New to this- Husband vpap III 5 days but not taking breaths

ozij · Post by **ozij** » Wed Mar 05, 2008 9:11 am

-SWS, RG and SAG
You guys are awesome.

O.

Guest · Post by **Guest** » Wed Mar 05, 2008 11:59 am

Read carefully above. Does this mean that, say if the EEP is 10, that at no time under any circumstances will the pressure go below 10. Ie it can be 12, 12, etc. but never 9?

Guest · Post by **Guest** » Wed Mar 05, 2008 12:04 pm

t also has been posted, and often, that ONLY a mask called "Quattro full face" is usable with the CS2/AdaptSV machine. The instructions that come with the machine say sever other ResMed masks can be used; and in fact the Quattro mask is not even mentioned, and for obvious reasons, when the machine first came out, the Quattro had not even been invented yet. Have the specifications now changed. I use a mask called "Activa" which for me is marvelous. I can't use the Quattro at all, it leaks l ike crazy. Am I UNable to successfully use the Activa mask with the CS2/Adapt SV machine? That would be a shame indeed.

dsm · Post by **dsm** » Wed Mar 05, 2008 1:42 pm

-SWS wrote: <snip>

CASE TWO: CENTRAL APNEA/HYPOPNEA OCCURS (REQUIRING ADAPTIVE PS)
So look at what happens when central apnea/hypopnea is detected and PSmax is eventually delivered by the ASV (please refer to that same graph):
15/5, 15/5, 15/5, 15/5, etc.

PSmax is finally delivered in this case so now the IPAP/EPAP cycling must be expressed by these values:
(EEP+PSmax)/EEP, (EEP+PSmax)/EEP, (EEP+PSmax)/EEP, etc.

Notes-
-1- IPAP adaptively fluctuates according to PSmin and PSmax settings
-2- EPAP stays constant according to EEP setting
-3- IPAP fluctuates adaptively, but does not necessarily reach PSmax
-4- Delivered PS will never be less than 3cm
-5- EEP + PSmax will never exceed 20cm
-6- PSmax minus PSmin must always be greater than or equal to 5cm
-7- That EEP of 5cm can be manually increased to address greater obstructive components (as a static-pressure bias)
-8- That Adaptively fluctuating PS is what stabilizes central dysregulation
-9- Once central dysregulation has been eliminated, "Case One" (described above) resumes

SWS,

Many thanks - your insights have proved a great learning opportunity.

DSM

dsm · Post by **dsm** » Wed Mar 05, 2008 3:04 pm

StillAnotherGuest wrote:
<snip>

pjd wrote:This may be redundant and inconsequential, but as I understand, the Adapt algorithm measures and adjusts over a 100 second traveling interval, so the proximal tube data is averaged and not reactive specifically to an individual event other than maintaining ventilation within the 90 percentile range for a perceived central event. Sort of a 90 percentile ventilation based on an average of an average taken over the previous 100 seconds of data collection.

which was from the patent, yet all of the other literature says the window is 3 minutes. This can have a substantial effect on determining Target if the window is 180 seconds:

or 100 seconds:

The additional dial that needs to be spun is the duration of the Floating Window, because the Average Minute Ventilation and consequently Target Ventilation could be considerably underestimated in a patient with long central apneas. And why a flow-based machine like BiPAP AutoSV might be a better choice in those cases.

<snip>

/quote]

SAG,

To you thanks for this very very informative info.

In general SWS SAG & RG, you have done an excellent job of explaining some very complex processes. This has been a great learning opportunity. I'd like to believe many of us (esp me) have learned a great deal - particularly the differences between the Adapt SV and the Bipap SV.

I want to thank you all too for your patience in getting this level of detail across.

DSM

Casiesea · Post by **Casiesea** » Wed Mar 05, 2008 3:26 pm

Banned - He said that he doesn't feel that much of a difference between the 6-4 and 7-3. I will say that he seems to sleep more soundly at the 6-4 setting. He LOVES the quatro FF mask and is sooooo happy u suggested it. It was a little tough to get used to the first night but now its great.

We are approx 680 ft above sea level.

Banned · Post by **Banned** » Wed Mar 05, 2008 5:43 pm

Casiesea wrote:Banned - He said that he doesn't feel that much of a difference between the 6-4 and 7-3. I will say that he seems to sleep more soundly at the 6-4 setting. He LOVES the quatro FF mask and is sooooo happy u suggested it. It was a little tough to get used to the first night but now its great.

Hey Casiesea,

We all learned allot from from your thread, here. Glad he likes the Quattro (nasal-pillows are for girlie-men). It was crazy and fun spinning those dials 'till SAG put a stop to it. At least it was just air and we weren't waterboarding or nothin'. Now all we need to do is get into your husband's new Adapt SV "Enhanced' when he gets it, so you're not quite finished with us. Heck, I saw my cardiologist today, she said she will have the Pulmo call me for an appointment to write a script for titration on my own Adapt SV. They're reining in the renegade. Thanks kiddo!

Banned

Oh, and to clean the Quattro, use one Alcohol Prep pad a day (Sterile, 70% isopropyl Alcohol). Get from hospital or drug-store. Do not take the mask apart (Pain in the butt), super easy, works great, Been doing it for six months. Absolutely will not hurt any part of the mask.

Banned · Post by **Banned** » Wed Mar 05, 2008 5:55 pm

Hi Guests,

1) I believe it is the consensus that once EEP is dialed-in, it remains a constant
throughout therapy until manually re-dialed.
2) The 'Activa' is acceptable for for use with the Adapt SV, as stated in all adapt
SV manuals. If you call ResMed they will simply say the Quattro is the
recommended mask.

Cheers

Guest · Post by **Guest** » Thu Mar 06, 2008 5:59 pm

nasal-pillows are for girlie-men

...is this another "official" pronouncement?

-SWS · Post by **-SWS** » Thu Mar 06, 2008 10:43 pm

nasal-pillows are for girlie-men

...is this another "official" pronouncement?

No, but it was taken from a hilarious Saturday Night Live comedy routine.

I'd like to add my thanks to everyone who shared information in this thread as well!

Good luck to Casiesea, her husband, and also Banned!

goose · Post by **goose** » Fri Mar 07, 2008 1:25 pm

Still very interesting stuff here -- SWS good to hear from you!!! As always you've added excellent info.....

(It was one of your "ancient" posts that RG brought to my attention that convinced me I was having Central issues with the change of pressure in the APAP mode (I'm one of them!!), so I started out by narrowing the range, and actually run in CPAP mode at this point -- quite successfully, so I'd add a healthy thanks for that analysis done so long ago!!!).....

This thread is still fascinating for me!!!!
Thanks to Casiesea for opening the topic for discussion. I would still say she is one of the best resources her hubby has, and again, I hope he'll post some of his experiences and frustrations once he gets out of the fog......

Ya'll take care.....
cheers
goose

-SWS · Post by **-SWS** » Fri Mar 07, 2008 1:43 pm

Cheers, Goose!!

Casiesea · Post by **Casiesea** » Fri Mar 07, 2008 2:07 pm

Hey guys,

My husband is feeling better, but still pretty tired! How long did it take yall to feel completely rested? or is that just not possible with sleep apnea? Am I expecting too much, too fast? He is also still doing that startling thing (while breathing).

Provigil seems to help but his sleep doc only gave him 14 pills (so he is almost out). She wasn't happy that I asked for them in the first place. Snarled at me like I was wanting them for myself. He has an appt with a diff sleep specialist this coming Monday (10th).

Echo is scheduled for Mar 18th.

P.S. DSM and Banned have been a godsend to us. Their help has dramatically changed my husbands life! Without them, I would still be completely lost in the Yellow lightbulb section! They are my knights in shining armor! Sniff, sniff.

Guest · Post by **Guest** » Fri Mar 07, 2008 3:32 pm

Well, I finally made it here. Many thanks to my wonderful wife for doing this for me(and her). I am blessed to have her.

I am feeling much better than before. I would best describe it as I feel normal. After I get up and get going I no longer feel completely drained like I just want to take a nap. I still feel like a nap in the afternoon but after that I feel good.

I am getting used to the current setting of the ADAPT SV. As far as we can currently tell I am no longer having central apnea's. I have had a couple of startles this week but compared to before that it nothing. This weekend we will download the data from the machine and see what it looks like then let you know.

For me, the Q FF is the way to go. Thanks for the suggestion.

goose · Post by **goose** » Fri Mar 07, 2008 5:15 pm

Far out -- glad to hear from you!!!! You are a lucky man!!!!

Not to sound discouraging, but the "feel better" seems to be individual.

Myself. I feel much better, but still not feeling that magic flash of energy that some get.

My RN wife ran into the referring doc one evening in the ER (where she works) and mentioned to him my compliance and that I seem to be sleeping an awful lot since being on the xPAP (8-10 hours a night). What he told her was that I probably have 20+ years of sleep debt to sleep off and that I'd probably be sleeping this way the rest of my life. Not particularly what she wanted to hear, but to illustrate that I didn't get here overnight. I won't get the "cure" overnight, so I don't expect miracles.

All that said -- compared to the way it used to be.....I feel great!!!!! I do get tired some afternoons and want to nap, but generally don't. If I do, I strap on the mask!!!

Like you, this forum has been a godsend to me. I'm a few months from a year on the mask, and a few days from a year on the forum. I just hope that I can give back half of what I've received!!!!

Take care -- keep us up on how you're doing!!!

cheers
goose

New to this- Husband vpap III 5 days but not taking breaths

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