I'm trying to stick with it...AVAPS user

zombee · Post by **zombee** » Fri Jan 17, 2020 11:05 pm

After years of deteriorating and practically giving up any hope of ever having a functional life, I decided to try another doctor and he put me on a sleep study. My AHI in the sleep study was 75 and I was diagnosed with sleep induced hypoxia. I'm hoping it's apnea that is destroying me and that this machine will help me fix it and get my life back. I've been using it for about a week now. The first few days were ROUGH. I felt horrible during and after the 3-4 hours I was able to use the machine. Each day after has been slightly better, but I never seem to get more than 3-4 hours of sleep at a time. But that's ok, I know I'll get used to it and will be able to sleep longer. My main concern right now is that my AHI still seems to be high. It's between 20-30 and I'm just wondering if there are any settings I should tweak or does it gradually get better or what?

I'm just looking forward to a day when I actually feel rested after sleep and I don't need 5 hours of naps in the day. Energy? What's that?

zombee · Post by **zombee** » Sat Jan 18, 2020 11:30 am

I actually got 8 hours of sleep last night. Here's the data from that. If you need anything else, lmk.

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zonker · Post by **zonker** » Sat Jan 18, 2020 12:40 pm

zombee wrote: ↑
Fri Jan 17, 2020 11:05 pm
After years of deteriorating and practically giving up any hope of ever having a functional life, I decided to try another doctor and he put me on a sleep study.

welcome to the zoo! i'm not the person to give you advice on avaps. others will be along soon. there are people here familiar with bilevel machines and such. just not me.

but i'll wager in the end you will end up changing settings on your machine.

good luck!

this does get both easier and better.

raisedfist · Post by **raisedfist** » Sat Jan 18, 2020 4:48 pm

Unfortunately the DreamStation AVAPS and the current version of OSCAR don't play very well together, making the data not make much sense. They are working on the new version, and some people are beta testing it, but I believe you have to be invited by someone on Apnea Board until it's made publicly available.

What mode of therapy are you currently using on the machine? It may be helpful to list all your therapy settings here as well. I am familiar with the AVAPS feature and how it works.

I'd be hesitant to make any suggestions without getting some more information here. But rest assured you should be able to get some help on this forum.

If you have a copy of your sleep study/titration you could upload that as well with your personal information edited out.

The AVAPS models are intended for very specific patient populations so any further information you'd like to share would indeed be helpful.

Cheers

zombee · Post by **zombee** » Sat Jan 18, 2020 10:35 pm

Here are the settings for my machine.

Mode: ST
IPAP: 16
EPAP: 11
BPM: 10
Ti: 1

Humidification: Adaptive
Ramp Time: 30
Ramp Start: 7
Rise: 1
Mask Type: Off (I did some research on my own and couldn't find what setting to use for AirFit P10 Mask. The clinician said this was fine)

I have attached my sleep study results. Note: I had a hell of a time falling asleep there. I only slept for about half of the time, so this data only shows me without a machine. My second test was when they actually hooked me up to a machine but I did not get the results from that, my doctor just referred me over to get the machine. Hopefully this helps.

zombee · Post by **zombee** » Sat Jan 18, 2020 10:37 pm

And here are a few more from the sleep study. Thanks so much for any help.

raisedfist · Post by **raisedfist** » Sat Jan 18, 2020 11:25 pm

Wondering if you should be using an ASV given the obstructive sleep apnea and central sleep apnea. ST mode is clearly not working for you. I don't think you need the AVAPS...one is usually only used if you were diagnosed with hypoventilation - which requires recording carbon dioxide levels during the night. At a moderate PS of 5 your tidal volumes are pretty normal. You have a lot of timed breaths which means centrals.

zombee · Post by **zombee** » Sat Jan 18, 2020 11:56 pm

Thanks for the input. I thought it was strange that my sleep study said to titrate to a cpap machine but then I got an avaps machine. Of course I'm totally new to this and dont know the difference. I noticed the apnea board seems to have a lot of posts on this device, maybe I'll give them a shot.

Pugsy · Post by **Pugsy** » Sun Jan 19, 2020 10:36 am

I agree with raised fist...I don't see the need for this machine at this time.

Plain cpap/apap might have even worked. Too bad they didn't at least try it. ASV would definitely have worked better.

Any chance you can get a second opinion from a different doctor?

The hypoxia could simply have been from the OSA and might have resolved itself with regular cpap optimized therapy.
Would have been worth at least trying. My O2 levels went to 73% during my diagnostic sleep study...totally fixed with cpap therapy.

You really need to get a copy of the sleep study results using the machine.

Pugsy · Post by **Pugsy** » Sun Jan 19, 2020 10:38 am

Mask type set to off is the correct choice when using a non Respironics mask and it isn't the cause of all the ugly on your report.
You would have the same ugliness even with a Respironics mask with the Resistance setting (that's what the mask type setting is) set appropriately.

raisedfist · Post by **raisedfist** » Sun Jan 19, 2020 11:56 am

Pugsy wrote: ↑
Sun Jan 19, 2020 10:36 am

The hypoxia could simply have been from the OSA and might have resolved itself with regular cpap optimized therapy.
Would have been worth at least trying. My O2 levels went to 73% during my diagnostic sleep study...totally fixed with cpap therapy.

This is definitely possible as a lot of the hypopneas on the study (and there are a lot of them in groupings) seem to correspond with oxygen desaturations. Indeed the desaturation of 3% may even be a requirement to flag a hypopnea in the lab, depending on what protocols they use.

zombee · Post by **zombee** » Sun Jan 19, 2020 12:06 pm

Thanks for the feedback pugsy. After browsing around here, I'm noticing you offer feedback to basically every post! I dont know how you find the time, but you help a lot of people!

After my first sleep study the recommendation was to "proceed with cpap titration". Now do you think that was sort of like a vague term to "get me on a machine" or did they literally mean a cpap machine and not this avaps one? It's just upsetting me that after finally getting treatment, I might actually be on the wrong one. My doctor and my provider seemed to genuinely care about my treatment, I think after they see my numbers they might switch me to a different machine but I'm not too optimistic that my insurance would get me a different doctor yet.

I can go into "therapy" mode on my device and change it from ST to CPAP, would that make any difference?

(As far as the oxygen levels, I guess maybe that could be contributed to the fact that I am a smoker. I even have some clogged arteries in my leg which is called claudication and requires surgery) I'm trying hard to quit, feeling pretty confident that I can.

zombee · Post by **zombee** » Sun Jan 19, 2020 12:16 pm

Also, my dad has an airsense10 that he's been using for a while. He's got no problem with me giving that a shot and seeing how it works out. Wanted to get some advice on that before I jump into it though.

raisedfist · Post by **raisedfist** » Sun Jan 19, 2020 12:27 pm

Is your dad's unit the airsense 10 autoset?

I definitely think you would be okay to try CPAP mode for a night on your current device and it would be good to see what happens as a result. I'm not exactly sure of a good starting point, maybe 10cmh2o or so. Should be more comfortable than a PS of 5 and rise time of 1 which is like being wacked in the face repeatedly.

Pugsy · Post by **Pugsy** » Sun Jan 19, 2020 1:07 pm

So they did at least attempt some sort of titration study on some sort of machine?????
It would be nice to know what happened and why they ended up with you on this AVAPS machine.
Maybe something weird happened. Definitely request a copy of that report.

Obviously this machine at these settings isn't working out so great so for sure need to be following up with the doctor sooner than later.
This is NOT acceptable and no amount of time is going to fix the problem.

So......for sure need a follow up with the doctor

and in the meantime I don't see where one night of cpap mode on your current machine or even one night on your dad's ResMed would hurt anything.
What settings to try....toss a coin but raisedfist's idea of 10 cm is as good as any.

I'm trying to stick with it...AVAPS user

I'm trying to stick with it...AVAPS user

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Re: I'm trying to stick with it...AVAPS user

Re: I'm trying to stick with it...AVAPS user

Re: I'm trying to stick with it...AVAPS user

Re: I'm trying to stick with it...AVAPS user

Re: I'm trying to stick with it...AVAPS user

Re: I'm trying to stick with it...AVAPS user

Re: I'm trying to stick with it...AVAPS user