First night with new Bipap after sleep study and 37 AHI mostly CA

[jcp519]

You definitely should try to get another ASV if that is what you were on before. The VAuto will not be able to do much against all of those central events. An ASV would more than likely get you to a sub 2 AHI in the first couple of nights.

Its crazy that a doctor knowing your history would not have given you another ASV to begin with.

[Sleeprider]

If you need a clinical manual for the S9 VPAP Adapt ASV, you can request it from the forum for free. https://www.apneaboard.com/adjust-cpap-p...tup-manual I'd like you to access the settings and let us know what the settings are on that device, and if we see something we might suggest to improve on that, then we can do so. Check for a SD card in that machine. It will work with Oscar, and even though the data is old, it gives us some idea of your history there. The best approach will be to record a session on the Adapt ASV and post it to the forum for us to suggest changes.

I'm sorry you had this happen. I don't know how doctors can excuse or explain such poor practice. This reflects very poorly on your medical team and I can only conclude they have no experience with central sleep apnea. My goal is to get a couple session recorded on your old ASV and send you back to your doctor with proof, ASV is the correct therapy, and get you into an new Resmed Aircurve 10 ASV. We can waste your time and attempt to optimize the Aircurve 11 Vauto,, but given your diagnosis, or at least what should have been your diagnosis, and history, I consider that a waste of time and effort. I will provide you with a suggested prescription for you doctor to use.

[TBrobbs]

I’m wondering what led you to stop using the ASV you had? And whether it’s still operable. If so, getting help here to set it up and use for a few nights would likely give you more info for when you talk to your doctor.

FWIW, I recently started on ASV with the support of Sleeprider and others on this forum, and had my settings pretty much dialled in within the first week with no events. Also just had my first solid 7 hour sleep a couple of nights ago. I’m finding it much more comfortable than my CPAP machine.

[PandaZA]

The reason I  stopped using it is I kept waking up at 3am and couldn't get back to sleep. I don't feel like the settings were every correct and the doctor was not much help. I ended up getting frustrated. I initiated a new sleep study with a new doctor as this was required for insurance. I am determined to get set up correctly now.

I restored S9 and current settings are as follows:

ASVAuto
Min EPAP 4.0
Max EPAP 15.0
Min PS 4.0
Max PS 15.0
Max Ramp 20min
Start EPAP 4.0

[Sleeprider]

We would change those settings fairly significantly, and if you don't mind a little trial and error, I can suggest an initial starting point:
Mode ASVauto
EPAP min: 4.0
PAP max: 7.0
PS min: 3.0
PS max: 10.0
Ramp off if you tolerate it, or set to auto.

[PandaZA]

Ok thanks, I will let you know how it goes.

[SarcasticDave94]

This old ASV info looks like a default setup except using PS min 4 instead of 3, with Ramp added in.

This is not your fault. This ASV was handed off to you with little thought about personalizing therapy setup. Try the settings Sleeprider stated. We'll get you to proper therapy ASAP.

[Sleeprider]

I went back and took a closer look at your sleep study and titration.  BiPAP was titrated with a backup rate of 14 breaths per minute.  The use of a backup rate suggests a much different device should be prescribed, and someone clearly missed the fine-print. Your Aircurve 11 Vauto is not capable of providing a backup rate, so the clear prescription should have been ST or ASV with a strong preference for ASV.  The backup rate is mentioned twice in the Scoring Summary section. The fact this is an ERROR on the part of the doctor should make it very easy to get corrected.

[jcp519]

It's good that you posted on here!

It's a shame, but not surprising, that a doctor missed such a critical thing in your sleep study. Unfortunately, these sort of situations are very common when it comes to sleep medicine. You stopped using your previous ASV because your doctor wasn't any help.

The good news is, with the proper settings, ASV can be tolerated very well and improve your quality of sleep greatly.

[PandaZA]

Good morning, for comparison I tried the new machine last night one more time and couldn't make it past the one and half mark (25 AHI) at which time I switched over to my old ASV machine and was able to fall asleep pretty quickly and then also sleep through the night. I was able to use zero ramp setting. Attached are my results. Let me know if I need to screen grab anything specific.

Thanks again for all your guys help.