confused over settings

but you see if the bipapst does give accurate readings I am only getting hypopneas or central apneas every night which means that the whole rationale behind the 15/5 auto cpap setting is wrong; I like the bipap st better than this new auto cpap because it can treat my centrals and that's what the sleep study says raises my O2 to 97
anyway I am still wheezing sometimes especially with exercise my FEV1 levels aren't going up on symbicort
you know I need to wade through a lot of this info which contradicts-

I am just worried about brain damage and sleep apnea ruining my career- the problem is my hand takes off the mask in my sleep

sickwithapnea17 wrote:but you see if the bipapst does give accurate readings I am only getting hypopneas or central apneas every night which means that the whole rationale behind the 15/5 auto cpap setting is wrong;

Not quite. If you have OSA as the new doc suspects, then your events without a CPAP are largely hypopneas and obstructive apneas. And you need positive air pressure to prop the airway open.

But the problem is that some people start having central apneas once they are started on PAP therapy at relatively high pressure levels: Somehow the positive air pressure seems to encourage the brain to get lazy and forget to send the message "Breath now" to the lungs. The hypothesis is that folks who experience this likely have some problems with their autonomous nervous system's handling of the CO2-trigger for breathing. In other words, their body doesn't reliably respond to the increased CO2 levels by triggering a breath when they are on PAP at high pressure levels. And when you use the BiPAP ST with pressure settings of 18/14, you are using PAP at high pressure levels.

So my guess is that the doc thinks its the high pressure levels that is causing the centrals. Now, one way to deal with the centrals is by setting the BiPAP ST up with a backup (so-called trigger) rate so that if you are not breathing sufficiently often on your own, the machine takes over and attempts to initiate an inhalation by really cranking the pressure up high. Leading to an intake in air, yes, but also potentially leading to a decrease in comfort.

So it may be that the new doc believes that since your OSA consists mainly of hypopneas, that what you need is a high IPAP, but that you don't necessarily need a high EPAP. And that may be where the doc is coming from.

Now if your BiPAP Auto is set to run in a range with

• MIN EPAP = 5
  MAX IPAP = 15
  PS = ????? (You need to find out this setting)

then, yes, it's quite liklely that you're not particularly comfortable at the beginning of the night due to the fact that the beginning IPAP is only 5+2=7, which is very low for you. And it may take that IPAP a while to respond to the hypopneas and flow limitations as they happen. So, you'd expect the HI to go up and the CAI to go down in this set up as compared to the high pressure set up. And the question becomes: How much does the HI go up and how much does the CAI go down?

Because you're looking for a sweet spot: A pressure setting (likely a fixed pressure setting) that is high enough to eliminate most of the OAs and Hs, but is low enough to NOT trigger an excessive number of CAs.

I like the bipap st better than this new auto cpap because it can treat my centrals and that's what the sleep study says raises my O2 to 97

Do you like the BiPAP ST better in theory ("because it can treat my centrals") or do you like the BiPAP ST better when you USE it ("because I sleep more soundly and longer and deeper with the BiPAP ST")?

That's an incredibly important question to ask yourself: Which machine gives you the best subjective quality of sleep? Because if you cannot sleep with the machine in practice, then the machine does you no good no matter how well it seems to be set in theory.

anyway I am still wheezing sometimes especially with exercise my FEV1 levels aren't going up on symbicort
you know I need to wade through a lot of this info which contradicts-

While the asthma affects the OSA/CompSA and the apnea affects the asthma, they are NOT the same condition. You need to get the asthma under control. See your asthma doctor and report the problems you are having. Don't expect the PAP therapy to make your daytime breathing problems go away.

I am just worried about brain damage and the end of my career- the problem is my hand takes off the mask in my sleep

When one door closes, another will open.

As I recall, you are still in school. (If not, then I have you confused with another poster.) Worry about the career AFTER you get out of school. And please look into a medical leave of absence if things are dire shape academically. Your first priority right now should be in securing quality medical treatment for your multiple medical conditions and getting well. After you are well, return to school. After you get out of school, worry about the career.

thanks very much!
the sleep docs say also that 18/14 is a pressure for someone who is 300 pounds
I noticed there are some papers which show a connection between diabetes high ha1c and sleep apnea and other problems so you should get that checked out with an endocrinologist- I had high ha1c and had early diabetes
I still am looking into the tonsilectomy- I found these snore herbs that seem to help with throat selling at the supermarket- they are called snorestop fasttabs. I also think maybe drugs like restoril may help the stage 3/4 sleep

sickwithapnea17 wrote:thanks very much!
the sleep docs say also that 18/14 is a pressure for someone who is 300 pounds

I don't believe that statement for one miniute.

I noticed there are some papers which show a connection between diabetes high ha1c and sleep apnea and other problems so you should get that checked out with an endocrinologist- I had high ha1c and had early diabetes
I still am looking into the tonsilectomy- I found these snore herbs that seem to help with throat selling at the supermarket- they are called snorestop fasttabs. I also think maybe drugs like restoril may help the stage 3/4 sleep

Is that all you think of is to take drugs to fix your sleep apnea? You have been given excellent advice, why don't you just follow it!!

I hate this auto pap it feels like there isn't any air going into my throat- the bipap st is a better machine

what is the reason behind having the exhalation and inhalation pressures close together like 15/11- how does that treat central apneas?
I read that the cas are caused by too much oxygen sometimes- the brain doesn't give the signal to breathe

I tried the new 15/5 on bipapst but while I took off the mask I didn't feel good in the morning like on 15/11
I find that empirically a little lower than the sleep lab settings are the best-
I have also heard that over time you have to get higher and higher pressure for it to be effective so maybe it's better to start out lower so that you don't run out of room- this is a BIG issue if I'm going to be on this for life

the problems is also I have asthma and I wheeze when I exhale, so any sleep apnea I have is aggravated by asthma and these exhalation/breathing problems

sickwithapnea17 wrote:I hate this auto pap it feels like there isn't any air going into my throat- the bipap st is a better machine

what is the reason behind having the exhalation and inhalation pressures close together like 15/11- how does that treat central apneas?
I read that the cas are caused by too much oxygen sometimes- the brain doesn't give the signal to breathe

I tried the new 15/5 on bipapst but while I took off the mask I didn't feel good in the morning like on 15/11
I find that empirically a little lower than the sleep lab settings are the best-
I have also heard that over time you have to get higher and higher pressure for it to be effective so maybe it's better to start out lower so that you don't run out of room- this is a BIG issue if I'm going to be on this for life

the problems is also I have asthma and I wheeze when I exhale, so any sleep apnea I have is aggravated by asthma and these exhalation/breathing problems

I was put on a pressure of 11 in April of 2010 and I am still at 11............you do not always need to go up in pressure. For your info many of the members here also have asthma and have learned to cope with both their asthma and their osa.

well what kind of sleep apnea do you have that needs only 11cm? I think I have complex/central apnea that was titrated on 18/14 at 97% O2 up from 75%

I have severe asthma that doesn't respond to steroids and prednisone- you have no idea what that is like and here you go making all these accusations

sickwithapnea17 wrote:...I have severe asthma that doesn't respond to steroids and prednisone- you have no idea what that is like

Asthma is other countries is sometimes treated using magnesium, any form other than magnesium oxide which is a laxative. Magnesium levels in asthmatics is often very low. There is a simple blood test that identifies very low levels. When I had asthma, my doc had me drinking much more water and using an inhaler before exercise. I no longer experience asthma. Magnesium helps smooth muscle tissue relax, the aveoli in the lungs are smooth muscle tissue so magneiusm helps them relax and function better. Asthma attacks create terrible anxiety and you seem to have a lot of anxiety.

Asthma is not related to apnea. Weight and the pressure needed to treat apnea are not related; it's the narrowness of the airways that determines pressure and that't an anatomy question. Centrals can be induced from high pressures--your doctor can advise you on this; this is why you need to be very careful about changing your pressure without your doctor's supervision. Nearly everyone has a few short centrals every night. Pressure needs do not necessarily increase as we get older. If you're worried about your oxygen levels, buy a recording oximeter to record your levels overnight.

Cognitive deficits and brain damage are reversible over time with restful sleep, good food, and the right supplements. Research now shows that humans create new brain cells and make new neural networks throughout the lifespan. My short-term memory was severely compromised by many years of untreated OSA. I also had verbal language deficits. Both are 90% healed and I continue to see small improvements over time -- I have been a hosehead since Aug '07 so I know that significant recovery is possible.

One thing you need to understand, the brain is slow to adapt to changes; my brain takes 2-3 weeks to adjust, so changing things like adding drugs or changing supplements will slow down how fast your brain adapts. 1 change at a time, then wait...observe the effect: better or worse or neutral? Adjust if necessary, then wait...observe the effect: better or worse or neutral? Adjust if necessary...repeat until you're sleeping well & waking refreshed.

thanks very much!
I'm trying dulera which a newer medication than Symbicort and also nasonex- even prednisone doesn't help me that much it seems even at 30mg and albuterol on the nebulizer
I was inhaling 2nd hand cigarette smoke at these internet cafes and I thought I was safe because they had these weak air conditioners and then a few months later I find I have developed adult asthma
I'm looking into anti-IGE Xolitor can't remember right now see it's really bad I'm worried I have brain damage from the low O2 levels? I looked it up it's Xolair I want to try

sickwithapnea17 wrote:well what kind of sleep apnea do you have that needs only 11cm? I think I have complex/central apnea that was titrated on 18/14 at 97% O2 up from 75%

I have severe asthma that doesn't respond to steroids and prednisone- you have no idea what that is like and here you go making all these accusations

I am not making accusations...........but yes I too have complex sleep apnea, but I have followed advice given and now have it pretty much under control. And yes, I do know what severe asthma is like, I have had asthmas since I was a kid.
And yes, my 02 has gone down to 72 during my testing. You see, you are not alone, but you think you that you are. I would suggest that you read an ongoing thread here by amyandtodd2011 called newly diagnosed - my story. There is always someone that is worse off than you but has one heck of a great attitude towards everything that has happened to her. As far as I am concerned this Amy is the poster girl for doing what needs to be done, no matter what has been thrown at her.
I wish you good luck in your journey to fix whatever is wrong with you............and I said FIX, not BLAME.

The type of apnea has nothing to do with the pressure setting unless you're centrals are caused by high pressures. It doesn't matter how big or small you are either. You could have 2 people that look exactly the same and both have OSA and each could have different pressures that work best for them.
As Nanwilson said, or at least implied, Attitude makes all the difference. If you want help, we can help...but only if you follow the suggestions given.
You stated in another thread that you have to tape oven mitts on your hands. To get used to leaving the mask on at night; wear it during the day when awake-with the machine on. Read, watch tv, listen to music, or do whatever will keep your mind off the mask. This might help you become used to the mask easier.

Brenda

for some reason I didn't have problems sleeping as much with the bipap auto machine- I don't know if I should try the Auto CPAP- maybe all the bad grogginess and fog was caused by the sominex?

it seems you really have to tape the mask onto your face sometimes- I can't sleep through the night without it

If I were you, I wouldn't waste any time worrying about brain damage...it's too late.
CN

CarpeNoctum wrote:If I were you, I wouldn't waste any time worrying about brain damage...it's too late.
CN

You heartless SOB. Clearly, you can see that this individual is struggling with therapy. We need to be encouraging this person and not trying to discourage .

I just read an article on CNN the other day about brain cell regeneration in Alzheimer's patients. Science is amazing and there is hope for anyone.

CarpeNoctum wrote:If I were you, I wouldn't waste any time worrying about brain damage...it's too late.
CN

And you... are a jerk!