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One way to test Rubicon's theory is to switch the machine to CPAP mode at pressure of 6.0 and see what kind of events and comfort result from that. We will likely at least see your real respiration rate, which I bet is greater than 9.4 BPM. A CPAP session would be similar to doing a sleep test and let us see what is really happening. The maximum IPAP is just over 12 cm in this most recent session, so you seem to be very sensitive to the pressure for aerophagia. The main problem remains you are persistently at or near the maximum pressure support setting of 8.0.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
I definitely agree that my overall sleep quality was poor. My apnea link results were reviewed with my pulmonologist. Prior to using my current ASV machine I used an APAP and these were my typical results in terms of AHI (see attachment). It’s not just in my head right?
Did your pulmonologist review the ApneaLink record page by page, in 2 - 5 minute segments (so like 60 - 100 of them)?
If not, he didn't review it.
With poor sleep, the only thing you've done is now is trying to sleep with a mask on your face. And when (if, really) you do sleep the therapy doubles your AHI while inflating your gut like a balloon.
A point for ASV is that it got her an hour with no events on OSCAR. I think we could swap pressure numbers about and see what happens.
What I mean is, say the known goal is IPAP 20. You can get that by Max EPAP 10 and somewhere in the PS range is the other 10. The extremes would be a lot of EPAP to get to IPAP 20 or less EPAP more PS.
I would consider maybe static (or nearly so) EPAP about 5 or 6 then PS does all the rest of the work. PS is short bursts typically so this might be worked to be less intrusive. I think though we'd need to work up to higher PS than Max 8 at some time.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Try Sleeprider's suggestion, go to CPAP mode on pressure 6.0.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Dave, after looking at the CPAP results posted above, that does not look like a good solution with all the centrals. The AHI is lower with ASV, but the complaint is low sleep efficiency or comfort, and we can see that in the short sessions. I don't know if we are even looking at sleep. My problem with this therapy is that without a setting for backup rate, PavlovsCat is experiencing the ASV setting the pace far too low in breaths per minute. I don't know how to help get the appropriate resp rate of 12 bpm based on the CPAP results. To be honest, the tidal volume, minute vent and respiration rates all look more normal with CPAP, so we need to deal with the AHI or more specifically the CAI without ASV.
The main difference I see, is that CPAP was using EPR 1, so I'm tempted to suggest setting PS min in ASV mode to PS 1 or even PS 0. I guess it's worth a try to reduce PS min to 1 and see if that helps prevent the machine from taking over the respiration rate.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
(03-24-2022, 04:24 PM)PavlovsCat Wrote: So what’s the actionable next step here for me?
Call your pulmonologist and ask if he reviewed the HST epoch by epoch (that'll get him to at least perk his ears up) to determine if your sleep apnea needs treatment, or even if it exists.
If you get a runaround, ask for another study, either in-lab or HST with EEG to determine sleep.
If he balks at that, ask for the ApneaLink file because you want to take it for a second opinion.
If those few centrals are benign (which I'm pretty sure they are) then your AHI is 1.6 and you're wasting time, money and comfort for nothing.
