Hello and welcome guidance, charts posted ...

[Walla Walla]

There could be a relationship between the higher pressure and the higher respiratory rate. I'm no Doctor so of course your Doctor is the one to check with. I don't see the need for an ASV machine. A regular Bpap on the other hand might be an option.

[SarcasticDave94]

Hi SteveMac, Welcome to Apnea Board.

No attempt to be Mr. Know-It-All here, which I'm certainly not, but I do know more or less what it takes to get the ASV approved medically. Personally, I don't think you need it from what we see here.

I would agree with Walla Walla on the possibility for BPAP though. It depends very much on your success with the currrent CPAP, and if it treats you fully and effectively. If the EPR limits you in gaining that success, and if you cannot begin to feel better, within a month or so, BPAP may be an option open to you. I suggest you take real or mental notes on "How you feel" after each night the CPAP is used. Why? You may need to be a whiner and complainer and tell your doctor that the CPAP is not working because of X complaints, whatever these may be.

I had to do this to move from CPAP to BPAP (and also to ASV), so I have had to do what I suggest. My reasons for the switch were being unable to breathe out against the straight CPAP pressure. I was a noob then, so forgive me on that wimpy half-hearted attempt at CPAP. Anyway, it got me the BPAP, which due to Central Apneas, BPAP was also the wrong machine for me, but let's leave that for another time.

You should do your best to try CPAP and if it does fail to give you fully satisfactory results, you owe it to yourself to build a case to switch to BPAP.

[SteveMac]

There could be a relationship between the higher pressure and the higher respiratory rate. I'm no Doctor so of course your Doctor is the one to check with. I don't see the need for an ASV machine. A regular Bpap on the other hand might be an option.

Hi SteveMac, Welcome to Apnea Board.

No attempt to be Mr. Know-It-All here, which I'm certainly not, but I do know more or less what it takes to get the ASV approved medically. Personally, I don't think you need it from what we see here.

I would agree with Walla Walla on the possibility for BPAP though. It depends very much on your success with the currrent CPAP, and if it treats you fully and effectively. If the EPR limits you in gaining that success, and if you cannot begin to feel better, within a month or so, BPAP may be an option open to you. I suggest you take real or mental notes on "How you feel" after each night the CPAP is used. Why? You may need to be a whiner and complainer and tell your doctor that the CPAP is not working because of X complaints, whatever these may be.

I had to do this to move from CPAP to BPAP (and also to ASV), so I have had to do what I suggest. My reasons for the switch were being unable to breathe out against the straight CPAP pressure. I was a noob then, so forgive me on that wimpy half-hearted attempt at CPAP. Anyway, it got me the BPAP, which due to Central Apneas, BPAP was also the wrong machine for me, but let's leave that for another time.

You should do your best to try CPAP and if it does fail to give you fully satisfactory results, you owe it to yourself to build a case to switch to BPAP.

Thanks to both of you for insight/suggestions.  I'll follow up with the sleep doctor at my two month follow up soon.

[SteveMac]

So ... I saw a "used - like new" Aircurve 10 vAuto on Amazon for 630.00  and snagged it.   It didn't say how many hours were on it and no ability to ask the seller this question via Amazon.    But price seemed good and I figured I could sell it on ebay if it doesn't work out for me for the same price at least.  Should be here next week.  

I'm still feeling tired and groggy (perhaps more than before starting therapy) and wanted to give this a try.   I have an appointment request outstanding with my sleep doctor, assume it will be mid-July.   I'm impatient though, so I'm going to try this vAuto myself with your help.

My question: Any suggestions on initial settings for me?   I see in another thread for someone who is "self-titrating" a vAuto that the recommendation was to start at  "Vauto mode at Max IPAP 14.0, Min EPAP 5.0, PS 4" and then go from there.    

PS - Attached last nights APAP screenshot for latest status.   Good news, my AHIs are well (seemingly) under control, so by most accounts I'm very lucky (notwithstanding how crappy i feel). I still have consistent "higher" resp. rate and "lower" tidal volume than may be expected.  I'm 5'9" 275lbs (i.e., overweight) and do have mild asthma (i.e., take albuterol as needed ... typically in allergy season).   

Thanks!

[attachment=7195]

[SteveMac]

So a few updates:

1) I'm on BP med now (losartan/hctz 50/12.5 mg) prescribed from my GP.  It had ticked up a bit and was clearly in zone considered "high" now, so doc insisted.  Thing to note, as mentioned previously, this uptick seemed to coincide with starting APAP therapy.

2) I did get the Aircurve vAuto as noted in my previous post.   It ended up only having 32 hours on it!  Was in perfect condition.   I have not used it yet beyond a nap.  It felt like I was breathing out easier for sure, but won't bother posting any data on that two hours (not indicative of anything/didn't sleep really).   I'm eager to use it, but want to keep my APAP usage data consistent for my doc to see.

3) My results with my Autoset has continuted to be consistent seemingly all along.   I guess I'm pleased in that regard (considering/comparatively to other folks hardships).  I seem to be sleeping comfortably and have settled successfully on mask (nasal P10).   I however, still feel tired and not like I used to at about 2.5 months in.   The only less than ideal numbers, per my understanding, are my respiratory rate (higher than average) and tidal volume (lower than average).  I hope I can switch to my vAuto after my doc visit and these numbers improve (and I feel better most importantly).  

4) I've purchased an oximeter and have used it past few nights.  Please see my attached charts.  I'd welcome any commentary/advice.  I think all looks ok.

Thanks

[attachment=7560] [attachment=7561] [attachment=7562] [attachment=7563]
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[Sleeprider]

Your results numerically are great, but for using the Vauto, I think my suggestion would be to start with the settings that are working with the Autoset, but experiment with increasing pressure support. With a minimum pressure of 10 to maximum 13, and EPR at 3, your Vauto settings should be EPAP min 7.0, IPAP max 16.0, PS 3.0. What you will want to do is simply increase PS in increments above 3.0 to see what works. You may tolerate lower EPAP min and higher IPAP max, but I think starting with the settings outlined here will give you EXACTLY what you have now, which is a known baseline.

[SteveMac]

Thanks Sleeprider ... I was hoping just for that kind of advice on initial settings. Will do and report back with some data and how I feel.