Machine is hyperventilating me!

[Josephdfco]

I was never able to get my hands on the titration study. I'll have to get a copy of it tomorrow. I'm going down to the VA to talk to a doctor. I told them "I cannot breathe with the way the machine is set up", so they agreed to see me tomorrow. I don't have any stats with the machine on ST because I was unable to make it work for me on that setting, so i changed it to ivaps. I tried my best to keep up with the machine, but i kept falling behind and the machine would "overtake" me, and literally gave me a strangling sensation. I think the most I was able to last was about 5 minutes.

[Sleeprider]

Before your appointment, you need to read about the ST-A IVAPS and ASV in the Resmed Titration Guide pp 27-40. https://www.resmed.com/us/dam/documents/...er_eng.pdf

What you should immediately notice is that ASV is for central apnea, and IVAPS is for respiratory disease. You have always had good tidal volume and minute vent, and you don't suffer from any of the diseases and symptoms IVAPS is suitable to treat. Your problem is central and complex apnea. Unless contraindicated by a cardiac condition, ASV is the correct choice. Read and learn this material as it is the basis of your argument you are being treated contrary to published guidelines.

[Josephdfco]

Ill read that, thanks! These, doctors (I'm going to refrain from saying what I want to call them) put you in a position where you have to garner some expertise in your illness because some are incredibly ignorant, but then they treat you with scorn because you're "playing doctor", even though you're going through contortions in order to tiptoe around their fragile egos.This gets exhausting. I've had to fight battles like this for years, sometimes many months at a time, needlessly suffering the whole time.

[Josephdfco]

I'm finishing a post-baccalaureate pre-med certificate, and starting med school in the fall. My concentration was biochemistry, and I took extra courses like pharmacology, toxicology, physical chemistry, and genomics in the hope of impressing med school entrance boards. I was also a navy hospital corpsman for 15 years, and a paramedic, so I know just enough about medicine to really get on doctors' nerves. I have to tread carefully and play dumb much of the time.
I just find it mind-blowing that these doctors don't make it their business to know these things, and to be up to date in their field. Its almost surreal to have to wrestle with them to get them to do their jobs.

[Sleeprider]

I know you're working on a degree and it's got to be a huge handicap to be unable to sleep restfully. This functional impairment imposed by your sub-par therapy is inexcusable. Be assured that once you have the right equipment (ASV), this all goes away pretty quickly.

[Josephdfco]

I know you're working on a degree and it's got to be a huge handicap to be unable to sleep restfully.  This functional impairment imposed by your sub-par therapy is inexcusable.  Be assured that once you have the right equipment (ASV), this all goes away pretty quickly.

It is a handicap.  In fact, it's so bad that I have to video record my lectures and watch them over and over again, because I'm almost completely incapable of following along during class.  Now that you mention it, I should make a point of mentioning that to the doctor. If anyone would be able to empathize about these classes, you'd think it would be him.
Meanwhile, I was hoping you could help set me up for the night.  This machine has at least a half-dozen different major settings (ST, CPAP, iVAPS, etc..).

[ajack]

There are a few contraindication that stop the use of ASV. There must have been a reason they chose the more expensive ivaps over ASV. It is unlikely the lab and doctors made a mistake, but it does happen. As I said it is something you are going to need to talk to the doctors about.

When you had an AHI of 3.3 and no UA on your first night, that was very rough with settings. it's hard to say it's not working

"Making it Simpler CPAP/BPAP airway - A/i VAPS lung (hypercapnic) - ASV brain (normo/hypocapnic)"

a 101 power point slides
http://www.nepolysomnographic.com/upload...0video.pdf

iVAPS
 COPD - hyperinflation
 OHS (obese)
 Neuromuscular Disorders
 Restrictive Diseases

ASV
 CSA
 Complex SA
 Mixed apnea
 Periodic breathing

Quick Takeaways
 AVAPS targets TV
 iVAPS targets VA
 AVAPS AE has auto-EPAP
 i/AVAPS - underachievers
 ASV – overachievers
 ASV Auto – tracks (minute) ventilation
 BiPAP AutoSV – tracks peak flow

[Josephdfco]

I have complex sleep apnea (primarily central, possibly aggravated by long-term opioid treatment), no pulmonary diseases nor contraindications to ASV treatment. This machine (ResMed Aircurve 10 ST-A) retails for $1000 less than the ResMed Aircurve 10 ASV, so I suspect they may be trying to save money.

[Josephdfco]

Also, I didn't spend the night with the machine set to ST; I was unable to tolerate it for more than a couple minutes at a time, so I switched to iVAPS, so my AHI wasn't indicative of my response to ST treatment (which is what they set it to).

[ajack]

here in australia the st and st-a are both dearer than the asv, pricing is funny. If you don't have any excluding issues, the ASV should be the choice for complex apnea. I haven't seen any articles saying otherwise on the net. It's going to be a matter of talking to your doctor.