Bipap called for?

[wm_hess]

Hi

My Mom is an 86 year old who recently started using a CPAP. She lives around 200 miles away from me, and doesn't have internet service in her neck of the woods. When I go up, I download her data to Oscar

I gave her an old CPAP of mine to use when she started. I ran her for a week and made adjustments to pressure. I like to think I decent at setting it up, but this seems to be too good. She's maxing out her pressure, but she's not having any apneas.

I did not see her sleep report, so I don't know what she was diagnosed with. I took her original settings from her machine and moved them to the S9 when we first started.

So looking at her chart, does she need to look at a bipap? She's maxing it out, which says yes, But she's not having apneas which says no. Are there reasons other than Sleep Apnea to use a CPAP?

Thanks for any observations/suggestions.

-Bill

[Julie]

Get the sleep report asap - not a good idea to be winging it with someone her age at a high min. pressure (based on what?).

Talk to her doctor(s) asap and find out if e.g. she has other resp. or cardiac conditions and what, if anything, is being done about them?

Please stay in this thread.

Doctors and EMT's will occasionally use Cpap in certain situations on a temp basis to boost breathing in people, but not otherwise that I'm aware of... and why have you got your mother on it now if she doesn't have OSA?

[Pugsy]

While she is maxing out at 20 cm for half the night (probably positional) that 20 is doing a bang up good job.
It's not like some where we see people getting truckloads of apnea events at 20 cm.
Technically the machine might want to go higher but we don't know how much higher and sometimes the reason it wants to go higher isn't really all that urgent.

I would tend to put the reason here as not all that urgent.
Now if she was having a lot of apnea events happen it would be a different story.

Are all the reports showing 0.0 AHI????
Though I do think that since this is the S9 model and with it's history of getting stuck reporting numbers especially 0.0 you should do the old unplug from power source trick and wait a few minutes and plug it back in and then force the machine to reboot.....if you are seeing all 0.0 AHIs.

[Miss Emerita]

It looks like her flow limitations are driving her pressures up. Is she sleeping comfortably, and does she feel rested during the day?

I see the usage here was less than 4 hours. Does she take the mask off during the night?

[wm_hess]

Hi I wanted to thank everybody for their input. My Mom had a sleep study and her doctor prescribed CPAP. They prescribed an apap with the pressures at the standard crappy 4-20 pressure range. She was sold a Resmed Airsense 10 apap. When I went up the first time, I checked her usage and stats to get an idea of what was going. This was a fairly typical night. Short night, take off and put on the mask. She also moves between bed and recliner. I was thinking of placing 1 cpap bedside and the other by her recliner for full time coverage. She on the other hand, has a rockwell rating on her cranium (seriously hard headed) and declines to clutter the living room with medical equipment. She also found it easier to fill the s9 humidifier, so her bedside cpap is the 9 and her travel cpap is the 10. Now the 10 holds significantly more data but remember that cranium issue?

After looking at a couple of nights of data, it's obvious that her pressure quickly went between 15 - 20. Instead of allowing the machine to slowly creep up to that range, I reset her range to 15-20 so her therapy starts immediately. I don't wing things when it comes to my family's health.

I've been bitten by the S9 0.00 AHI bug before, so did double check and she does have a good variety (normally under 1) of ahis.

I've been here now for about 11 years and have read a lot of posts from a lot of people. I'm not real chatty, but I trust the information presented by the people here just as much or more than a person who issues the machine and walks away, never looking at the therapy, only the hours used.

Thank you all again, and have a great day!

-BIll

Mom - Aug 22-21.png (79.2 KiB) Viewed 10986 times

[Pugsy]

Given the cranium issues (my mother has them as well) I don't know that there is an urgent need for the machine to go above 20 that a bilevel could do for you.
I guess it would depend on how often you see the really good reports and compare to not as good reports.

Would it be nice to know for sure??? Yeah but I don't think it is so urgent that therapy effectiveness critically impaired at this point.
You might keep your eye out for a S9 VPAP Auto (since she prefers the S9 humidifier) and if you find one for cheap....snatch it up and give it a try as the bedside machine.

And move the AirSense 10 Autoset to the recliner and try to figure up something to make it less annoying looking.
Though the cranium issue will likely be a big hurdle...
Hardheaded old women....sometimes we just have to shake our heads and accept that this is the best we are going to get.
Been there and done that with my own mom.

I do think that likely the FLs are position related and just because the machine wants to go higher sometimes...doesn't mean that the FLs are causing a major huge problem.
BUT there is one thing you could do to see if it helps or not and that's add EPR into the mix if she would tolerate the change. Sometimes adding in EPR helps with FLs.
But with any change....the potential for the cranium issue to raise its ugly head.

Is it urgent that you get her a bilevel? No, it's not like she is having an untoward number of OAs or hyponeas when maxed out.

[Miss Emerita]

I think I know the answer but -- would she tolerate wearing a soft cervical collar? She may be tucking her chin down toward her chest, which can lead to flow limitations. Another possibility: if she uses a high pillow, could she try a lower, fairly firm one?

You are such a good son.