HELP reading Sleepyhead

[racprops]

I understand but it seemed First, sadly this has been jumping around as people seemed to stop reading and responding to my eailer threads.

Sorry but a new thread seems to get noticed where a new post doesn't.

Thanks for you informed answers...

I kind of thought so...

Rich

Rich, I merged your SleepyHead thread along with the "where did the help go" thread.

Starting numerous threads on the same issues doesn't help folks to help you. I've already merged four of your threads together as it's better to keep your information on this subject in one or two threads so folks can read through it to provide better assistance to you. Scattering your posts all throughout the forum makes your issues more confusing, in other words.

Thanks.

[racprops]

Well as there is almost no one that can help I am kind of lost.

My Doctor has a cranium anal inversion and is not willing to work WITH me on these problems.

I kind of fear he is also in over his head with my problems.

Rich

[Sleepster]

A big part of adjusting to CPAP therapy is just giving your body and mind time to get used to it. I realize that your issues are more complicated than those associated with simple OSA, but I still think this notion applies.

If your doctor is that lame you may want to find a pulmonologist who specializes in SDB.

[vsheline]

I keep waking up and ripping off my mask as I feel suffocated...
...
I really need help reading the reports of sleepyhead and help fixing this.

Hi Rich,

Haven't been able to spend time on the Forum lately, but want to respond to your request.

Two issues:

1. Please list all the settings you are using. SleepyHead is only reporting your machine's bi-level mode settings (which you are not using) instead of the ASV mode settings you are using, so you will need to separately list for us the ASV mode settings you are actually using. After you do this, I hope to be able to have time tomorrow to comment on your SH report(s).

2. I suggest you continue as best you can to use the machine (preferably using your doctor's prescribed settings if you can manage it) because we need to look at data over a period of time and not try to make adjustments unless you positively cannot use the machine with your (ex-)doctor's settings.

i see your using the Philips Respironics FitLife i could see how that would make you feel like you feel

Try the mirage-liberty lower profile on the Face

there are
lower profile masks out there
keep looking and good luck with the treatment

I think the ResMed Mirage Liberty mask is only recommended for pressures up to 20 cmH2O. I tried it, and on me it tends to leak or fail at the high pressures my ASV machine needs to use to treat my CSA. So I doubt it would work out for Rich, who sometimes needs pressures higher than 20 cmH2O.

Personally, at high pressures I have had the best luck using the two ResMed masks listed in my profile.

Take care,
--- Vaughn

[racprops]

Well I know I have caused some concern.

But I have listened and I think I have done a fair job.

Last night was one of the best, and I was able to keep the mask on almost all night.

The reports of the other nights also show these kinds of reports for the time I was able to keep the mask on.

I was having problems keeping it on...

I see long periods of no events and low pressure and good breathing.

I see an AHI reading of 13.71.

I see great progress.

Does anyone see any problem??







Rich

[vsheline]

Does anyone see any problem??

Hi Rich,

I'd be happy to offer comments on your posted data if you list all the settings you are using. SleepyHead is only reporting your machine's bi-level mode settings (which you are not using) instead of the ASV mode settings you are using.

Take care,
--- Vaughn

[racprops]

I am using:

Max Pressure= 25cm

EPAP Min and Max 10/15

PS Min and Max 0/10

BPM Auto

BiFex settings 3.

That is all the setting it has:

Max Pressure

EPAP Min and Max

PS Min and Max

BPM (Usually auto)

TI if not using BPM on auto.

Flex type/BiFex settings 1, 2, 3.

And a few lock outs and alarms...

Does anyone see any problem??

Hi Rich,

I'd be happy to offer comments on your posted data if you list all the settings you are using. SleepyHead is only reporting your machine's bi-level mode settings (which you are not using) instead of the ASV mode settings you are using.

Take care,
--- Vaughn

[racprops]

Bad night: Tried sleeping back in bed with wedge…with only three hours of sleep I got an AHI of 36.84. 16.32 was Clear Airway with only .97 as Obstructive and 10.88 Hypopneas.

Switched to recliner and slept for one hour and had only one event a Hypopnea.

But after an hour of staying up, I tried to go back to sleep and things when bad again… Final total was 28.18 AHI.

I seem to need a more upright position than I get with a wedge in bed; just enough recline to keep my head in place.

I will have to look into blocking my recliner from allowing me to push it back to a fuller recline as I believe that is when my apneas run wild during the times I sleep in the chair. (I wake up laying nearer flat without my knowing how I got so far reclined, I seem to push back in my sleep.)

Rich

[vsheline]

I am using:

Max Pressure= 25cm
EPAP Min and Max 10/15
PS Min and Max 0/10
BPM Auto
BiFex settings 3.

Hi Rich,

For reference, these were the original settings you reported your machine had when you started using it:
Min EPAP: 10.0
Max EPAP: 15.0
Min Pressure Support: 0.0
Max Pressure Support: 15.0
Max Pressure: 25.0
Flex Setting: 2
Backup Rate: Auto

Your leak sometimes gets too high but overall I think you are doing well controlling leaks, considering the high pressures you are using and this is still your first month of using your machine.

I think there is little-to-no reason to think that excessive leaks have anything to do with the problem we see, that your machine has not been eliminating your Central Apneas (CAs). Whether your total leak is very large (and it usually is not) or whether your total leak is low, it looks to me like the machine acts about the same.

When you are having CAs we see from the Mask Pressure waveform that the IPAP often quickly shoots up to 9 higher than the EPAP. This means the Pressure Support (PS) has shot up to 9. When you are having CAs, the PS stays at 9 much or even most of the time. Since you say you have the Max PS set to 10, I don't understand why SleepyHead indicates the PS never goes higher than 9, even during the times when you are having many central apneas.

Perhaps something is preventing your machine from going as high as it needs to, to eliminate your CAs.

Just to be sure the PS is not maxing out and needs to be allowed to go higher, I suggest you set the Max PS to your doctor's prescribed setting of 15, rather than the 10 you have been using. If you set the Max PS to 15, the PS won't necessarily ever go as high as 15, since it will not go higher than is needed.

I suggest making that change, in order to be able to rule out that the problem is that the Max PS needs to be higher.

Hang in there. You'll beat this yet.

Take care,
--- Vaughn

[racprops]

Here is where things go off the tracks.

The summery from my first sleep study said I have Complex Apneas, centrals CAUSED by the introduction of CPAP.

The second study also said I was not treated by Bilevel either.

As I understand it, I need a ASV partly so that the pressure is relaxed to clear my Centrals and pressure enough for and when I have OAs, and intelligent enough to tell the different.

I was under the impression the machine would not ram high pressure down my air pipe (pun intended) but lightly feed air though my clear airway to insure breathing.

It kind seems counterattacking the problem.....My centrals are caused by CPAP like pressure so pushing a high pressure should make them worst...

But I kind of see how once I am in a central, IE NOT taking a breath, then it need to VENTILATE me and push in the air..so then Higher pressure might be needed to get the air in.

So my thinking is the base pressure, the EPAP 10cm used to clear my OAs might be triggering the centrals I then NEED higher pressure to ventilate me with.

It almost seems a catch 22.

I will try your suggestion, but kind think it will go the wrong way.

Rich