[Health] Interpreting sleep study results, EERS enhanced expiratory rebreathing space

[JoeyWallaby]

maybe i should just pay out of pocket the big bucks for an ASV... so tired of failing. i tried fixed pressure, tried auto, now trying bilevel... i'm just so tired of this.

[JoeyWallaby]

resmed apparently thinks asv is the way to go for treatment emergent and treatment persistent central sleep apnea, from their youtube channel

[mper6794]

Hi, Joey, good morning!

_ HYF wise, a poor night, indeed! I emphatize. But, please, calm dow. In terms of therapy, you are doing much faster and better than so many in this Forum. Be pacient!

-Not so good in terms of HYF, but very good in terms of understanding of your problems.

_Pressure wise, we now have your end-member in terms of P.S, something around 6.0/6.2. There are strong suggestions you would be tiny beats of tailored parameters. To get this, if were me, I would keep P.S 6.8 and slow down P.S beat by beat 0.2: 6.0....5.8...Yet, all of this, can be sligthly masked by leaks and previous outcomes parameters under EERS.

_however, taking in account this night and previous ones, pressure adjustments would not be enough in your case. Your CA's triggers are in clusters, late night, with strong indications of association with REM stages, when you are having both main RERA's-sleep transition CA's and your main LEAKS/CA's. CA's look ressonate after those weak points sometimes, like I saw many times in my therapy.

_ BTW, CA's from your dec 11th night, were more associated with Arousal-sleep transition, so that if your are under tailored seetings they may diminish, luckily.

_Therefore, in my opinion, LEAKS would be the first and most important thing to tackle for now. In future, if you don't work out the leaks properly, you could eventually slow down EPAPmin+P.S a little to not optimum settings to tackle RERA's, but to a proper balance to HYF.

_Actually, concidence, I am doing this right now in my therapy: I got my fine-tuned parameters to tame RERA's, but did not resolve leaks under those parameters on my FFM airfit 20, the only one I can bear up to now, main deleterious events. Sheepless, on the other hand, just as an example, has been able to live with the tailored parameters with no problems with leaks)

-you might already good papers on such problems, for instance, https://www.ncbi.nlm.nih.gov/pmc/article...8.1121.pdf

_ASV wise: in my modest opinion, it would not worth in your case. This would be treat genuine CSA, such as PB, CSR, etc, maybe. Moreover, I suspect it could add instability during your arousals within REMS.
all the best

[JoeyWallaby]

i cant stop the leaks because the events cause the leaks. the centrals aren't in rem, everything i posted says treatment-emergent CAs occur in N1 and N2 and some in N3, no REM

there's no point continuing to try, it's failed me.

[mper6794]

...Ok, Joey, I would not insist. You are looking at data closer and know a lot on this....

Good luck

[mper6794]

... to finish, concerning leaks, I would like to just add this from my last two nights, when I realized how serious are leaks, more than I ever imagined (reviwed my all 7 month-therapy), which I could manage just by slowing down 7.8/5.2 to radical 5.6/5.2 (I am going to keep myself in this direction up to some 7.0/7.4...5.2, maybe). Night 11th, innocent leaks from two first hours, destroy my day...today much better, thanks Prana!).

all the best.

[slowriter]

i cant stop the leaks because the events cause the leaks. the centrals aren't in rem, everything i posted says treatment-emergent CAs occur in N1 and N2 and some in N3, no REM

That's an unfortunate conundrum.
Did you ever try a nasal mask?

I'll just mention again: the Bleep is the one mask I've tried that completely eliminates mask leaks. You still have to deal with the mouth leaks, but that seems straightforward.

[JoeyWallaby]

I've always used a nasal mask

[slowriter]

I've always used a nasal mask

Doh; now I'm embarrassed!

Well, then, a different one.

[JoeyWallaby]

All good, I am going to try a different mask.