IVAPS vs Vauto BPAP - Tidal Volume Question

[cmpman1974]

All going downhill.  Even the DME supplier has no clue how to help. I had a long conversation with a respiratory therapist y-day late afternoon.   They are thinking about swapping my machine wondering if the sensor went bad. Something is very wrong though as I had a 37 second unclassified apnea followed by a 24 sec one.  All went to hell later in the night with crazy high leaks wavering up and down. 

No one at all here has any other ideas? ANYONE here seen anything like these leak rate patterns? It seems illogical. I don't believe the reported AHI numbers one bit.

[Sleeprider]

I have been following, but I got nothing for these unexplained leaks. Maybe a machine error is the best explanation.

[cmpman1974]

I have been following, but I got nothing for these unexplained leaks.  Maybe a machine error is the best explanation.

I have to agree, but all this is just getting silly.  Out of curiosity, I went back to my old ResMed Air Curve 10 VAuto I had in my closet.  I wore the same mask as I've been wearing all these months (Vitera).  Quite the change in reported leak rates for the night I used the old machine.  it's the same model exactly as my new one.  Though w/o supplemental O2, my time under 90% was almost 2 hrs.  Somehow I removed the O2 ring in the middle of the night so there's a missing gap of time for reported SPO2 and pulse readings.  However the last few nights with the new machine, the reported time under 90% was way less even with the massive leaks.  You can see after a while all this gets to be a jumbled mess in which the end user has no idea what's reality anymore. Kind of sad.

I have to believe there is something wrong with this new ResMed machine. The reported leak rates make zero sense, especially with this new set of data last night. How exasperating!

On a different note, I just underwent a two night overnight sleep review (pulse-ox, HR, etc) with my new doc. I should get the results in a week or so. I am very, very interested to hear how these medical-grade device results compare to the CheckmeMax O2 wrist device. I'm really starting to think my big issue may be lack of appropriate REM sleep. My spine is just too stiff to get decent sleep. I am constantly stretching my spine in the middle of the night trying to get relief despite using a muscle relaxer. I am curious how reliable Apple watches are for accurate sleep staging. I know 'Uncle Nicko' is big on them in his channel, but he also has a commercial interest too so I take it with a grain of salt.

[Sleeprider]

Pretty significant difference with the Vauto. I have to say, you are a spontaneous breather and the ST-A does not make a whole lot of sense. It lacks the EasyBreathe wave form and some timing and sensitivity controls that would seem to make more sense for you.

[cmpman1974]

Pretty significant difference with the Vauto.  I have to say, you are a spontaneous breather and the ST-A does not make a whole lot of sense.  It lacks the EasyBreathe wave form and some timing and sensitivity controls that would seem to make more sense for you.

No, I got rid of the ST-A a while back.  I meant I went back to my old VAuto machine (8 yrs old) instead of the new one the DME sent last month (same model).  It seems like the new VAuto machine may be defective in recording leak levels.  It doesn't even seem possible to have those leaks the last few nights w/o crazy noise coming out from the mask or hose.

[cmpman1974]

Seems hard to believe my SPO2 dips this low with 10 second apneas.  How on earth would one drop to 77% on that little of an amount?  It really makes me question the CheckmeMax at some point. It said my average SPO2 level was 90% last night. Wow that kind of sucks, if true.

[cmpman1974]

Last night....2 hrs under 90% - no major mask leaks - avg leak rate was 4L/min

[cmpman1974]

Last night's session....

[Jay51]

Just an interesting observation Cmpman.  When you had a small group of UA's there, your pulse stayed relatively normal.  Most oximetry I have seen shows heart rate increasing with clusters of events.  Maybe this points to the V/Q mismatch Sleeprider described earlier.

[cmpman1974]

Just an interesting observation Cmpman.  When you had a small group of UA's there, your pulse stayed relatively normal.  Most oximetry I have seen shows heart rate increasing with clusters of events.  Maybe this points to the V/Q mismatch Sleeprider described earlier.

I'm not sure.   I spoke to another sleep doctor this afternoon.  He said based on a two night home oximeter study (something called Night Owl), my sleep apnea is not well controlled.  This certainly is no surprise, thought the other sleep lab proclaimed i was perfectly controlled at 17/9 on BPAP-S in mid-April.  This is all just a silly runaround IMO.  I'm so tired I'm falling asleep all the time. 

The new doc said some people are just always tired and said I need a stimulant.  I took a stimulant once in late 1997.  I couldn't sleep for over 60 hrs, collapsed at my work, and was taken by ambulance to the local hospital.  That worked out real well. I am not sure if that class of drugs has changed over the years.

I asked if I had a pulmonary or cardiac issue that could possibly be a reason for my issues.  I was told not sure I am not a pulmonologist but feel free to see one.    I currently have a cardiologist and pulmonary hypertension doctor who cares for me, but they don't cross info sleep medicine at all.

I don't know if the Night Owl testing shows specific SPO2 figures by the minute or two minutes.  

I have no one left to go to and still don't have this under control well.  Sounds like a recipe to die early. Most physicians seem SO rushed you can barely get 3-5 minutes to talk and less to provide data to analyze. It just is so difficult when there's no time to have your info looked at.