Why doesn't APAP respond to apneas?

[OutaSync]

[quote="Snoredog
But her 8/31/07 Split-night CPAP study shows 21 apneas and 17 Hypopnea at 0 pressure, her SAO2 levels also dropped to 64%, must be from those long apnea. There were no Centrals seen on that study at all even with CPAP, I wonder if that might be because Jason wasn't looking for any?[/quote]

Hopefully, we will soon find out. My raw data is on it's way to SAG.

So, for tonight
EPAP 14
Ipap Min 14
Ipap Max 14
Ramp 14

Anything else?

[dsm]

No, I didn't press ramp again. I would have had to sit up, take the cooler off the machine and find the ramp button, as I am not that familiar with this machine and I don't have a habit of hitting the ramp button. I KNOW that I didn't do that. I'm going to set the ramp to 14 tonight to see if that will stop allowing the machine to go that low.

Yes, I have allegies to all kinds of things. I went out to sweep the leaves off of my deck this afternoon and my nose shut off. I always end up breathing through my mouth when I'm outside. I use Nasonex Spray daily for allergies. oops, I forgot to add that to my "cocktail". I can actually breathe better with xpap. It must be the filters.

SWS, I hope you werem't messing with me , because I actually tried that pressure on the base of the skull thing, and didn't see my eyes dilate and no fluid. But I can breath a little better now. Thanks.

Bev

Bev,

I too am using Nasonex again (after a break for a few months). I also use a small spray as well, that has Oxymetazoline hydrocloride 0.05% w/v in it (it says to limit use to 5 days but over the past month I have almost used it every night time).

Also taking Pariet daily for GERD.

I am still thinking the solution for you is going to be independent of the xPAP.

Doug

[dsm]

[quote="Snoredog
But her 8/31/07 Split-night CPAP study shows 21 apneas and 17 Hypopnea at 0 pressure, her SAO2 levels also dropped to 64%, must be from those long apnea. There were no Centrals seen on that study at all even with CPAP, I wonder if that might be because Jason wasn't looking for any?

Hopefully, we will soon find out. My raw data is on it's way to SAG.

So, for tonight
EPAP 14
Ipap Min 14
Ipap Max 14
Ramp 14

Anything else?[/quote]

You could also set BPM=off for tonight as I am willing to be big it will make no difference. I am thinking your BPM will most likely average around 15 BPM (mine last night average 14 BPM so I don't see your as any problem at the moment. Mine is usually lower than 15 av).

[OutaSync]

When I set everything for 14, I don't get a choice for BPM. I'll try changing Ipap Max and then turning BPM off and then set Ipap max back to 14.

[-SWS]

duplicate post deleted (see below)

[dsm]

When I set everything for 14, I don't get a choice for BPM. I'll try changing Ipap Max and then turning BPM off and then set Ipap max back to 14.

Bev,

Of course - setting them all to 14 forces cpap mode and cpap mode has no such thing as a backup rate (no pressures to cycle between). I should have realized that right away.

The good thing though, is the SV machine will record & display your breathing rate despite being in cpap mode. That is helpful info.

DSM

[-SWS]

If no one minds I'll consolidate the ASV charts on this page for easier comparison. Please note that I did not include the first night ASV chart since Bev was awake almost that entire night.



ABOVE: 2nd Night ASV @ EPAP=9, IPAPmin=12, IPAPmax=18, BPM=Auto (BiPAP+SV on 10/18/08)







ABOVE: 3rd Night ASV @ EPAP=14, IPAPmin=14, IPAPmax=18, BPM=10, IT=1.2 (CPAP+SV on 10/24/08)







ABOVE: 4th Night ASV @ EPAP=14, IPAPmin=14, IPAPmax=14 (CPAP on 10/25/08)

[StillAnotherGuest]

I think you have to verify the operation of that thing before you do anything else. Any chance of getting a cheap manometer? Notice any error codes at any time?

With the Synchrony, you could query the history of memory codes, but I haven't found if you can do that with SV.

SAG

[-SWS]

Bev, ask if your RT or even sleep clinic will verify the machine's pressure output for you.

Bring a hard-copy of the procedures on page 11-1 (PDF page 59 of 72 in the link kindly provided by dsm):
Chapter 11: Operational Verification

Probably a good idea to use APAP tonight as SAG suggests.

[dsm]

Bev, ask if your RT or even sleep clinic will verify the machine's pressure output for you.

Bring a hard-copy of the procedures on page 11-1 (PDF page 59 of 72 in the link kindly provided by dsm):
Chapter 11: Operational Verification

That manual also has a useful chart on pressure loss in a 6ft hose based on airflow rate through the tube.

It also mentions that the SV compensates for the loss.

DSM

[ozij]

And I would stop using entirely until it was verified.

O,

[StillAnotherGuest]

Yeah, and I think now some of the ASV Mode data comes into question. Like that IPAP getting pegged at max on 10/18/2008, especially at the beginning of the night where by history she tends to have stable sleep.

Another possibility could be the software. Encore 1.8.49 doesn't have the BiPAP AutoSV update.

OK, good news (sorta). You can query the error log (well, not "you" per se, "they").

SAG

[OutaSync]

From last night:


Looks as though we fixed the pressure dropping problem by making the ramp be the same as EPAP and turning off BPM before setting.

Bev

[StillAnotherGuest]

I'd still try to get the error log queried. A substantial pressure drop that lasts ~2 hours that might be corrected by changing ramp and/or rate is still very abnormal behavior. I mean, if that's the "fix", that's one bizarre workaround.

SAG

[StillAnotherGuest]

...then check to see if the Ramp Button is faulty (sticks in the "on" position, etc.)

SAG