Highest Periodic Breathing, Leaks and Apnea Ever!

[Dormeo]

I'm sorry you're having such a lot of trouble with this. Could you catch us up to date? Did you try to get a ResMed Airsense 10 Autoset? Have you tried other FF masks? Can you analyze why you have such extended periods of large leaks?

Did the Hs come down at all when you set your minimum pressure to 13? With the PR, your main approach will have to be raising the minimum, since it has a very conservative algorithm.

I'm actually wondering whether you'd do better with a bilevel machine with greater pressure support than the Airsense can give you. I hope an expert can swing by to opine.

[Sleeprider]

You still need a soft cervical collar. Since your efficacy is so poor on CPAP, you should ask your doctor if you can move to BiPAP, preferably the Resmed Aircurve 10 Vauto.

I'm not expecting too much, you have ignored every suggestion to improve your results and your sleep since the beginning of this thread.

[SarcasticDave94]

I'm sure in some way stress can hinder sleep. Unfortunate, I don't think your new Respironics will work any better than the last one. You asked for our suggestions and we had said to get the ResMed. The Respironics has proven not to work for you.

[jennie54]

I am not on the Airsense 10 machine because when I was due for a new machine last year my medical supply company does not carry that one so I was given the Dreamstation. I also use the Dreamwear full face mask and my doctor said it was the best mask available. My leaks will continue to be high most likely because I am not a sound sleeper - I toss and turn constantly and the tubing gets pulled here and there making the mask slide around on my face. I am scheduled to see another sleep specialist next month (they have me on a cancellation list if a sooner appointment becomes available) so I'll see what he has to say after looking at my data. The pandemic has definitely added a whole other level of stress to my life (I do not and have not had Covid 19;I have been extremely safe during this pandemic and have gotten tested on a regular basis to give me peace of mind) and I don't know if that in itself could have a negative effect on my sleep apnea. I think I also need to consider that taking that 0.5mg Xanax tablet at bedtime to help me fall asleep may be doing more harm than good since it's known to slow my respiration. Should I continue to try different pressures myself or leave that up to the doctor to make changes? I've bounced back between a fixed pressure to Auto PAP and back again over and over. I am at a total loss as to what to try next.

[jennie54]

I agree with you that my Respironics Dreamstation is not benefitting me at all - so my best option might be to purchase the Airsense machine out of pocket. I have asked my doctor in the past whether Bi-Pap might be better for me but he did not agree. I don't know how much control I have over this on my own since I will most likely need an Rx from my doctor to even get a new machine. Also, I have really bad reflux and I was recently put on Pantoprazole 40 mg for it so trying the cervical collar in the past made me feel like I was suffocating and made me even more claustrophobic. It's too bad there aren't any decent sleep medicine doctors where I live or I would try yet another one.

[SarcasticDave94]

You can do what I have done. If the DME you're using does not offer ResMed you go somewhere else. If it's an insurance paid device, make sure to check that the DME is in-network.

PS if this current Respironics is an insurance rental, return it and shop elsewhere for ResMed either AutoSet for CPAP or VAuto for a BPAP. Explain to all how poor the therapy is. And it looks like you'll need a soft cervical collar to combat positional Apnea.

[Gideon]

NOTHING WILL WORK until you fix your neck alignment/chin-tucking/positional apnea. This is evidenced by the clusters of obstructive events that you continue to have.
You need to use a soft cervical collar.

Until then, changing your settings, your machine, your doctor, your mask, even getting a BiLevel/BiPAP WILL NOT WORK.

[Sleeprider]

I agree with Gideon that a soft cervical collar will make a huge difference for you, even with your current Philips. Your events have a classic positional clustering.

If you want to try a different machine, there is a Resmed AirSense 10 CPAP Machine w/ Humidifier for Sleep Apnea - $500 in Colerain in the Louisville Craigslist for $500. It has zero use hours and the picture shows it is an Autoset. I think it's overpriced by $100 because you can buy one from Supplier #2 for $539 with a warranty (new open box), but there are deals out there if you look. You can buy from Supplier #2 with existing documentation or they can call your doctor.

Regarding your current DME, they have an exclusive marketing agreement with Philips. You will need to find alternative providers in your area that can also sell Resmed. These marketing agreements are not fair to the consumer, and while the suppliers make more money and get lower prices by not selling competing products, it is the consumer that loses. I would not work with a supplier with such an agreement that was not in my interest.

[DaveL]

Fascinating Sleeprider.

I bought my ResMed S9 used and put 21,000 hours on it. It cost me $200 Canadian. And came with two masks (that didn't fit.)
My machine still works.