Back On The Machine

[eseedhouse]

Hypopneas are better than apneas. If your machine is preventing apneas at the cost of a few more hypopneas then you are better off. How long are these events lasting? A few 10 or 11 second hypopneas are really no big deal, especially if these would have been actual apneas without the machine.

[storywizard]

Hypopneas are better than apneas. If your machine is preventing apneas at the cost of a few more hypopneas then you are better off. How long are these events lasting? A few 10 or 11 second hypopneas are really no big deal, especially if these would have been actual apneas without the machine.

Last night I had 76 CA's, 11 Hyp all listed at 10secs), 2 OA's..

very tired today...thinking of biting the bullet and getting an ASV machine...

Storywizard

[retired_guy]

Story, I've been following you for quite a while now. In spite of some mis-steps along the way, you have been giving this cpap stuff a very good try. Good job sticking with it and doing the best you can.

But it does sound like it's time for you to migrate to the ASV machines. Where do you stand with the sleep docs? Can you discuss it openly with them and get a good reading on what they think given your latest results?

Cpap pressure of 8 is too low. We've talked about that. But you cannot increase it with the strong central results you are seeing. And clearly with just 2 OA's and a handful of hypops, you don't need to other than for comfort.

So resolve to migrate to the ASV. Talk to the docs. If your insurance cannot help, then get a prescription from the docs and score a good used machine from one of our on-line suppliers, craig's list, or wherever.

Hang in there Story, you are a great testament to the perseverance that we sometimes need.

[storywizard]

Story, I've been following you for quite a while now. In spite of some mis-steps along the way, you have been giving this cpap stuff a very good try. Good job sticking with it and doing the best you can.

But it does sound like it's time for you to migrate to the ASV machines. Where do you stand with the sleep docs? Can you discuss it openly with them and get a good reading on what they think given your latest results?

Cpap pressure of 8 is too low. We've talked about that. But you cannot increase it with the strong central results you are seeing. And clearly with just 2 OA's and a handful of hypops, you don't need to other than for comfort.

So resolve to migrate to the ASV. Talk to the docs. If your insurance cannot help, then get a prescription from the docs and score a good used machine from one of our on-line suppliers, craig's list, or wherever.

Hang in there Story, you are a great testament to the perseverance that we sometimes need.

thanks for that RG...:-)
The sleep docs don't want to know about the centrals, I did not have any on my overnight sleep test last October...but they come on bad with the pressure. Present doc refuses to read data from machine, the tech sees there is something, he got me to do an overnight oximetry last Tuesday, was sending a report to the doc.
My GP is on my side, will write a prescription for whatever I need to get, so I am thinking it is time to at least try...
Not sure about used machines in Canada, and am leery of the border re customs letting a machine through, so I may go new machine from a supplier here...big bucks, but at this point I realize I need to take care of myself as the system will not...

This is the machine I am thinking of getting:

{link removed}

Thanks again RG, I needed that...

Story...

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[Sleeprider]

It's a shame it has come to this. Your sleep professional should have a keen awareness of complex sleep apnea. I asked you at one time what cereal box his diploma came in, and he has certainly earned that insult since. Is he a health professional, or a gatekeeper to the governments CPAP purse? He deserves some of your scorn.

[storywizard]

Just bought myself a ResMed S9 VPAP Adapt SV with Heated Humidifier - REF - 36007 from Supplier #2.

Looking forward to the next part of the journey....

Storywizard

[retired_guy]

Just bought myself a ResMed S9 VPAP Adapt SV with Heated Humidifier - REF - 36007 from Supplier #2.

Looking forward to the next part of the journey....

Storywizard

Good job Story,

Now reach out to the guys around here that are using that machine so you can get some pointers as to set-up and how to adapt to it successfully.

I believe you will do great.

[storywizard]

Thanks RG...

I will look at the manual...and start reading....

Storywizard

[DeepBreathing]

G'day Storywizard

It's a big step up from an Autoset to an ASV machine, and they have a very different "feel", but you should find that your centrals disappear pretty quickly once you get used to the machine. The biggest difference is that the ASV doesn't operate at a more-or-less constant pressure like a CPAP or Autoset, but breathes with you - every time you inhale, the machine will increase pressure, and every time you exhale it will reduce pressure. This does take some getting used to, and it can feel like the machine is trying to force your breathing. The Resmed has a patented algorithm called Pacewave which adjusts the machine's rate to match your own more closely, so that it works with you, not against you. When you start using it, just breathe slowly and regularly, and the machine will match your rate quite nicely. If it occasionally tries to rush you, just blow back quite forcefully, and it will get the message.

The difficult thing to advise is what pressures you should be using. With this type of machine, you have five settings: EPAP min, EPAP max, PS min, PS max and IPAP max. EPAP is the exhalation pressure, and should be set low enough to be comfortable but high enough to prevent obstructive apnea or hypopnea. IPAP is the inhalation pressure. On an ASV machine this can go up to 25, which you will definitely notice! PS is pressure support, which is the amount of extra pressure to get from EPAP to IPAP. Remember: EPAP + PS = IPAP.

To start out, I'd suggest the following settings: EPAP Min: 7; EPAP Max: 12; PS Min: 3; PS Max: 5; IPAP max: 20. (In fact it won't actually get to 20, but you can leave it there as a convenient ceiling for later adjustments). Try this for a week, review in SleepyHead and see how it goes.

Good luck!

[storywizard]

Thanks so much for this guidance DeepBreathing, I have printed it off and will use it to set up...Machine is shipping today...

I would be excited if I was not to sleep depraved...lol



Storywizard