Am I on the right track? Not feeling it yet.

[benseidler]

Hi All,

I have recently been diagnosed with idiopathic CSA. I started using a Philips Respironics BiPAP autoSV Advanced (system one?) about 3 weeks ago.

I have been suffering from extreme exhaustion to the point that I had to take a few months off of work. Since I have been on the machine, I have started to feel a little better, but I am hoping this is not it.

I have just started pulling data into sleepyhead over the last week or so, but based on the numbers that I am seeing, it seems to me that I am not doing so well on this.

My gut instinct tells me that I need to call my doctor and schedule an appointment to look at my progress, but can anyone here help me confirm what I think I am seeing by these results... which basically looks like I am still a train wreck?.?.?.

Side note: I wore the pulse oximeter last night, and imported the data also, and my low was 89, which also appears to be a big red flag.

Thanks in advance for any help or guidance. I am really hoping to feel better soon, but I feel like I might not be on the right track just yet.

Thanks,
Ben

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[srlevine1]

My gut instinct tells me that I need to call my doctor and schedule an appointment to look at my progress, but can anyone here help me confirm what I think I am seeing by these results... which basically looks like I am still a train wreck?.?.?.

Ben,

Go with your instinct and call the doctor to schedule an appointment. It could be that you require supplemental oxygen and this is the type of thing that needs action sooner, not later.

As for an analysis of the data itself ... this is but one snapshot in time and may not be representative of your true condition or be useful in constructing a speculative progress report or future prognosis.

While many in this forum can interpret what the software appears to be telling you, it would be equivalent to treating the machine, not the patient.

Again, go with your gut and call the doctor. Best of luck with your therapy and continuing progress

[Sleeprider]

While you're waiting for your appointment start raising the EPAP min by 1.0 until you see a marked reduction in the hypopnea. I would not exceed 8.0 without further consultation. We just want to make sure your hypopnea is not obstructive related. Given the fact you are having vibratory snore and flow limitation coincidental to the hypopnea, I think you need more EPAP minimum pressure, and in spite of snores, the machine 95% EPAP was still less than 5.0. Increasing EPAP pressure could potentially clean up the problems.

If this doesn't work, when you see the doctor, ask for a change in machine to the Resmed Aircurve 10 ASV. Some people have better luck with a different machine, also the Resmed is less likely to loiter on the minimum pressure with these kinds of events.

[benseidler]

Thank you both for the info and guidance!

Could the vibratory snores be me clearing my throat or my sinuses? I know I have been doing that a little bit... would the machine be able to differentiate between those and an actual snore?

The only reason that I ask, is that my wife, and also the results of both sleep studies indicated that I don't actually snore... It was strictly CSA...

Thanks,
Ben

[OpalRose]

I believe the PR machines tend to pick up and detect sounds that are not actual snores. My husband says he hasn't heard me snore for over two years. I don't normally see many snores on my graphs, but the last few nights there were quite a few flagged. I'm pretty sure it was due to dealing with a cold and congestion for the last few days.

I wouldn't worry too much over it. The only thing I don't like is that the PR machines won't hesitate to raise the pressure if it detects snores.

Good Luck in your therapy!

[Sleeprider]

Your machine appears to be setup with default settings. I think you'd benefit from additional EPAP. It's one of those things that is pretty easy to try, and determine the result is better or worse. Nothing dangerous in raising the minimum EPAP to 5 or 6. You are not the first we have seen here with similar settings and results. Hypopnea with the AutoSV often responds in a positive way to increased EPAP pressure, but within limits.

[benseidler]

I kicked up the min pap to 6, and we will see how it goes tonight!

Thanks Again!

[trish6hundred]

Hi benseidler,
WELCOME! to the forum.!
Good luck to you as you continue your CPAP therapy.

[vsheline]

I kicked up the min pap to 6, and we will see how it goes tonight!

The PR machines are too slow to increase EPAP for some users.

Like Sleeprider, looks to me like you would benefit from higher Min EPAP.

I suggest leaving Min EPAP at 6 for at least a week. Each night is unique, and we really cannot properly evaluate the effect of a setting change without observation for a week or two.

If the weekly average AHI improves after the change then it was a good change, even if results for first day or two seemed worse (which may have been caused by the always-present random variability, one night to the next).

Would be good to post a 2 minute period of the Flow waveform which includes one or more hypopneas, which would enable us to see whether it looks Central or Obstructive.

Take care,
--- Vaughn

[Sleeprider]

I'm sure you will see a difference at EPAP 6. Good move!