Important Questions

Guest · Post by **Guest** » Thu Oct 19, 2006 10:24 am

Hi again,
I could really use some expert advice, I am going back in to the sleep lab Monday Oct.23 for another titration night.......If some of the folks here with experience can please go to the strand "last straw" that I posted some time ago, and review my results from my first titration ( I know this is a pain) as it is in several posts on that strand, and help me with questions to as the sleep techs. or drs. I would really appreciate it.....I have been 100 percent compliant on my cpap with a 8.8 setting of straight cpap epr3 and the numbers are good for a few nights and them climb steady upwards. I have some great info. from here on mixed and central event apnea. But I would still like to know what to ask so this titration goes better than the last one. I may be hoping against hope with this, but the last titration had me a 9cms. (that's where I had my 11 central events.
Any advice is very much appreciated.
I don't plan on a 3rd visit.....very leary of these tests.
Thanks,
Ellen

Snoredog · Post by **Snoredog** » Thu Oct 19, 2006 10:54 am

Like I said before, you cannot use the Resmed Vantage if you have central or mixed apnea. The machine is stupid (sorry no other way to say it) it cannot distinguish the difference between a obstructive hypopnea and a central hypopnea. Then if you snore it is even worse. This is probably because they still use thermistors instead of more sophisticated pneumotach sensor like the Devilbiss, Remstar and PB 420x machines.

The machine logs central hypopnea as obstructive, this in itself causes a pressure increase the next time the machine sees that very same central event and the cycle repeats (apnea climbs so does pressure).

If your 95% pressure is a "moving" target that is why. If your 95% fluctuates +-1cm that is normal. But if you increase the Max. pressure and it continues to climb to the new Max. pressure the machine is MISREADING the SDB event (sees a central apnea as a obstructive one, logs it as obstructive, a big NO NO).

If you have CA's and MA' noted on your PSG, you MUST:

1. Limit the Max. pressure on the Vantage to the titration pressure found by the Sleep Lab. They CAN see those centrals on the EEG you and the Vantage cannot. The lab tech will give you a pressure that AVOIDs those centrals.

2. if you are using cpap with EPR mode, you have to reiterate yourself or retitrate in the lab using a machine with same EPR mode. If you were given a pressure in the lab of say 10cm and use EPR=3, then you are probably only getting 7.0cm of actual treatment pressure out of your machine because of EPR.

Please do NOT PM me if you are going to ask the same questions over and over again. Thanks.

SelfSeeker · Post by **SelfSeeker** » Thu Oct 19, 2006 11:01 am

Link to Last Straw, Please help posted by whatrdreamsmadeof

viewtopic.php?t=14040&highlight=last+straw

curtcurt46 · Post by **curtcurt46** » Thu Oct 19, 2006 11:42 am

Are you being treated for PLMD? You need to take a careful look at this if you are not being treated at this time.