Matilda19 Thread - APAP v. ASV treatment questions

[Pugsy]

Check these out

I personally know each person and will vouch for them.

https://www.cpaptalk.com/viewtopic/t182 ... pping.html

https://www.cpaptalk.com/viewtopic/t182 ... E-425.html

If something unforeseen should happen you could turn around and sell the machine and put that money towards a different machine but again....at this point I don't see you needing ASV which is a LOT more expensive and hard to find.

[palerider]

palerider, thank you for both of your comments! All of this makes sense. I appreciate the road speed limit metaphor & also your comment about ignorance.

For "hard to tolerate" what I meant is I wake up--no stomach pain--and I thought the reason I was waking up was the increased pressure causing my mask to sort of flap against my face / leak air (I have the F30i mask). However, you are right that the breathing events themselves could be the cause. Very good point.

Which is why it's important for us to ask what someone means when they say something like "hard to tolerate", and not just assume we know what you mean.

If the mask is leaking too much, then try fitting the mask at a higher pressure, and/or use mask liners to tame the leaks so they don't bother you. Mask liners were a game changer for me when I was wearing a FFM. padacheek.com makes the best ones, and the owner is a really sweet lady that wants to help fellow CPAP users, not just make a quick buck off of them.

The reason I was worried about a max pressure of 20 being dangerous is I have read that before getting an ASV you are supposed to get tested to make sure your heart is working well.

There was *ONE* partial study, since mostly disaccredited that suggested that with equipment that was a couple generations behind the current state of the art, in people that were near death already, that didn't have the machines set up well and didn't use them anywhere near enough of the time (to name some of the glaring problems) there was a *VERY SMALL* percentage increase in mortality.

I think I read ASVs can cause heart attacks in some patients from the sudden, high pressures.

Not heart attacks, just undetermined mortality, with people that already had severe heart failure. The *cause* of that was never determined, they just saw about 2% more people (out of 1200 or so in the study) and FREAKED THE FUCK OUT (to use the technical term.) My brother, on the other hand, with severe heart failure, used an ASV for 6 years, till they killed him in the hospital with crappy care.

But clearly the source could be wrong or I could be wrong, as I am just beginning to learn everything.

For more info on the myth of ASVs being "dangerous":
https://journal.chestnet.org/article/S0 ... 5/fulltext
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6277244/

until that flawed "study" is substantiated, I'm calling BS on it.

[palerider]

Thank you, Julie. That makes sense.

Do you (and palerider) think it'd be better to first:
a) keep minimum the same (at 8 ) and move the maximum up (to 20)
or
b) move minimum up to 9 and keep maximum the same (12)
or
c) something else?

The minimum is the important number. The max is only an issue if you need more for some reason (REM sleep, back sleeping, something else) than the set max allows the machine to do, which I why I don't like seeing it lowered, unless someone has a compelling reason (usually painful bloating from swallowing air).

So, I'd bump the min to 9, (or 10) and do something you're comfortable with on the max.

[palerider]

Also, I am gathering it will likely take some time to try various settings with the APAP before I would know if I need to upgrade to ASV. Is that true?

If so, what are all the things I would need to try with APAP before I could "rule it out" as a machine that will work for me?

For example, would I need to make sure I have tried APAP with a maximum pressure of 20 & maximum EPR (3)? Would I need to try different types of masks? Et cetera

I very much appreciate your help.

The primary reason to move to an ASV is if you're having a LOT of centrals. And believe me, I know what a LOT of centrals looks like:



That's what my brother's looked like when I suggested he needed to go to a cardiologist, do not stop, do not pass GO, "make an appt with a cardio post haste", because breathing like that suggests (but doesn't conclusively prove) heat failure.

I haven't seen anything so far that makes me think "this guy needs an ASV" even thought I have three for sale.

[Matilda19]

Pugsy, thank you so much for sending me those links!!! I hope to buy the brand new one; I sent a few questions to the seller (for chemical allergy reasons). I cannot believe I might get to save $450 on a brand new APAP just due to the sheer luck of joining CPAPtalk.com today. THANK YOU.

[Matilda19]

palerider - Thank you *so much* for all of your responses. I have received more useful information in a few hours on this site today than I have in weeks elsewhere.

I am so sorry to hear about your brother. That is terrible. I truly hate when people are killed by the failure of people and places that are supposed to help them.

[Matilda19]

Hi everybody. Thank you all again for your help last night. I feel so much less anxious now about my future with APAP. I have a few questions & updates.

When I get my new machine, will I need to use a new SD card or can I continue using the same one? The SD card is my property & there's plenty of space on it, just wanted to check if using it in a new machine will confuse the machine or the card.

Last night I did settings of 9.0-16.0 with EPR 2. I think it went pretty well, though I did feel like the pressure was irritating my throat and chest at times. This morning my upper chest is a bit sore like the muscles got a workout. It felt that way the first month or so when my settings were 6.0-16.0. I do have allergies & possibly asthma (TBD as I need lung function tests).

I've attached screenshots from last night so you can see how the majority of my central events tend to happen after 12 noon, which is the last few hours I'm sleeping. This has been going on since I started PAP therapy. If anyone has feedback, re: if those central events are a concern and how to deal with them, I'd be glad to hear it. Apnea Board said those were likely "Sleep Wake Junk" and I could disregard them.

[Pugsy]

http://freecpapadvice.com/sleepyhead-free-software

Watch the videos here and they will help learn to spot arousal/awake flagged events...otherwise known as sleep/wake/junk..
and real asleep flagged events.

If you aren't asleep they don't mean much except poor sleep quality.

[palerider]

you can see how the majority of my central events tend to happen after 12 noon, which is the last few hours I'm sleeping. This has been going on since I started PAP therapy. If anyone has feedback, re: if those central events are a concern and how to deal with them, I'd be glad to hear it. Apnea Board said those were likely "Sleep Wake Junk" and I could disregard them.

The last knowledgeable sleep center manager I talked to about those things says "we don't know, it just happens with some people, there's nothing to worry about though.

I wouldn't think it was SWJ for that long, but without more detailed view of the breathing, I don't know for sure.

[GrumpyHere]

I've attached screenshots from last night

A little tip regarding OSCAR usage, you can make OSCAR easier to read by deselecting sessions that contain no useful information.

For example, on the Sep 15, there is the little session before 13:00, that if unselected would eliminate the giant white gap.



.
Scroll down to Session Information and remove check marks from the session you don't want to see.

I was adjusting a strap liner and was turning my machine on and off.



No junk sessions

[Matilda19]

GrumpyHere - Thank you so much for the tip! I have fixed it. I will keep that in mind for future posts.

2021-09-16 part 1 better version.png (188.87 KiB) Viewed 1498 times

[Matilda19]

Pugsy - Thank you for your post. I will watch those videos!

palerider - Thank you for passing along the info from the knowledgeable sleep center manager. Would you like me to upload a more detailed view of the breathing?

[Matilda19]

Hi again, everyone. I hope you all are well. Thank you so much for your help back in September 2021; it got me set up on the path to success. I have a couple of new questions.

1. Humidity issues - The air I'm breathing in has been feeling less humid even though I have it on the highest humidity setting. I also have to get up in the middle of the night to refill my tank. I'm wondering if anyone has tips for how to deal with that. I have the settings on humidity level 8 and tube temp 80 degrees F.

Suggestions I have seen on the forum are:
- replace the water tank because the gasket/seal might be worn out due to rinsing it out every day.
- stop rinsing out the water tank & gasket every day, just dump it out & let it dry
- wash my mask and hose less often (I wash my mask cushion every day & replace it once a month; I like to wash it rather than just wipe it out because there is saliva in it each morning. I wash the hose about once a month)
- run the mask fit function on the machine once or twice per morning to dry the hose and avoid mildew
- get a room humidifier

2. Do you recommend making any changes to my settings based on my results over the past 6 months?

I have posted some screenshots that have my Statistics and my last Daily chart.

My current settings are (also listed in my signature): Current pressure (Feb 2022): 10.8-20, EPR 2 full-time. Mode: AutoSet for Her. Tube Temp: 80 Fahrenheit. Humidity Level: 8. Machine: ResMed AirSense 10 AutoSet For Her. Mask: ResMed AirFit F30i. Tubing: ClimateLineAir.

Thank you all very much!

Screen Shot 2022-02-14 at 6.58.15 PM.png (224.03 KiB) Viewed 377 times

Screen Shot 2022-02-14 at 6.59.39 PM.png (185.06 KiB) Viewed 377 times

[Pugsy]

Do you have one of those gadgets to check the ambient room humidity to see exactly what the machine is working with?
It's not unusual for the air in homes to become a lot drier during the winter because furnaces or wood heat will dry out the air. If it's really dry...that could account for using up all the water.
If that is the case I would be buying a room humidifier if it were me.

As far as your settings....your overall averages are acceptable. I don't know that I would change anything as long as you are sleeping decently and feeling decently. Last night was a bit ugly but it seems to be an outlier as your other averages are much lower.