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Barb (Seattle) wrote: ↑

Wed Apr 18, 2018 5:53 am

ca...isn't that central apnea?

Yes CA means central apnea or clear airway. But that is not what I said. I said the events look like OSA to me. That means obstructive sleep apnea. Have you tried IPAP above 20?
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just did last night. horrible results once more.......



22/18

stupid stupid stupid I am beginning to think there's something wrong with my brain...it just keeps stopping no matter what settings I use.

I take it last night's experiment did go so great. What happened?

Pugsy wrote: ↑

Tue Apr 17, 2018 11:19 pm

Going to use auto mode tonight
12 EPAP
PS 4 min and max
IPAP 25

We will see if the machine wants to go higher and the results.

well, this didn't work. I had to try. I was curious. now, I'll try the settings you wanted last night tonight. One more day

23 CA apneas. per hour.

The Hypopneas are probably central related as well mine were and all resolved by my ASV I had similar patterns to you on a bad night (AHI of 30) now a nightly AHI of 0.1 I hope the machine Pugsy is loaning to you works as well.

Still curious about auto mode at the settings I suggested which apparently have not been tried before.
It might be a disaster..might not but I don't think any worse than last night.

Plan B still in the works.
Here's the deal...the Adapt/ASV will treat both any obstructive apneas and the centrals if/when they pop up.
If centrals reduce for some reason ...the Adapt won't need to do much in terms of centrals and it still does its job on the obstructive stuff.
Win win...IMHO. It works based on the workload it faces.

Pugsy wrote: ↑

Wed Apr 18, 2018 6:38 am

Still curious about auto mode at the settings I suggested which apparently have not been tried before.
It might be a disaster..might not but I don't think any worse than last night.

Plan B still in the works.
Here's the deal...the Adapt/ASV will treat both any obstructive apneas and the centrals if/when they pop up.
If centrals reduce for some reason ...the Adapt won't need to do much in terms of centrals and it still does its job on the obstructive stuff.
Win win...IMHO. It works based on the workload it faces.

it does seem like win-win to me too.

Jas_williams wrote: ↑

Wed Apr 18, 2018 6:35 am

The Hypopneas are probably central related as well mine were and all resolved by my ASV I had similar patterns to you on a bad night (AHI of 30) now a nightly AHI of 0.1 I hope the machine Pugsy is loaning to you works as well.

that's great to hear. hope it works that way for me too!

Have you ever tried *less* pressure support?

And have you had your heart checked out?

palerider wrote: ↑

Wed Apr 18, 2018 10:56 am

Have you ever tried *less* pressure support?

I wondered about this myself but I haven't seen any reports from before the bipap...as in the probable first DreamStation if there was a first non bilevel DreamStation after the M series.

I was going to suggest reducing PS after tonight's auto bilevel trial while the ASV is in transit.
Kinda wanted to get an idea where the bilevel wanted to go to first because if it wants to spend all night up at 18...going without much PS might not be much fun.
I was thinking maybe let PS run between 1 and 2 just to see if there was much difference...or off maybe.

palerider wrote: ↑

Wed Apr 18, 2018 10:56 am

Have you ever tried *less* pressure support?

And have you had your heart checked out?

pressure support?


I was on bipap...I'm not sure about the pressure support....I think it has to be on Auto for that?


I haven't had my heart checked out, but that did cross my mind. if the machine that's coming doesn't work, I'll go to my dr and tell
her what's going on.

Barb (Seattle) wrote: ↑

Wed Apr 18, 2018 12:36 pm

I was on bipap...I'm not sure about the pressure support....I think it has to be on Auto for that?

Nope...you don't have to be on auto to be using Pressure Support.
Pressure Support is nothing more than the difference between inhale and exhale.

Example

16 EPAP and 20 IPAP...that's a difference of 4 cm...so PS of 4
14 EPAP and 19 IPAP...that's a difference of 5 cm...so PS of 5

now in auto mode with your machine the PS can either be fixed or vary some but it doesn't vary fast enough to do what the ASV can do when it varies and that's why it can't help your breathing that much.

The reason PR asked if you ever tried no PS...is because in some people it's the PS that triggers centrals. It's not hugely common though but I have seen it happen.
Had a lady that I was helping that had a truckload of centrals with PS of 4 and essentially none with PS of 3.

It's something that I was aware of and was going to discuss with you when we get a chance to chat.
Problem is when people need the PS for comfort and if that PS causes the centrals...damned if you do and damned if you don't.
But like I said...it's not all that common but something I was planning on ruling in or out in your situation just in case.

I first wanted auto bilevel mode at the settings I suggested...then depending on those results and your comfort and what pressures you appeared to be needing for the obstructive stuff I was going to suggest playing with the PS a bit.

If it is your heart, you do NOT want to wait.
Call the office, and at least talk to a nurse or PA.

Barb (Seattle) wrote: ↑

Wed Apr 18, 2018 12:36 pm

I haven't had my heart checked out, but that did cross my mind. if the machine that's coming doesn't work, I'll go to my dr and tell
her what's going on.

The last time I saw a person with a chart that looked like yours from the other day,



was from someone that turned out to have severe heart failure...



It was actually discovered from that very image... his doctor had been fobbing him off saying he thought he just had a hiatal hernia...

Now, I'm *certainly* not saying you do... but I'd hate for that to be the case, and you not know, till it was way too late.