Seeing Sleep Doc todat

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Cr1kk1t
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Seeing Sleep Doc todat

Post by Cr1kk1t » Wed Apr 16, 2014 7:05 am

Good morning everyone.

I am going to see my sleep doc this morning and I am expecting to change to either Bipap or ASV. I know I have already asked this but I can't get the thread to open.

What machines should I ask for? What is the top of the line for each?
What else should I be asking?

I have printed multiple nights of sleepyhead data along with corresponding O2 reports to share with her. Although I forgot to print a summary sheet. But I will have my computer to show her any nights therapy she wants to see.

Thank you for your help.

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robysue
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Re: Seeing Sleep Doc todat

Post by robysue » Wed Apr 16, 2014 7:14 am

The top of the line machines are:

PR System One Series 60 BiPAP Auto with Bi-Flex (Model number has a 760 in the middle)
Resmed S9 VPAP Auto

The fixed pressure bi-levels are:
PR System One Series 60 BiPAP Pro with Bi-Flex (Model number has a 660 in the middle)
Resmed S9 VPAP S

The long detailed comparison of the two bi-level auto machines that I wrote is at:
viewtopic/t97212/viewtopic.php?f=1&t=95 ... ke#p880411

Good luck!

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DeadlySleep
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Re: Seeing Sleep Doc todat

Post by DeadlySleep » Wed Apr 16, 2014 7:49 am

I am expecting to change to either Bipap or ASV
Why?

You use a low pressure and have very few centrals.

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LSAT
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Re: Seeing Sleep Doc todat

Post by LSAT » Wed Apr 16, 2014 7:53 am

DeadlySleep wrote:
I am expecting to change to either Bipap or ASV
Why?

You use a low pressure and have very few centrals.
I agree!

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Re: Seeing Sleep Doc todat

Post by robysue » Wed Apr 16, 2014 7:58 am

DeadlySleep wrote:
I am expecting to change to either Bipap or ASV
Why?

You use a low pressure and have very few centrals.
Don't know why the OP is interested in a BiPAP or ASV.

But I can say this: I was switched to BiPAP solely because I had very severe aerophagia at very low pressures on CPAP and APAP. And it was the sleep doc's PA who made the suggestion. It never dawned on me that a BiPAP might help with the aerophagia, but it did.

Aerophagia is not a reason to jump to an ASV machine however.

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Re: Seeing Sleep Doc todat

Post by Pugsy » Wed Apr 16, 2014 8:25 am

OP has documented (in sleep lab) ComplexSA that was pretty severe and right now is using a fine line between pressures on a cpap machine to sort of control the obstructives and not trigger the centrals (and they are triggered by as little as 8 cm pressure) and I don't think plain bipap is what she needs.
She needs ASV.
The pressures needed to better prevent the obstructive events simply trigger way too many centrals.
She lives at altitude which doesn't help...and she has oxygen issues requiring O2 at night...
She needs ASV.
I don't think a regular bipap will do the trick in this situation. It might but chances are slim.

She has had to make do with cpap and fine line pressure settings and less than optimal results often until recently got some insurance coverage to help pay for the high dollar machine.

So....either a S9 Adapt SV or PR System One60 series BiPap Auto SV model 960
Either one will do the trick are are super nice machines.

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DeadlySleep
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Re: Seeing Sleep Doc todat

Post by DeadlySleep » Wed Apr 16, 2014 8:29 am

It might be interesting to know what your settings were when,

robysue wrote: I had very severe aerophagia at very low pressures on CPAP and APAP.
and when,
switched to BiPAP

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Cr1kk1t
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Re: Seeing Sleep Doc todat

Post by Cr1kk1t » Wed Apr 16, 2014 8:30 am

DeadlySleep wrote:
I am expecting to change to either Bipap or ASV
Why?

You use a low pressure and have very few centrals.
Since being on the oxygen my AHI and such has been better. But I do still throw quite a few centrals and flow limitations. I also still have OSA's that wake me up. I am still feeling quite exhausted during the day. My primary care doctor has been watching my reports and is the one sending me to the sleep doctor to change machines to either BiPAP or ASV. I normally have a lot of centrals and I do have cheyene stokes breathing, although again the oxygen has helped with that as well. I also have pressure induced centrals so as we try to raise the pressure I have way more centrals. So I am kinda stuck where I am and feeling icky.

Does that help?

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DeadlySleep
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Re: Seeing Sleep Doc todat

Post by DeadlySleep » Wed Apr 16, 2014 8:48 am

Does that help?
Oh, it's not about helping me, take care of yourself and best of luck whatever you choose.

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Re: Seeing Sleep Doc todat

Post by chunkyfrog » Wed Apr 16, 2014 9:38 am

Remember, we are all different; our therapy may need to be different, but we share many of the same issues.
We are in this boat together, but some were stuck with the leaky end.

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Re: Seeing Sleep Doc todat

Post by robysue » Wed Apr 16, 2014 11:06 am

DeadlySleep wrote:It might be interesting to know what your settings were when,

robysue wrote: I had very severe aerophagia at very low pressures on CPAP and APAP.
and when,
switched to BiPAP
Started out at CPAP at 9cm (with EPR = 3) and felt like I'd swallowed a basketball every night.

Switched to APAP at 4-8cm (with EPR =3) and the aerophagia ranged from feeling like I'd swallowed several softballs to the occasional basketball each night. Severity of aerophagia seemed correlated to the amount of time with pressure AT or ABOVE 8cm.

First BiPAP titration resulted in fixed BiPAP pressures of 8/6. Softball aerophagia and basketball aerophagia was still a problem, but not every single night. And I was much more comfortable breathing while awake.

Second BiPAP titraion resulted in fixed BiPAP pressures of 7/4. Stomach felt it had died and gone to heaven: No aerophagia at all. But snoring and AHI crept up on some (not all) nights significantly.

Switched to current BiPAP Auto settings of min EPAP = 4, max IPAP = 8, min PS = 2, max PS = 4. Most of the time my 90% EPAP is about 5cm and my 90% IPAP = 8. Median EPAP is often 4 or 4.5; median IPAP ranges from 7 to 8. Aerophagia is an intermittent problem, but seldom reaches a significant level. When it does, most of the time my median EPAP is above 5 and my 90% EPAP = 6.

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DeadlySleep
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Re: Seeing Sleep Doc today

Post by DeadlySleep » Wed Apr 16, 2014 11:08 am

Switched to current BiPAP Auto settings of min EPAP = 4, max IPAP = 8, min PS = 2, max PS = 4. Most of the time my 90% EPAP is about 5cm and my 90% IPAP = 8. Median EPAP is often 4 or 4.5; median IPAP ranges from 7 to 8. Aerophagia is an intermittent problem, but seldom reaches a significant level. When it does, most of the time my median EPAP is above 5 and
What are you treating?

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Cr1kk1t
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Re: Seeing Sleep Doc todat

Post by Cr1kk1t » Wed Apr 16, 2014 7:35 pm

So I saw the sleep doc and she really wasn't interested in what I had to say or my reports. She was more interested in my weekly and monthly overall numbers as well as my family history and current health. And since I have a family history of heart disease and we are currently trying to get my blood pressure under control she decided that I needed to have an echocardiogram done. She thinks it is other health issues causing the centrals, particularly my heart. She said I had mild edema in my legs and feet yet my primary doc and I don't see it. My primary doc disagrees with her but said we will jump through the hoops if it means getting my sleep therapy adjusted. So next Thursday I will be getting the echo done.

I was really frustrated when I left today.

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Re: Seeing Sleep Doc todat

Post by JDS74 » Wed Apr 16, 2014 8:19 pm

cr1kk1t:

Hang in there. Every time I went to a new doc and mentioned my centrals and Cheyne-Stokes breathing, it was off to the echo lab. Eventually they all got tired and I tried an auto BiPap for 3 years and finally got to my current ASV machine.

Feeling much better now.
There is light at the end of this tunnel.
{{{{{hugs}}}}}

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Re: Seeing Sleep Doc todat

Post by jaye8898 » Wed Apr 16, 2014 8:31 pm

Cr1kk1t wrote:So I saw the sleep doc and she really wasn't interested in what I had to say or my reports. She was more interested in my weekly and monthly overall numbers as well as my family history and current health. And since I have a family history of heart disease and we are currently trying to get my blood pressure under control she decided that I needed to have an echocardiogram done. She thinks it is other health issues causing the centrals, particularly my heart. She said I had mild edema in my legs and feet yet my primary doc and I don't see it. My primary doc disagrees with her but said we will jump through the hoops if it means getting my sleep therapy adjusted. So next Thursday I will be getting the echo done.

I was really frustrated when I left today.
Sorry to hear about your visit. I felt the same way when I went for my compliance check. They based everything on one week's average and the overall score and no attention to what I had to say. Very disrespectful! I wish you well in your journey to fix your sleep issues!

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