Changed to BIPAP Auto SV, need help with results

[TylersDad]

Guys,

With alot of your help, I am still making progress. I got started on the Auto BIPAPSV (my fourth machine) and I finally got the software installed and the card reader working. I am going to post some graphs and then ask some questions and comments below the graphs.

Here is a graph of my worst day:

http://i664.photobucket.com/albums/vv5/ ... AP1117.jpg


Here is a graph of my best day:

http://i664.photobucket.com/albums/vv5/ ... 1114-1.jpg


Here is a summary sheet of the time I have been on the BiPAP (almost a month):

http://i664.photobucket.com/albums/vv5/ ... ummary.jpg

Here are my questions:

1) Based on the three graphs, how do my numbers look? I still feel like I am tired every morning. My numbers are much better than changing to the BIPAP, but I still feel tired.

2) What is a good leak target number for the BIPAP using the full face Quatro mask?

3) Is there anything that can be observed/learned by the other results? (items like Patient triggered breaths, avg breaths per minute, current backup rate setting, avg tidal volume, avg peak flow, PB, any others?) I did not have these results on the old CPAP machine so I really do not have much idea about what they mean.

4) On the average sheet, how do those numbers look? Are they close to what I should be shooting for?

5) Any other observations or thoughts?

Thanks for all of you guys help, it is greatly appreciated. I definitely would not be where I am today if you it were not for you guys!

Thanks,
TylersDad

[JohnBFisher]

... I am still making progress. I got started on the Auto BIPAPSV (my fourth machine) and I finally got the software installed and the card reader working. I am going to post some graphs and then ask some questions and comments below the graphs. ...

Here are my questions:

1) Based on the three graphs, how do my numbers look? I still feel like I am tired every morning. My numbers are much better than changing to the BIPAP, but I still feel tired.

First, always remember that how you feel is more important than the numbers. Though we might get your sleep perfect, there may be some additional issue that disturbs your ability to feel rested.

Seoncd, the disclaimer ... I am new to the need for an AutoSV unit (and am awaiting mine), so I am trying to come up-to-speed as quickly as possible. So, take what I say with a lick of salt.

Third, you will note some subtle, but probably important differences in the average Patient Triggered Breaths and average Leaks. Both are improved on those nights where you slept better. Also the Breaths per Minute seems to increase and stay up for longer on the poorer night.

2) What is a good leak target number for the BIPAP using the full face Quatro mask?

I think less than 30 is the target.

3) Is there anything that can be observed/learned by the other results? (items like Patient triggered breaths, avg breaths per minute, current backup rate setting, avg tidal volume, avg peak flow, PB, any others?) I did not have these results on the old CPAP machine so I really do not have much idea about what they mean.

Another item to note is the increased tidal volume on the better night. Again, it could indicate you are breathing more effectively during your better night of sleep.

Also note the night with poorer sleep had an increased amount of hypopnea (decreased breathing, but not full apnea).

4) On the average sheet, how do those numbers look? Are they close to what I should be shooting for?

Well, first thing I would point out is that on the good night (11/14), you had a lower hyponea index and no apneas. But on the bad day (11/17) you had lots of hypopneas and some apneas. Seems as if the hyponeas are disrupting your sleep quite a bit.

Otherwise, to my untrained eye, the numbers appear fairly good.

5) Any other observations or thoughts?

Good for you for trying to learn more. That's the first step to managing your situation. Knowledge really is important as you take responsibility for your own health.

Hope it helps. I know it helps me to see this type of information.

[dsm]

Guys,

With alot of your help, I am still making progress. I got started on the Auto BIPAPSV (my fourth machine) and I finally got the software installed and the card reader working. I am going to post some graphs and then ask some questions and comments below the graphs.

Here is a graph of my worst day:

http://i664.photobucket.com/albums/vv5/ ... AP1117.jpg


Here is a graph of my best day:

http://i664.photobucket.com/albums/vv5/ ... 1114-1.jpg


Here is a summary sheet of the time I have been on the BiPAP (almost a month):

http://i664.photobucket.com/albums/vv5/ ... ummary.jpg

Here are my questions:

1) Based on the three graphs, how do my numbers look? I still feel like I am tired every morning. My numbers are much better than changing to the BIPAP, but I still feel tired.

As already mentioned by John, it is how you feel that matters & that usually overrides the numbers. The numbers aren't to bad other than excessive hypopneas

2) What is a good leak target number for the BIPAP using the full face Quatro mask?
Those leak graphs are better than mine using similar set up

3) Is there anything that can be observed/learned by the other results? (items like Patient triggered breaths, avg breaths per minute, current backup rate setting, avg tidal volume, avg peak flow, PB, any others?) I did not have these results on the old CPAP machine so I really do not have much idea about what they mean.
A bit more history (maybe I have missed it) would help as the issue I see here is are we looking at central hypopneas or obstructive (at a very rough guess I would say central ? - were you diganose with OSA & if so what AI & HI was noted ?)

4) On the average sheet, how do those numbers look? Are they close to what I should be shooting for?
Again I'd come back to how you are getting by in the day rather than shooting the numbers. If you were reporting good daytimes then the numbers could be said to be ok

5) Any other observations or thoughts?
Can you add a bit more about your breathing, are you prone to slowing down you breathing without snoring ?. How would you describe your weight and also do you sleep a lot on your back ?. There are so many factors that can affect numbers & feelings.
One question I do have is was there a particular reason your doc went for cpap mode with SV ? - is that related to past lack of success with bilevel mode ? - my instinctive guess is that a little bit of an epap-ipap gap might ease the hypopneas. I can see from your breathing rate there is no obvious hyperventilation. I also wonder why your epap-ipap is set so low (suggests the doc doesn't see Obstructions as an issue). From the settings I am guessing your doc sees you has having central related respiratory problems & he has used cpap+SV to treat it ?.

Re the numbers, I would prefer to see a higher tidal volume (say 600-750) but I don't know enough about your physical size & condition to know if that is reasonable. I wonder if the daytime drowsiness is because you are getting too little air through your system ?.

#2: What I do notice in your charts is that the SV algorithm is activated a lot of the time. This tells me that you are tending to be below target in your av peak flow a lot of the time (again I wonder if this from centrals but need so much more info).


Thanks for all of you guys help, it is greatly appreciated. I definitely would not be where I am today if you it were not for you guys!

Thanks,
TylersDad