BIPAP AUTO-SV SETTINGS HELP

I have added weight over the last two years - too much chocolate and not enough exercise. I have started working on both.

CROWPAT wrote:I have added weight over the last two years - too much chocolate and not enough exercise. I have started working on both.

Know that situation well - as soon as I stop cycling (I cycle to work & back on av 4 times per week) my weight creeps up & can easily add 2-3 kilos in 2 weeks of reduced cycling exercise.

Speaking of exercise, can you remind me how much you are doing each day (week).

There is a good picture emerging that am sure will help us greatly in following best suggestions.

DSM

Too much time on the computers with web site work and volunteer stuff. Probably walk about 1-3 km per day on purpose + the normal moving around actions.

dsm wrote: There is a good picture emerging that am sure will help us greatly in following best suggestions.

I have the Muffy zapper ready.

Banned

Guest wrote:

dsm wrote: There is a good picture emerging that am sure will help us greatly in following best suggestions.

I have the Muffy zapper ready.

Banned

Banned,
Muffy is very clearly angry at me & I have offered a genuine apology for my role in the
past slanging we have done at each other.
I don't think it very helpful to do any more 'bell ringing' of either of us by anyone. I am
pretty sure Muffy could sort these issues out better than any of us here. Also, life is too
short for any of us to hang on to the past to our own detriment.

DSM

Well, I happen to enjoy Banned's humor immensely as well.

But I agree with CROWPAT about Banned's legendary AVAPS contribution to Laryssa. Banned will always be "Sir Banned" in my eyes!

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Back on track with CROWPAT: What might we be able to say about those useful preliminary questions dsm has posed and CROWPAT's answers?

Also, does this clue say anything about CROWPAT's situation:

CROWPAT wrote:The one thing I have noticed on the BiPapAutoSV is that when my "Breathing on my Own" number is 99.9% I feel better even if some of the other numbers are not as good as usual.

Where are we at this early point?

SWS - on the matter of 'patient triggered breaths' - my thinking is these are really RR issues. CROWPAT appears to be shifting outside the target (AUTO) RR and the machine timed mode is kicking in. Am thinking that up to about 96% that should not be that big an issue if tidal flow (volume) is normal.

The hint is I guess that CROWPAT has spells where he slows his rate & thus volume & is not getting enough air through his system. I gather we are not attributing poor sleep to arousals, just hypops & slowing rate.

DSM

How about the preliminary questions and answers? I think they are very good questions and answers, BTW.

How might those be incorporated into our tentative approach?

I'm out of action until about 16 hrs time. Hope to have a summary of the inputs ready if someone else hasn't done one.

DSM

I forgot one piece of physical information that may mean something. Generally, I wake up and feel fine for about 30 minutes to an hour before the "fog" settles in for the day.

CROWPAT wrote:I forgot one piece of physical information that may mean something. Generally, I wake up and feel fine for about 30 minutes to an hour before the "fog" settles in for the day.

Don't know if it is an issue for you or not, but I've discovered that I have days where I need to constantly remind myself to breathe. Everyone is fairly dismissive of that, with the wonderful exception of my sleep specialist, who basically said "Let's see what the numbers say." And guess what? The numbers (from Arterial Blood Gas and Pulmonary Function Tests) show that I'm right. I don't breathe as often as I should.

Why do I mention that here? Well, I also tend to have the same thing occur. If I slept well (and it does happen), it's not long (30 to 60 minutes) after I awaken that the fog starts to gather.

Even if you don't have the same issue, I think the general approach might be helpful. If you awaken clear headed, then what is changing as the day progresses? Maybe you can use an oximeter to see if this is an issue during the day, not just when you are asleep. Another thing that can contribute to the mental fog could be blood sugar values. Don't know if that's an issue for you, but it's a thought.

Anyway, here's hoping this will at least trigger some additional thoughts.

Oximeter showed good numbers throughout the day when I had one on for a day so I don't think that is the issue. Blood sugar levels OK too. I do know that I do not breath all of the time during the day. Kind of like I just forget to do it, or daytime apnea. Doesn't appear to be often though, but who knows - not something you can keep track of because if you try to do that you will be sure to breath.

CROWPAT wrote:Oximeter showed good numbers throughout the day when I had one on for a day so I don't think that is the issue. Blood sugar levels OK too. I do know that I do not breath all of the time during the day. Kind of like I just forget to do it, or daytime apnea. Doesn't appear to be often though, but who knows - not something you can keep track of because if you try to do that you will be sure to breath.

Yup. You would have an inkling if you were doing it a lot. I keep noting I need to do a deep breath frequently throughout the day. My O2 levels are okay, but ny CO2 levels are elevated. Essentially, I am not blowing off the CO2 as I should. So, an oximeter says O2 is okay, but the ABG (arterial blood gas) says the chemistry is not right.

Occassional "daytime apneas" are normal. Frequent events are not normal. Nor is shallow breathing (often caused by a great deal of added weight, which can trigger Obesity Hypoventilation Syndrome - or OHS). It does does not sound as if it applies to you. I just thought I would add the info for others that are reading the thread.

Well, I've used up my not so good ideas.

CROWPAT wrote:I forgot one piece of physical information that may mean something. Generally, I wake up and feel fine for about 30 minutes to an hour before the "fog" settles in for the day.

I think that symptom is probably common to a variety of sleep disorders---and perhaps sleep deprivation in general.

But that pretty much describes what I also feel after a bad night of sleep that might occur for a variety of reasons...

Just read the other very interesting comments regarding sleeping ok but feeling tired in the day. This is dear to my own heart as it also happens with me from time to time.

I have some additional thoughts to the already excellent ones posted.

I suspect that we older members (lets say round the 50 to 60+ yo range) have an additional challenge to younger apnea sufferers & that is the aging process. I can't run as fast or as bouncily as I could 20 years ago, I can't speed up hills on my bike quite as well as a teen to 40 yo - I accept that my musculature is aging & not as elastic nor effective as a young persons is even if I can maintain a very good level of fitness (for my age). The lungs and supporting muscles appear to me to be no less in decline & thus I have believed for some time that there can well be apnea due just to natural aging & I also think that some aspects of daytime drowsiness are more age related for some of us irrespective of any natural leaning to OSA/CA.

I believe a number of our personal factors impact our daytimes (just as they can our sleep). Many of the questions I asked flow from these ...

Daytime Factors:
==============
Excess weight
Lack of fitness
Stress & Anxiety (from work or home or whatever - an important factor, stress can inhibit good breathing practices)
Age & Aging (the older we get, the less elastic our muscles tend to become)
Specific Health Issues (this is an obvious inclusion - i.e. heart issues, lung problems etc:)

Nightime Factors:
===============
As above plus ...
Sleeping Position
Bedding & general comfort (i.e. too much or too little warmth)
Cpap Machine noise
Mask leaks (one biiig issue for many of us)
Badly configured machine

I hope to do a summary of CROWPAT's status from the input we have & hopefully we can get into a diagnostic phase & I think
SWS has already offered some excellent & easy to try steps.

The benefit of the holistic approach is to look at life & circumstance matters as they can and do play an important role & again
it may be that CROWPATs machine is already doing its best job (but with careful evaluation we can hopefully work out if it can
be improved on).

DSM