Back up rate?

[hueyville]

Did 3rd sleep study just over a month ago. Sent me home with instructions to use cpap and change pressure once week slowly increasing from 17 to21. All the numbers sucked so I had 4 nights left before doctor appointment once I did their deal. I set machine to best bipap settings from a year of dial winging and let it run. Numbers still sucked. AHI's as high as 94 with average in 50 range no matter setting. Next week they are going to restudy using bipap with a backup rate. Whats a backup rate? If doesnt work then we will retry using an SV machine. Doctor says if we can get my AHI averaging 15 will be about all can expect for me. Apparently head injuries where brain matter leaks out onto concrete screws up your sleep, especially if you have obstructive apnea before the head injury. Any other brain damaged experts with tips. I really would like a good nights sleep before I die.

[JonathanCPAP]

You seem pretty coherent and intelligent for someone whose brain matter is lying partially on the cement. But still, I am very sorry to hear about your accident. Are your apneas mainly central apneas or obstructive?

[hueyville]

Started with obstructive then fell off a radio tower while carrying up an antenna. Short tower, no helper, really hot day so decided to move fast and light. Had harness on but can't clip in while moving just while stationary doing work. Got helmet out of truck, picked it up three times and set it down every time because it was just too hot for it. On way up slipped foot caught, tipped me over and fell 25 feet head first onto concrete slab. When woke up in pool of blood wrapped a towel around head and drove to closest medical help as no cell signal at radio tower site. Had hole in back of head big enough to put two fingers in. I broke every safety rule in the book due to lack of respect for short towers. Less than a year later was rear ended by lady text messaging and fractured it again. Has messed up several brain functions like pituitary gland, sleep center etc. Now my obstructive apnea is complex due to centrals from the head injuries. Doctor says will be lucky to get my AHI average to 15. Weird is about once a month will have a night of less than 3 to 5 range. So now be wants to add a backup rate to my bipap therapy. I was hoping someone might could tell me what that is.

[JDS74]

Hueyville:

Backup rate is the respiration rate the machine uses when your breaths per minute fall below the backup rate. That setting only applies to ventilator type CPAP equipment, not BiPap machines.

That they are discussing it with you implies severe central sleep apnea. What do your reports say for the number of OSA's, number of CA's, and numbe of hypopneas per hour?

[hueyville]

Average Sept 1 thru Oct 1
CA: 5.9
OA: 19.2
H: 7.8
Averave night periodic breathing: 10.1

Worst night
CA 16.4
OA 21.9
H: 11.8

[hueyville]

Have a doctor friend can get me any machine at bargain and write script for it. What are the best two do all machines on market price no option. Sleep doc said something about SV or VS next step. I want to get machine on way that will do anything they need it to including fetching a midnight snack.

[JDS74]

Periodic breathing and high CA's combined justify an ASV type machine.
The OSA and hypopnea numbers suggest your pressure is too low.

Sounds like a ASV type sleep study is appropriate to figure things out.

Because higher pressures like yours can make CSA's worse, I don't recommend that you fiddle with your pressures until after you see your doctor and / or have another sleep study.

I think your doctor's comment may come from his expectation that raising your pressure will also raise your CSA numbers. The good news is that the appropriate ventilator machine will treat them while a BiPap machine will note them without treating them.

[hueyville]

Saw doctor today. We went over last months data and I go back for another study about 10 days. When I asked what setting to use till tben be said I am so all over the map past year to just dial up my favorite till next study. Have another scheduled for six weeks out. That is as close as my insurance will let us with max of six per year.

[hueyville]

Set my machine up last night using the best setting I had from last year of dial winging before the new sleep doctor. this morning had AHI of 6.4. Slept 6.5 hours and only had to remove mask once. Of course tonight AHI will probably increase by factor of ten which is normal for me but it felt good to have one good nights data.

[hueyville]

Talked to doctor and respiratory tech again today. Just for grins to see what machine might do I set it in biflex auto mode with a range of 8 cm H2O on bottom and high side of 25 cm H2O and let it play roulette with my brain. Nothing else has worked yet so why not.