Pressure Change on Vpap Auto 25

[dlp1195]

Friday night was good and I felt pretty good all day. Sat. night was difficult, and I partialy woke around 3 or so and my mask was about to blow off my face and after checking chart I was having a cluster of episodes and the pressure got up to 22.2. I have not felt as good today( Sun). Here is charts.

FRIDAY NIGHT


SAT. NIGHT

[twokatmew]

dlp, if I were you, I'd leave minEPAP at 11 instead of dropping it down to 10 as you did on Saturday. For me, anyway, I like to have IPAP start pretty close to the 95% pressure. I feel better, and my numbers are a lot better.

[dlp1195]

I had moved it back down since I had better numbers on the 10 setting the night before. I need to set the pressure and leave it alone for a few days. I see from the posts on here that it takes a while to adjust to a change. I guess I am grasping at straws trying to find an answer before they call for my new sleep study. It took years to get this way and I guess I want a solution right now which ain't going to happen. Tired of being wore out and having a foggy head.

[twokatmew]

I had moved it back down since I had better numbers on the 10 setting the night before. I need to set the pressure and leave it alone for a few days. I see from the posts on here that it takes a while to adjust to a change. I guess I am grasping at straws trying to find an answer before they call for my new sleep study. It took years to get this way and I guess I want a solution right now which ain't going to happen. Tired of being wore out and having a foggy head.

Ah yes, leaving it be for a bit is a good idea. I've only recently started doing better now that I'm trialling a VPAP Auto 25. I'm hoping I get to keep it, because I don't do nearly as well on CPAP. I should find out in a few days.

BTW, when is your next sleep study? Is it a titration study or what? Sorry if you've posted about this and I missed it.

[dlp1195]

They want to check to see if I am having a problem with centrals.

[jnk]

jnk is smarter than me about these things. And has a better memory.

I disagree with the first sentence, and the implications of the second sentence. My memory is only better in the sense that I DO remember the fact that most of what I know, I learned from you--and you seem to have forgotten that.

. . . I guess I am grasping at straws trying to find an answer before they call for my new sleep study. . .

Well, yes, this does seem to be a bit of a straw-grasping exercise. And part of that may be my fault, and I apologize if it is.

Here is the thing, according to my limited understanding as a fellow patient: If raising pressure helps, then the apneas are most likely obstructive and treatable as OSA. If raising the pressure does not help, those apneas may be central, and moving pressures around may just make things worse as the body tries to figure out what is going on, especially on bilevel. Some people get centrals that are caused by the PAP pressure itself, and leaving the machine at one pressure to see if those go away is sometimes a big part of the doc's game plan. In other words, the doc and RT may have known what they were doing all along. It happens that way at times. That is why, in my opinion, it is good to keep them in the loop, whenever possible.

If those are centrals and they don't go away, it may be time to try a machine designed to deal with that. It may be mixed sleep apnea (central apnea and obstructive mixed together), or, more likely in this case, perhaps, what is sometimes called CompSA, or complex sleep apnea. I don't claim to understand the subtle differences in how those syndromes are defined from one year to the next. This explanation, for example, may, or may not, be up to date, depending on whom you talk to:

http://www.resmed.com/us/clinicians/abo ... clinicians

Bottom line is that it may take a sleep study to figure out if those are centrals. And if they are, it may be important to figure out what is causing them beyond just writing them off as something caused by the pressure. That is my opinion, anyway. But it very well may be that a titration is in order with a machine designed to treat whatever name they are giving these days to the syndrome with both obstructive events and central events that don't go away over time with treatment.

This video may help:

http://www.vpapadaptsv.com/ResMed.htm

jeff

[dlp1195]

No apologies necessary. I think I will leave it set where it is and do the other sleep study and see what comes out of it. I am better than I was and it was such an improvement I wanted too much too soon. I appreciate the help.

[jnk]

I think your approach has been reasonable, and when straws are all we've got, we're gonna reach for them.

It is important for you to be as informed as possible so you can participate fully in decisions about your therapy.

You try things till you find what works. So you are well on your way.

Please keep us informed. We all learn from one another here.

jeff

[dlp1195]

Had a much better night last night. AI 1.6 and HI 9.0 on 8 hours sleep. I even played 18 holes of golf without wearing out. I go for my new sleep study on Oct 11th.

[Slinky]

Glad to hear that last night was a pretty good night!!! Ahhh, getting that golf game in improves the mind and mood too!!! We all know that golf is good for the soul.

[dlp1195]

This is my latest and best data so far. I am excited about getting my AI below 1.

[jnk]

Impressive!

That's more like it.

[Slinky]

Now lets see what you do over the next 2-3 nights at those same settings!! No changes. No mask change. No pressure changes.

[dlp1195]

Now lets see what you do over the next 2-3 nights at those same settings!! No changes. No mask change. No pressure changes.

Here is my data from last night and I can really tell a difference in the way I feel today compared to when the numbers was lower a few nights ago. Don't know what changed. I had hoped to not have to go for the sleep study titration on the 11th of Oct. but think it best I go. Thanks for your comments.

[jnk]

. . . I had hoped to not have to go for the sleep study titration on the 11th of Oct. but think it best I go. . . .

Hopefully, a titration should be able to tell if those are obstructive events or central events that you are dealing with. If they are obstructive, higher pressure may address them. If they are central (and centrals are notoriously erratic from night to night with some people, I think), then you may graduate to one of the machines that are designed to deal with those. If they are centrals, lets hope you have a "bad" night on your titration night. If you have too "good" of a night, then maybe the ResScan reports will be enough to let him make his case to insurance for your needing a different machine, if that's the route you both want to go.