interesting. Does your RT give you access to the Direct View data? I've heard it's pretty expensive software.
Machine: ResMed AirCurve 10 ST
Mask: Fisher & Paykel Simplus FFM

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Madalot
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Re: Issues with Respironics Trilogy/Specialists

Post by Madalot » Fri Sep 18, 2015 12:25 pm

Matt00926 wrote:Interesting. Does your RT give you access to the Direct View data? I've heard it's pretty expensive software.
That's a VERY long story. In short, no, my RT doesn't give me access to it (the DME doesn't even have it). Early on in my "journey" I was able to get a copy of the software. Later, someone here (I don't remember who) sent me an updated version of it.

_________________
Mask: FlexiFit HC431 Full Face CPAP Mask with Headgear
Humidifier: HC150 Heated Humidifier With Hose, 2 Chambers and Stand
Additional Comments: Trilogy 100. S/T AVAPS, IPAP 18-23, EPAP 10, BPM 7

Matt00926
Posts: 266
Joined: Sat Apr 25, 2015 9:15 am

Re: Issues with Respironics Trilogy/Specialists

Post by Matt00926 » Fri Sep 18, 2015 12:44 pm

Madalot wrote:
Matt00926 wrote:Interesting. Does your RT give you access to the Direct View data? I've heard it's pretty expensive software.
That's a VERY long story. In short, no, my RT doesn't give me access to it (the DME doesn't even have it). Early on in my "journey" I was able to get a copy of the software. Later, someone here (I don't remember who) sent me an updated version of it.
Could you by chance upload the installer onto dropbox so I could get it? Or did it come on a CD? This would be amazing.
Machine: ResMed AirCurve 10 ST
Mask: Fisher & Paykel Simplus FFM

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Madalot
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Re: Issues with Respironics Trilogy/Specialists

Post by Madalot » Fri Sep 18, 2015 1:54 pm

Matt00926 wrote:
Madalot wrote:
Matt00926 wrote:Interesting. Does your RT give you access to the Direct View data? I've heard it's pretty expensive software.
That's a VERY long story. In short, no, my RT doesn't give me access to it (the DME doesn't even have it). Early on in my "journey" I was able to get a copy of the software. Later, someone here (I don't remember who) sent me an updated version of it.
Could you by chance upload the installer onto dropbox so I could get it? Or did it come on a CD? This would be amazing.
Came on CD (both did). I'm not even sure I could put my hands on it. Maybe you could post a new thread, something titled "Looking for DirectView Software for Trilogy" and see if anyone else has it. In the meantime, I'll try to see what I can find. We recently completely redid my office area and a lot of stuff got moved/put upstairs/thrown out. If I get a chance over the weekend, I'll look.

_________________
Mask: FlexiFit HC431 Full Face CPAP Mask with Headgear
Humidifier: HC150 Heated Humidifier With Hose, 2 Chambers and Stand
Additional Comments: Trilogy 100. S/T AVAPS, IPAP 18-23, EPAP 10, BPM 7

Matt00926
Posts: 266
Joined: Sat Apr 25, 2015 9:15 am

Re: Issues with Respironics Trilogy/Specialists

Post by Matt00926 » Thu Sep 24, 2015 2:21 pm

Madalot wrote:
Matt00926 wrote:
Madalot wrote:
Matt00926 wrote:Interesting. Does your RT give you access to the Direct View data? I've heard it's pretty expensive software.
That's a VERY long story. In short, no, my RT doesn't give me access to it (the DME doesn't even have it). Early on in my "journey" I was able to get a copy of the software. Later, someone here (I don't remember who) sent me an updated version of it.
Could you by chance upload the installer onto dropbox so I could get it? Or did it come on a CD? This would be amazing.
Came on CD (both did). I'm not even sure I could put my hands on it. Maybe you could post a new thread, something titled "Looking for DirectView Software for Trilogy" and see if anyone else has it. In the meantime, I'll try to see what I can find. We recently completely redid my office area and a lot of stuff got moved/put upstairs/thrown out. If I get a chance over the weekend, I'll look.
Able to rummage anything up?
Machine: ResMed AirCurve 10 ST
Mask: Fisher & Paykel Simplus FFM

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Madalot
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Re: Issues with Respironics Trilogy/Specialists

Post by Madalot » Fri Sep 25, 2015 6:02 am

Matt00926 wrote:
Madalot wrote:
Matt00926 wrote:
Madalot wrote:
Matt00926 wrote:Interesting. Does your RT give you access to the Direct View data? I've heard it's pretty expensive software.
That's a VERY long story. In short, no, my RT doesn't give me access to it (the DME doesn't even have it). Early on in my "journey" I was able to get a copy of the software. Later, someone here (I don't remember who) sent me an updated version of it.
Could you by chance upload the installer onto dropbox so I could get it? Or did it come on a CD? This would be amazing.
Came on CD (both did). I'm not even sure I could put my hands on it. Maybe you could post a new thread, something titled "Looking for DirectView Software for Trilogy" and see if anyone else has it. In the meantime, I'll try to see what I can find. We recently completely redid my office area and a lot of stuff got moved/put upstairs/thrown out. If I get a chance over the weekend, I'll look.
Able to rummage anything up?
I won't lie to you - I haven't had a chance to look and it keeps slipping my mind. I promise I'll try to do it this weekend and if you don't hear from me by Sunday, pop me a PM to remind me, k? I'm sorry. Life is just hard sometimes and things like looking for things tend to slip my mind.

_________________
Mask: FlexiFit HC431 Full Face CPAP Mask with Headgear
Humidifier: HC150 Heated Humidifier With Hose, 2 Chambers and Stand
Additional Comments: Trilogy 100. S/T AVAPS, IPAP 18-23, EPAP 10, BPM 7