I feel Terrible Please Help (Phillips Bipap ASV)

[Zoltyzolt]

Hi, I will keep all my information going forward on this thread. Background to all those who haven't seen my previous posts-I have UARS with Sleep Apnea as well as Narcolepsy. I just got diagnosed by Dr Gerald Simmons in Houston. I will try to attach the studies down below. 

The reason I am coming to this forum is since November I have been using a ASV Philips Respironics Bipap (System 1) with a min PS of 4, epap min of 7 with great results and a nasal N20 (small Resmed mask). I had been feeling a lot better until came June, when for some reason the pressures didn't seem to work anymore. I am currently getting the machine looked at to see if the pressure system is off but I don't think so as I used a similar machine with the same pressures and that did nothing again.

I will attach all OSCAR data that I can (Ideally please compare the March data with the August data-I really don't know what is going wrong).

Please tell me if you can't view the attachments, this is my first time using this website and I am not so good at it.


I really need guidance and looking forward to any advice!

[Zoltyzolt]

Hi, I have no idea what I am doing wrong I had been using my ASV for a while now with the same pressures and I noticed around a couple months ago I haven't been getting the same rest I used to. I could use any guidance! I can't find any leaks among my equipment and I so lost. I really need to get back to sleeping well.

[OpalRose]

Please clarify the exact name of the machine you are using. Your profile states Phillips Bipap Auto 10? The 10 reference refers to a ResMed machine?



Also, repost your graphs from the daily page using the F12 Key.
Standard View. Eliminate the Calendar.

[Sleeprider]

Your charts are not as useful as they could be, and we especially need to see the settings. Reduce the monthly calendar by clicking the ^ in the date line. The most useful charts are events, flow rate, pressure, leaks, snores and we may sometimes look at respiratory statistics like tidal volume, minute vent and respiration rate. The stand-out feature of your therapy by month is the lack of therapy hours, averaging from 4 to 6.5 hours per night on a monthly basis. This will explain a great deal about a growing sense of fatigue. The event rate is low, however a relatively high flow limitation index prevails throughout.

Your current settings appear to have been significantly changed during the night, and that clearly didn't work. Your history is for much lower pressure settings, but it is not possible to correlate the changes in the summary graphs to actual results. You seemed to do well with EPAP 10, IPAP 13.5 on the chart from 8/23. We can go much farther into assessing your therapy, but you're going to need to be more disciplined with pressure changes. My overall impression is that you are on the wrong machine and my experience is that using the BiPAP ASV has rarely proven to be ideal for individuals with UARS. By far the preferred device is the Resmed Aircurve 10 Vauto due to its predictable pressure support to mitigate flow limitation along with inspiratory controls such as Ti Min, Ti Max and trigger sensitivity, with perhaps the biggest difference being the shaping of the pressure transitions with EasyBreathe™.

Let's get a better idea of your pressure history and what worked. best up to now using the Statistics Report standard view that shows the settings history. It may be helpful to get a close-up 2-3 minute view of the Flow Rate from the 8/23 chart at about 5:30. We want to zoom in close enough to see the respiratory wave.