"Dying" To Find ST-A User to Help Me

[Rubicon]

Are the massive leaks causing the weird shaped machine breaths in the flow rate? If so, why or how?

The leaks in the area I'm looking at are 80 L/M.

What about the rest of the night? Mostly machine breaths? Or mostly spontaneous breathing? Or too hard to tell without the mask pressure data?

Looks to me ~2 hours of machine-controlled breathing.

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I'm not sure why the doctor has me on IVAPS ...

IMO before you do any more DWing you need to find out exactly why those settings were chosen. There's either a error in transcription, your physician is insane, or there's some REAL important information he got that you don't.

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Are these also machine breaths?

Those look patient-initiated, and if it weren't for the fact they're on ~21/14 in a patient with TWA, they'd be fine.

BTW look at submitted sleep study. N1 42.8% N3 0.0%. Sleep Efficiency 74.1%. I'm tired just looking at it.

335 4% desats nadir 75%. Oximeter mandatory for DWing.

[Rubicon]

Looks to me ~2 hours of machine-controlled breathing.

Now you might be saying "WTF? There's a ton of other obvious machine breaths!"

Can we get a daily report of Spont Trig/Cycled Breaths?

[Notgivingupagain]

(I'm trying to do the quote thing without the images, not sure how though).

As I have indicated prior, I have been on three different type machines over the years. (The sleep diagnostic study you have referred to is from 2019 and was not my first study). Since my first study (before 2019), I have been on basic CPAP machine, then when that didn't work they put me on the next level up, regular Bipap, then when that didn't work they put me on ST-A. But if I remember correctly it wasn't prescribed as set to iVAP. I just experimented with iVAP. Now, for some reason this years go around with my doctor prescribed iVAP.

When I say the other machines did not work I mean that I was ALWAYS waking up with my mask on the floor. I woke up zillions off times. I just wasn't able to be compliant. I was having the same troubles on all the other machines as I am having now on this one, EXCEPT my mask isn't ending up on the floor without my knowledge.

Notgivingupagain,

Given this diagnostic sleep study, how on earth did you wind up on a Resmed AirCurve 10 ST-A running in iVAPS mode?

Were you ever put on a simpler machine like a Resmed AirSense 10 AutoSet? If so, what caused the doc(s) to prescribe the ST-A in iVAPS mode?

[Notgivingupagain]

BTW if you're going to be making changes, and since you've had documented significant desaturations, it would be a wise investment to get a pulse oximeter that can be downloaded (uploaded?) directly to Oscar and SleepHQ to insure your changes are appropriate. Wellue O2 Ring is a popular model (it's a little coarse, but it'll work).

I have always wanted one and one time I bought one but it was so complicated to use I think I threw it out. Is the one you suggest pretty good simplicity wise?

[Notgivingupagain]

The ultimate fix for leaks, however, is silicon earplugs....

Also, I HIGHLY recommend you try herbal medications first, for sleep and relaxation, such as Valerian and many others, before you go and take prescriptions ones. And whatever you do, stay away from Clonazepam and other benzos, they are extremely addictive and you will pay for it if you take it long enough. You will need to continuously increase the dosage the longer you take it, and you will suffer withdrawals if you ever decrease dosage.

Hope this helps.

Thank you SO much for your reply. My f20 is the silicone one. Will these plugs still help with leaks if my mask is already silicone?

As for the Clonazepam, it's going down the toilet. I hasn't worked one iota anyway.

Thank you again!

[Notgivingupagain]

I'm not sure why the doctor has me on IVAPS ...

IMO before you do any more DWing you need to find out exactly why those settings were chosen. There's either a error in transcription, your physician is insane, or there's some REAL important information he got that you don't.

Hi.

First, what is DWing?

If you mean the latest lab study, the titration report, I had to call the sleep lab to get it because they forgot to give it to me. As I was speaking to the tech I asked about the settings. Not the iVAP part, but the numbers for the settings. She told me that they had titrated me on Bipap and then moved to higher up machine and numbers because I didn't reach a satisfactory level until such was done.

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I have always wanted one and one time I bought one but it was so complicated to use I think I threw it out. Is the one you suggest pretty good simplicity wise?

Yep plenty of support easy to sync to SleepHQ and Oscar.

Spont Trigger and Cycle can be accessed from the machine. Can you jot those down and monitor? The driving parameters of iVAPS are rate and volumes instead of events so monitoring DWing is going to be a little different from what's normally tracked.

[Notgivingupagain]

Looks to me ~2 hours of machine-controlled breathing.

Now you might be saying "WTF? There's a ton of other obvious machine breaths!"

Can we get a daily report of Spont Trig/Cycled Breaths?

I don't see an OSCAR graph for those categories. Is there a way to get them from the machine itself? Or do they go by another name in the OSCAR graph categories?

[Rubicon]

First, what is DWing?

"Dial Winging".

Making unmonitored settings changes and hoping they work.

[Rubicon]

I don't see an OSCAR graph for those categories. Is there a way to get them from the machine itself?

Right it's only in the ResMed software. Should be on the machine.

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Have to solve the "Last 20 breaths" thing too.

Oh well. We got time.

[Notgivingupagain]

My thought recently is that all the sleep doctors I have seen have cared more about the AHI than anything else that shows up in. these studies. When I have gone to the last few doctors I have told them I am concerned about the amount of time I sleep. I am concerned about the shapes of my wave forms more than I am concerned about AHI. I firmly believe and try to convey to them there is something amiss in my ACTUAL breathing that is not being addressed in my therapy attempts. I even have brought OSCAR charts to my appointments. Most of the doctors don't really care to look at them. But went I went back to my original sleep doctor from the early 2000s, they looked at them, a little anyway. They did make copies at least.

Not tying to DW here, but maybe I should get out of the iVAPS mode and do the other mode? But what would the number settings need to be?

I am posting last night's OSCAR chart here. It was pretty bad number wise compared to my other few nights, but I had set the EPAP to 10 and the Max PS to 10, DW'd, I think the reasoning is to get to a baseline?

LAST NIGHT'S READINGS:

Pressure 19.8
Exp Pressure 10.00
Leak. 464L/min
Vt 440ml
RR 15
MV 7.0L/min
Ti 1.35
I:E 1:19
Spont Trigger 96%
Spont Cycle 90%
AHI 7.7
Total AI 1.0

[Notgivingupagain]

Have to solve the "Last 20 breaths" thing too.

Oh well. We got time.

What is the Last 20 breaths thing.