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avi123 wrote:If I was you I would then seek a Sleep Physician holding an MD in Sleep Medicine to check me. You probably have underlying medical ailments which need to be treated. You did not register your local and age. Members on this forum are not qualified to solve your problem but they might have suggested to where you should go for help.

Avi just hangs around to scare people, he's best put on the foe list.

Well...as bad as I hate to admit that agree with Avi...I think you should be checking around and maybe finding another doctor to manage your sleep apnea.

Even with the higher pressure not causing the bloating...the settings were woefully sub optimal and a doctor that refuses to educate himself on the benefits of the various models and get stuck in a rut prescribing something that is obviously not working...he wouldn't be my doctor anymore.

You need a machine that is able to stay relatively low in pressure the time you don't need higher pressures and then go high when needed and hopefully that would give you the best chance of seeing optimal therapy without blowing you up like puffer fish. Right now with the machine you have you would have to use a lot higher than what you were using all the time to stand any chance of reducing that AHI of 40 you were seeing and if you couldn't tolerate what was giving you the AHI of 40 then there's not much chance of you being able to tolerate what is likely needed.

With auto ASV type of machine the machine stays a lower pressures until you really need the big burst for the centrals. Since you would most likely be using lower pressures for a good deal of the night and the burst higher is relatively short lived...we hope that is enough to keep the puffer fish syndrome away.

I don't think that tweaking this machine is going to be of any real benefit since we know that serious aerophagia issues await the higher pressures you would have to use all night long...and even then I don't know it would work. Is this doctor, who is so stuck on fixed pressures and the 1060 machine, a doctor who actually specializes in sleep or just a doctor who dabbles in sleep apnea stuff?

You need to be able to at least try the 960 model or the equivalent in the ResMed line which would be the AirCurve 10 ASV and see if it helps or not. If the doc won't get on board....time to find a new doc.

About Hypopneas:

https://en.wikipedia.org/wiki/Hypopnea

Pugsy wrote:Well...as bad as I hate to admit that agree with Avi...I think you should be checking around and maybe finding another doctor to manage your sleep apnea.

Even with the higher pressure not causing the bloating...the settings were woefully sub optimal and a doctor that refuses to educate himself on the benefits of the various models and get stuck in a rut prescribing something that is obviously not working...he wouldn't be my doctor anymore.

You need a machine that is able to stay relatively low in pressure the time you don't need higher pressures and then go high when needed and hopefully that would give you the best chance of seeing optimal therapy without blowing you up like puffer fish. Right now with the machine you have you would have to use a lot higher than what you were using all the time to stand any chance of reducing that AHI of 40 you were seeing and if you couldn't tolerate what was giving you the AHI of 40 then there's not much chance of you being able to tolerate what is likely needed.

With auto ASV type of machine the machine stays a lower pressures until you really need the big burst for the centrals. Since you would most likely be using lower pressures for a good deal of the night and the burst higher is relatively short lived...we hope that is enough to keep the puffer fish syndrome away.

I don't think that tweaking this machine is going to be of any real benefit since we know that serious aerophagia issues await the higher pressures you would have to use all night long...and even then I don't know it would work. Is this doctor, who is so stuck on fixed pressures and the 1060 machine, a doctor who actually specializes in sleep or just a doctor who dabbles in sleep apnea stuff?

You need to be able to at least try the 960 model or the equivalent in the ResMed line which would be the AirCurve 10 ASV and see if it helps or not. If the doc won't get on board....time to find a new doc.

The doctor specializes in pulmonology, sleep disorders and internal medicine. Thanks for your advice. I am definitely going to try to get an appointment and discuss my treatment with him. Is it typical to only have a conference with the nurse practioner and never meet the doctor? If he won't see me, I will go somewhere else. I dread starting over with the insurance company.

My sleep doc was seen by be for maybe 60 seconds. Spoke with NP first then he came in and looked up my nose and at the back of my throat and grunted and said "go ahead and schedule for study" and left.
Mr Personality he wasn't but I actually really liked the NP so I had no problem just seeing her for the follow up BUT I have plain jane vanilla OSA and I had already taken control of my own therapy and all I had to do was show her the results and she basically agreed with all my conclusions so we were good.

I think it is common for NPs to handle things and most of the time they probably do a better job than some docs do because they tend to be less "set in their ways" as the docs can be.
Unless you get a young doc who hasn't got into the bad habit of being stuck in the past and won't even entertain something new as maybe being appropriate.

Give it a go with the doc and if he refuses to budge out of his mud quagmire....start looking for another doc.
I wish I could offer some ideas to make your machine work for you but for it to even remotely do what you need the pressures are going to be high all the time and that's going to be bad for the aerophagia situation.

Please do keep me posted though.

Update - I have FINALLY been switched to a new machine. ResMed AirCurve 10 ASV. My settings -
Mode - ASVAuto
Min EPAP - 9.0
Max EPAP - 15.0
Min PS - 5.0
Max PS - 16.0
Mask - Pillows
Ramp Time 30min
Start EPAP - 5.0
Humidity Level - 6
Tube - Slimline
I am beyond discouraged ... the bloating is much, much worse than with the last machine. So not what I expected. I have used this machine for 7 days total and my average usage hours is 2:38 per night. The only good news is my highest AHI was 7.33. I called the NP 2 weeks ago and was told she would call me back after researching to see what can be changed. Guess she is still researching. Any suggestions on what I might try? There is no way I can tolerate this bloating. Sleep for a couple hours then walk the floor for and hour with pain and nausea. I was able to tolerate the swallowed air with my CPAP machine but I cannot tolerate this.

jpshunt wrote: Any suggestions on what I might try? There is no way I can tolerate this bloating. Sleep for a couple hours then walk the floor for and hour with pain and nausea. I was able to tolerate the swallowed air with my CPAP machine but I cannot tolerate this.

can you get us a couple days of sleepyhead daily printouts?

I am only getting summary data in SleepyHead. I am not getting the information I uploaded previously with the graphs when I was using the different machine. Sorry I am not familiar with the software and do not know if there are any settings I can change to get the same data as before??

jpshunt wrote:I am only getting summary data in SleepyHead. I am not getting the information I uploaded previously with the graphs when I was using the different machine. Sorry I am not familiar with the software and do not know if there are any settings I can change to get the same data as before??

what version of sleepyhead?

palerider wrote: what version of sleepyhead?

His report in June from the PR S1 60 series machine was from using Sleepyhead 1.0.0Beta 2...so should be the most recent version.

Maybe try creating a new user profile and seeing if the detailed data shows up???

Also...confirm if the SD card is actually correctly inserted in the machine all during the night when the machine is in use. It's a ResMed now and if the card isn't in the machine then we lose the detailed data graphs.

Pugsy wrote:

palerider wrote: what version of sleepyhead?

His report in June from the PR S1 60 series machine was from using Sleepyhead 1.0.0Beta 2...so should be the most recent version.

Maybe try creating a new user profile and seeing if the detailed data shows up???

Also...confirm if the SD card is actually correctly inserted in the machine all during the night when the machine is in use. It's a ResMed now and if the card isn't in the machine then we lose the detailed data graphs.

good catch, good suggestions.

Is this any help?

That's just ResScan's summary page...not the detailed page.
Do you have detailed graphs available in ResScan?
Have you been leaving the SD card in your machine all night when you are using the machine?

I do not have detailed graphs in SleepyHead or ReScan software. Yes, I keep the SD card in the machine at all times unless I am transferring data. Data is also sent to myair.resmed; however, it is summary information also.

In ResScan did you select "All Summary Data and... " and "All" most recent Detailed Data as in the box below?

You may not see this dialogue box if "Quick Start" has been selected under Tools/Options/Download. If so, clear the check mark under Quick Start.