[Diagnosis] Severe Sleep Apnea - Titration Test Completed

[Apnea45]

So I have my new doctor and already did the 1st Sleep Lab to be an updated proper diagnosis as well as the 2nd Sleep Lab which involved the Titration Test.

My AHI: 85.2
CPAP Pressure: 21/17 cm H₂O
Specifications: Bilevel PAP S - IPAP = 21 cmH₂O, EPAP = 17 cmH₂O.
Mask requirements: Airfit F20 - small used during titration study.

I will get my BPAP once my Provincial Disability approves the cost for it.

[Apnea45]

Welcome back.  We learned from your last attempt that you probably have positional apnea issues and need to work out comfort and leaks. Those won't magically disappear with a BPAP, but if you get a Resmed VPAP S or Vauto, there are a number of settings that can help.  Your previous settings were minimum 6, maximum 18 with EPR at 3 and your machine consistently shot to the top of the pressure allowance. There is a lot more to work with using a VPAP, and it may be a good thing if it is fixed pressure. We'll see.  Good luck and keep us posted on getting equipped and started.

Thank you. I still have a lot to learn about what all the numbers and acronyms mean, but this time I have more hope. One thing that is interesting is ever since I got a kidney transplant I do not wake up and fall asleep standing up anymore or fall into things. This new doctor, Dr. T, has acknowledged my concern over the next time I am on dialysis and the need for adjustments in my settings at that time. He also acknowledged because of my Severe Sleep Apnea being complicated by my other health issues that directly affect energy levels and my Magnesium levels that I do need a doctor who is in constant contact with me, and he has agreed to do so. Not like Dr. K was. He was the hardest doctor to get hold of that I have ever had. And with my health I have had a lot of doctors of various types.

In the prescription I got, does any of this mean or tell what my minimum and maximum are (is the min 17 and the max 21?) and my EPR? Is it 17?

All I know so far is that the CPAP Pressure is supposed to be 21/17 cm H₂O and that Bilevel PAP S - IPAP = 21 cmH₂O, EPAP = 17 cmH₂O.

But to be honest, I can only guess on what any of that means.

[Apnea45]

Finally, my insurance (Provincial Disability) approved which supplier they will cover. So I called the supplier, but they said the soonest they can book me Oct 27th.

Still, I am one step closer.

[Apnea45]

Okay so I have been using my machine and the first night I actually got 7 hours of sleep straight through! The most I have gotten in literally 5 years in one night without interruption! Was so excited! But then the next night I started having mask leakage and trouble falling asleep and the ramp speed going up before I fell asleep and waking up often.

I tried to installed OSCAR since the ResMed App which worked on my old cell phone (from 2016) won't work in the one I am currently working (2014) and I can't yet afford a newer one. I just thought no big deal I can just install OSCAR like I did before. I had no issue doing that before but this time I cannot get the SD Card from the RESMED machine to even be viewable on my Windows 10 PC or even on an old laptop I tried so I figure it is something with the SD card itself. Does Resmed block reading from computers? Looks like I will have to get a newer cell phone just to use the compatible app.

Help?

[Crimson Nape]

It could be your SD car reader is bad. To test this you should be able to see the SD card as an additional drive in Windows Explorer. You would preform this test while OSCAR is not running.

- Red

[Apnea45]

I also tested it in a completely different computer with the same results. It is a new SD card that I got WITH the ResMed 10 machine.    I tried it on a laptop with built in SD reader thinking that my card reader for my main computer was just not reading properly. Did not read on either computer.

Do some not let you read from any device but their approved ones?  Or only can be read by the doctor?

The machine just tells me to use the ResMed myAir™ app but it is not compatible with my cell phone.

[Sleeprider]

Apnea45 you should update your profile to your new bilevel machine and settings. https://www.apneaboard.com/forums/usercp.php No need to have it in a signature line under every message.

Were you issued a Vauto or VPAP-S? I'm sure the new settings are more comfortable with the PS 4 on EPAP 17. Once you get Oscar sorted out, we can look at whether a lower pressure might be possible.

[Apnea45]

Apnea45 you should update your profile to your new bilevel machine and settings.  https://www.apneaboard.com/forums/usercp.php  No need to have it in a signature line under every message.

Were you issued a Vauto or VPAP-S?  I'm sure the new settings are more comfortable with the PS 4 on EPAP 17.  Once you get Oscar sorted out, we can look at whether a lower pressure might be possible.

I did. Doesn't that show up? Okay, I will take it out of my signature though. The reason I had it in is when I change or update my profile it shows always the old info. If I update ANY field I have to type in all the fields all over again or it saves my old info. I have no idea why it does this on this forum (possibly a cookie issue with my browser or else my password encryptor/form filler?) but when I do save it it does show up as the new info. Just a pain if I change anything.

I think VPAP-S. All I know is my prescription said: BiLevel PAP S - IPAP = 21 cmH2O, EPAP = 17cmH20 but when I looked up the 2 terms you asked me, the VPAP-S showed my machine so I assume it is that. I also put in the SN and DN on the ResMed site and showed me what mine is so now I know the official name and updated my profile to reflect that. The front of my CPAP says ResMed AirCurve 10 [VAUTO] so I updated my profile to say that.

Also still learning the acronyms and terminology. What is PS4? At first I thought you were talking about an operating system.

My Ramp Time is 20 min.
Humidity Level is 4.

That is what it says on my CPAP screen.

I just noticed you use the same machine as me. Should I try using ResScan instead of OSCAR? Or will I still have an issue with the SD card until I talk to my doctor about it?

[Apnea45]

Oh I have Vauto! I did not know and could not update my post after 90 min.  
Auto-Bilevel I guess?

Oh and I finally figured out what PS means from another post since I started searching the forums. Now I know where you got PS4 from.

PS the VAuto has a single PS number that separates EPAP and IPAP. An ASV has 2 PS numbers, a Min. and Max.

I still have no idea how that affects things, but I noticed that 4 years ago it was PS 12 if I understand this right on my old CPAP machine. But to understand what that even means, I have no clue to be honest. Why do you say I must be more comfortable with the PS 4?

[Apnea45]

Okay, the website https://myair.resmed.com/dashboard is linked to my machine if I log in. I wake up often, which I don't understand why, as I slept 7 hours the first night. I do know my mask leaks sometimes and that does wake me up, so perhaps that was why. It did not record the mask leak, though, probably because I wake up as it starts.

Haven't had the time to figure out why the card doesn't read on my PC since I have been busy with family and a funeral in 2 days.

Attached is a screenshot of the reading on the site from my machine: