Lindanhotair Treatment review

[S. Manz]

This article can help you to understand better how Resmed and Philips differ and work to resolve various respiratory problems http://www.masm.wildapricot.org/resource...Morgan.pdf  The graphic below is the simplified Philips Titration Protocol for SV.

BTW, just so you know this is not an "article".
It is a slide presentation by a MD who would have narrated his slides to his audience, maybe students or some other congregation.
But Thanks for posting it anyway.

[OpalRose]

S. Manz,
I'm going to ask that you stop hyjacking this thread.  

It may be best if you start a new thread to express your thoughts on the differences between the ResMed and Phillips ASV's and Titration protocols.

[S. Manz]

I am responding to posters who have addressed me in this thread.
How does that count as "hijacking" a thread in your opinion, one which by the way isn't even your thread?
I also have a thread that explores some of these differences. Why not contribute here:
http://www.apneaboard.com/forums/Thread-...#pid423798

[SuperSleeper]

S. Manz, you've edited out large sections of your posts now, and I've deleted the post where you posted your disagreement with the forum Admin's request... so a lot of the hyjacking OpalRose is referring to is no longer viewable to readers.

Please do as she suggested and move on - and do not post any further replies in this thread.

[LindanHotAir]

I updated my Dreamstation bilevel AutoSV from firmware V1.01 to V1.06.  It corrected 2 issues that I could identify.  First, it now reports the proper values for mask pressure, rather than clipping off the high values. Second, although the machine appeared to operate correctly, in the check machine self test, it put up a red X and 5 cryptic codes, which were different every time I ran the test.  After the update, it ran the self test and completed it with a green check mark, so whatever had previously set the error conditions had been cleared in the update process.


All the settings were maintained, but I did need to re-sync the bluetooth.  DreamMapper still reports the same minimally-useful data.
The first 2 charts are from the sessions before the update running V1.01, and the third is after the update, running V1.06.  You may notice the mask pressure graph shows a higher top value both in the trace and in the scale.

                                                                              


If anyone notices any other differences, please point them out.

[sawinglogz]

I just noticed that in S. Manz's screenshots and data too. I'm glad they fixed it. I'll update the comment in the code.

[LindanHotAir]

It was apparently fixed between V1.01 and V1.06.

[LindanHotAir]

In many posts, users have shown how the Sleep Medicine - Insurance Establishment can provide totally inappropriate devices and settings, even after they get results of sleep studies and machine data.  My case was no exception.  Earlier I posted my sleep study results which show mixed (complex) apnea.  Below I will post an example of the use of an APAP where the ASV is more appropriate and effective.

The various on line resources, YouTube videos, and this forum have been very informative and useful.  I would like to thank the volunteers for all the knowledge and hard work.
Before this forum and OSCAR, I did not have the information to know what I should expect, or what was possible.

My sister was diagnosed with AFIB and severe central apnea, and her doctor prescribed the appropriate machine, ASV with programmable timing.  Her DME totally screwed up the order, so it took some time before she received the prescribed machine.  Her results have been great, AHI between 0 and 2.

I was able to get a slightly used ASV machine from a private party.  The second and third charts show a typical good and a not so good (but tolerable) night with serious nasal congestion from Omicron.

This is an example of the APAP's effectiveness (or lack thereof) on treating central apneas:
   
It generated pressure pulses as breathing reminders, in place of the actual breaths that the ASV will deliver.

Below is an example of a recent night on the ASV:
   
If you look at the Patient Triggered Breaths chart (% spontaneous breathing) and also the mask pressure (blue chart) you will see some black marks along the top edge (also duplicated on the flow rate graph). 
Those are the breaths initiated by the ASV (Auto Servo Ventilation) algorithm.  This machine is set for a manual backup rate of 9 breaths per minute, so it will replace missing breaths if the respiration rate drops below 9.

Below is a night after developing Omicron symptoms:
   

These examples show why you need to get all the available information and, if necessary, be the squeaky wheel when it comes to getting the appropriate therapy.

[Sleeprider]

The pressure pulses on a Philips Respironics CPAP are used to determine if there is an open airway or obstruction. While that may serve as a reminder to breathe, there is no claimed therapeutic application for the pulses other than determining if apnea is obstructive or central. I know I have beat this dead horse before, but most members find much lower AHI and better comfort on a Resmed ASV. If you ever get a chance to try one, take it. The pressure support response is faster, and the pressure delivery with Easy-Breathe™ generally more comfortable. There are some that find a better result on Philips due to more settable parameters, so YMMV. Your point about the tail wagging the dog in sleep disordered breathing medicine is totally correct. You have been around the forum long enough to see how many people arrive with the wrong diagnosis and wrong therapy. It makes you wonder where medicine will end up as doctors surrender more and more control to insurance deciders.

[LindanHotAir]

A few weeks ago I was infected with COVID Omicron, and overnight my AHI increased.  It has been quite variable over the last month, but the trend appears downward. I have had variable amounts of nasal congestion which I treat with generic Flonase.  I use a soft cervical collar and a flat pillow.


 Recently the majority of the reported events have been hypopneas, which have been more frequent than they were previously.  I am seeking guidance on whether some settings changes can reduce them, or if some of them are just shallow breathing.

First Attachment - 3 minute view of hypopneas with detail on left.
   
Second Attachment - 3 minute view of CA, OA, H, VS with machine settings on left.
   
Third attachment - Daily view of events, flow, mask pressure, patient triggered breaths, tidal volume, leaks, with events on left.
   

Thank you for any advice or observations.