Central & Obstructive - AHI always around 10 with ASV. Tweak Settings?>?

[metsfan302]

Well my Sleep Doc, She must of already received my Tritration as I see my settings were changed remotely

Big Change!

Now its -

ASVAuto
Min Epap - 7.0 vs 14 lol
Max Epap - 15.0 vs same
Min PS - 1.0 vs 4.0
Max PS 15 vs 11 i think

Hope since the tritration was on a philips that these numbers work for me on my Resmed

[metsfan302]

Well After doing my first ever Pulmonary Function Test last week, I went yesterday to the follow-up with the best Pulmonologist in my area. My lung function is 126% above the "average" - I learned that its based off my Height, Weight, Ethnicity, Age, and Pack Years -20 (Was a smoker back in the day) - Once I was diagnosed with COPD and also sleep apnea in 2012 I quit smoking for good.

(I made this Appointment a few months ago when my AHI was out of control and there were no answers as to why it was never below 10.0 and never the magical below 5 while on my ASV.

A week prior to this appointment my Sleep Doc sent me back into the Lab for another ASV Tritration.

Not sure if I told anyone here but I had bariatric surgery on October 9th - Robotic Assisted Vertical Sleeve Surgery. I gained almost 250lbs in a few years! Well in a little over 5 Months I am down 130lbs so far and about 100 left to lose! What I am guessing happened was with the weight loss my body did not need the pressure settings I was on (14-min Epap, ps min 5) as once tritrated last week my optimal settings are way lower! So now my min epap is only 7 and my min ps is 1

I was also told, I do not have COPD and I can stop taking - Symbicort I was using once a day that my family doc prescribed as when I was 445lbs! I think he just assumed I had copd and asthma.

So that is that for now, my AHI is the lowest it has ever been - around 1.5 - 5.0 Ill post some screens and also the tritration later on, but past that I can actually let this thread die off - amazed my AHI is in the "NORMAL RANGE" and I want to thank everyone for helping and with suggestions etc

[zonker]

So that is that for now, my AHI is the lowest it has ever been - around 1.5 - 5.0 Ill post some screens and also the tritration later on, but past that I can actually let this thread die off - amazed my AHI is in the "NORMAL RANGE" and I want to thank everyone for helping and with suggestions etc

tapdancing.gif

outstanding!!

[metsfan302]

Ugg, I don’t know what to say or do anymore...... my AHI was 11.2 last night, like 8.9 the night prior. Seemed ok after the adjustment for a couple days then just started climbing back up. They said my oxygen did not drop low enough for them to need to hook up oxygen during the tritration even though the doc was trying to have them do that also to kill two birds with one stone ( the asv tritration to get new pressure setting and to show oxygen helps so we might be able to submit to insurance).

The two nights I was in hospital on my ASV with the prior pressure setting and Oxygen were the best AHI numbers ever of 1.1 and 1.3

I guess maybe looking for my own oxygen set up out of pocket to see if it helps might be the direction I head. With no knowledge of oxygen use at night with a pap device, I’ll have to do some reasearch. I’d think it’s the Bigger Oxygen Concentrators I see online for that type of set up vs portable devices as it would only be used when sleeping.

[palerider]

I guess maybe looking for my own oxygen set up out of pocket to see if it helps might be the direction I head. With no knowledge of oxygen use at night with a pap device, I’ll have to do some reasearch. I’d think it’s the Bigger Oxygen Concentrators I see online for that type of set up vs portable devices as it would only be used when sleeping.

Two quiet ones are the Respironics Everflow OPI and the Invacare Perfecto 2. We've got both here.

The perfecto2 sort of purrs and every few seconds it thumps when it's switching from tank to tank.

The Everflow just goes 'pfffft pffft" every few seconds, I can barely hear the compressor.

Others are noisier.

You're doing a brisk trade in used cpaps, you shouldn't have any problem picking up a concentrator. Get one with the oxygen purity monitor (Needs to say "OPI" on the everflow.. as far as I know most of the perfecto2s have monitors in them.

Parts for the perfecto2 are more readily available, whereas Respironics is less free with repair parts.

[metsfan302]

Thank You! Thank You!! That is great info as that area is not even close to my wheel house! I will def have to do some reading on this / them (the two you mention) So glad you said others are much louder, will be sure to stick with either of those two brands/models. Id assume these devices like paps - as Technology changed so did these machines vs earlier models

[palerider]

Thank You! Thank You!! That is great info as that area is not even close to my wheel house! I will def have to do some reading on this / them (the two you mention) So glad you said others are much louder, will be sure to stick with either of those two brands/models. Id assume these devices like paps - as Technology changed so did these machines vs earlier models

I'm not saying that there aren't other quiet concentrators out there, but those two I have experience with... Some say the Perfecto2 is a tiny bit noisier... but it's a different sound. We nicknamed that one 'thumper' cuz of the thump sound every few seconds, and the other one 'windy' cuz... well pffft pffft...

Either one is a reliable source of oxygen. there are others... see what you've got from your usual sources.

Concentrators have mainly just gotten quieter, the technology hasn't changed much, as far as I know, just 'better built'.

What they do is filter the nitrogen out of the air, and feed you whatever's left (mostly oxygen).

[bwexler]

I agree with the PR Everflow. That's what I have. My insurance wanted perpetual rental with a copayment. I choose to buy new from theOxygenConentratorStore.com. At least i think that is the correct name. They offered me the best price and also seemed knowledgeable like the folks at CPAP.com. you will probably want to get the heated hose with the oxygen inserrter at the CPAP end. I also got a 50' oxygen hose so I could keep the concentrator in the bathroom where I can't hear it.

[metsfan302]

Ugg, I just cant get a full night of great rested sleep. I am wondering if Sleep Hygiene has any part of this and my high AHI numbers... I am at wits end, went to bed super early tonight like 8am woke up at like 1-2am and wide awake. I do have Ambian or Trazadone to take but I think that would just muddy up my apnea and AHI even worst.

Working on getting the Oxygen set up to see if I can duplicate those 1.1 and 1.3 numbers I had after surgery..... Yes I am on a Opiate, Methadone so maybe that is the magic thing I keep searching for that keeps my AHI from being in the sub 5.0 range. OR Do I need to forget about this sub 5 AHI and be lucky it is not what it was prior to starting cpap or what it was when I was on a normal Autoset-Cpap. My Wife also mentioned that I am snoring even with my ASV/ P10 Mask use, Is that normal? (I never go a sec without using them, even for naps etc)

[palerider]

Ugg, I just cant get a full night of great rested sleep. I am wondering if Sleep Hygiene has any part of this

Probably.

[zonker]

Ugg, I just cant get a full night of great rested sleep. I am wondering if Sleep Hygiene has any part of this and my high AHI numbers...
<snip>
My Wife also mentioned that I am snoring even with my ASV/ P10 Mask use, Is that normal? (I never go a sec without using them, even for naps etc)

i'm just ever so slightly modifying my diet to try to get more solid sleep. here is what i've been doing-

viewtopic/t175056/OT-calling-light-slee ... emedy.html

and have been having encouraging results.

tl;dr i'm cutting back on coffee and have stopped all of my supplements. only taking d3,zinc and baby aspirin.

as to the second, i have had occasion to snore through the p10. be advised that snoring is pretty much a sign that your therapy isn't optimal yet.

keep at it, you'll get there.

[metsfan302]

Well, had my 90ish day follow up and after Tritration follow up. The doc thinks that just maybe I’d be better off switching from what I’ve had the past 4 years and Swapping out my Resmed ASV for the Philips Dreamstation BiPAP AutoSv. We have not been able to get my numbers sub 5 at any pressure setting on the Resmed and the past 4 years have only been able to get my ahi down to 8ish average. Sure there have been the odd night of a sub 5 here and there, but nothing consistent. I tritrated on a Philips “ASV” (sorry pale, BiPAP autosv) just a few weeks ago and they got my ahi down to zero. I do not know how I feel about the switch, but hell what can it hurt? What’s the worst that could happen? Lol UGG! Higher AHI or Lower AHI I guess lol....

I’ve already spoken to my DME I swore I’d never deal with again, since they would not rent me or lend me as they promised a philips. They have gotten the paperwork together and she’s handing it to the RT to schedule the swap...... if it totally sucks, I can always find a secondhand Resmed ASV either the Aircurve again or the S9 adapt as I did like that one.

Only get one exchange/swap with my insurance or DME

Hopefully this will help or I dunno, Seems there are a few more settings with the Dreamstation as far as BPM - Breaths Per Minute and Ti - Inspiratory Time Setting...... I know it’s just feels so natural on the ResMed and when I was Tritrating on the Philips is was like I had to adjust my breathing to the machine vs the machine adjusting breath by breath but may be this will help. Ugg I hope

[metsfan302]

Was just informed from the DME that they are planning on setting me up with a refurbished Respironcs SVauto - is that normal or standard when exchanging a pap or?

Update - they told me the machine has zero hrs on it, so if it’s a refurb I assume the factory might reset it or?

[beautifuldreamer]

.

[palerider]

Was just informed from the DME that they are planning on setting me up with a refurbished Respironcs SVauto - is that normal or standard when exchanging a pap or?

Update - they told me the machine has zero hrs on it, so if it’s a refurb I assume the factory might reset it or?

They cannot reset the runtime hours on a PAP device . . .

Please provide evidence that the factory can't change hours. (hint, they can).