BIPAP making my CSA worse

[ImAlwaysTiredd]

finally saw a walk in clinic about chest pain I was having and ignored, turns out I got costochondritis

Wondering if I should just stop bipap and return it, or if that will set me back in advancing to asv

[Sleeprider]

I think you are already on step 2 of 3. Failing at bilevel and scheduled for evaluation of ASV. You quit and you will return to step one, evaluation for CPAP. http://www.apneaboard.com/wiki/index.php...P_Machines

[ImAlwaysTiredd]

It gets difficult now, as I'm only going back to my state for a week for tests, then I'm out for the winter again. I wont be back for months. So I dont know if I should continue to keep using the bipap or just get a used asv, or probably, end up just waiting anyways for an asv prescription and asv stock.

Would I need to keep 90 days compliance, yet be failing with over 5ahi? it would appear my ahi is under 5, with the changes, but not really helping

Another note, my stomach seems to fill up with a lot of air still

[Sleeprider]

Aerophagia is something that could be worse with higher pressure. Your current therapy is only EPAP min 4.0, PS-2 and we could limit the maximum pressure to as low as 7 or 8 cm if you want. With ASV you would need to have at least PS 5, and more likely 8. This is still lower than the settings we started with. The decision on whether to self-treat with a used machine really depends on whether you think you are making any progress with your current medical team. They seem to be slowly moving the right direction with the heart evaluation and CPAP/BPAP/ASV titration at a time TBD. If you want to just skip all the BS, then a used machine lets you ask forgiveness rather than permission. You will immediately have results in data and how you feel to report. The risk is the money you spend to do that vs the time and cost of continuing on the current path.

[ImAlwaysTiredd]

I suppose the heart echo is the important first part I'm waiting on. I'm still trying to figure out the difference between s/t mode and an asv. I see some pretty fancy looking BIPAPs S/T with avaps/evaps on alibaba for <$300 and wonder if those would help

[Sleeprider]

The Resmed Clinical Titration Guide describes all of the Resmed machine. You can focus on ASV on page 28 and ST-A on page 34 to answer your quesitions https://document.resmed.com/en-us/docume...er_eng.pdf I don't see any conditions that would suggest ST-A iVAPS would be suitable vs ASV which is the appropriate therapy for complex and central apnea.

[ImAlwaysTiredd]

I'm not sure I see the difference between asv and s/t, is it variable volume?


Also, I try to wear my muse eeg headband to know if I'm asleep during events.

And found this to happen, When I fell asleep at 11:48pm to ~11:55, according to the band data,
I see I had a large leak in OSCAR data below, which appears to be right as I was dozing, which I guess woke me up immediately again.
This was with the nasal pillow.




What's going on here? I thought I took the mask off when the leak happened, but apparently not till a while later
Also an interesting note, I smelled burnt plastic after that leak happened and some paranoid thoughts at the moment, but was not coherent enough to understand if something was wrong, machine seems to work fine and is new, but that is kinda concerning.

zoomed out a bit

[Sleeprider]

ST - Spontaneous-Timed is a fixed pressure bilevel device that triggers and cycles spontaneously or triggers with a timed backup rate. There is no intelligent algorithm in the ST in any mode,. and it provides a square-wave pressure wave, meaning IPAP is on and off when EPAP is delivered. Most useful for COPD or hypoventilation. The ST has been replaced in many cases by the ST-A which includes an intelligent volume assured pressure support (iVAPS) algorithm to maintain respiratory volume, rather than the simple trigger of a timer.

ASV - Adaptive Servo Ventilation is a variable pressure and adaptive pressure support device that learns the user's 90-second minute vent and respiration rate and uses pressure support withing a set range to maintain that whether the user is breathing spontaneously or not. In AutoASV mode, the machine will increase EPAP if it detects obstruction or untreated flow restriction similar to your Vauto. The ASV uses the Easybreathe flow shaping you are accustomed to with your Vauto that looks like a cresting wave and follows your breathing naturally,. Most useful for complex or central apnea and hypopnea or periodic breathing and Cheyne-Stokes Respiration (like the wavy tidal volume and oscillating flow in your chart as well as the central apnea and hypopnea).

[ImAlwaysTiredd]

so I'm thinking using a lower bipap setting isnt the best idea, seems to cause more o2 drops, or actually, using a bipap vs not, seems my o2 is better without

This whole process to get an asv is ridiculous, more weeks wait for a test that can only be started at 9pm on a week day.

Heart electrocardiogram was healthy

[Sleeprider]

If you are using ramp, turn it off. This segment is apparently 50 minutes in total length and may not be representative of sleep. I agree with your frustration concerning the "process" to get ASV. Your therapy is ineffective and uncomfortable. We discussed the alternative of self-treating.