NEW TO CPAP AND FORUM

[Sleeprider]

Kijabekid, thanks for posting your sleep study and titration results. Now everything makes sense. Your study concluded you have severe obstructive apnea, but in reality it found mixed (complex) apnea, that was confirmed by the titration study. In titration, you were found to have OA an snores controlled at 4 cm. They tried increasing pressure, and began to get centrals, so could not titrate higher than 6.0. At that pressure you continued to have poor SpO2 results (oxygen desaturations) and central events.

For individuals with complex apnea, the best CPAP therapy tends to be a low fixed pressure with no exhale pressure relief. You are on a CPAP trial at 6.0 cm pressure. Don't change it. It appears you will fail the CPAP trial, then be titrated on ASV. This is an normal progression, and is required by insurance, to demonstrate you cannot achieve medically acceptable treatment on CPAP, or can't tolerate CPAP therapy. You were issues a "trial" because the doctor probably expects you to fail.

You should contact your doctor and explain that you are continuing to have a high number of apnea events, and schedule your follow-up as soon as possible. The sooner you are scheduled for ASV titration, the better, and the sooner you will be issued a machine that works. As you move in that direction, keep in mind, we have seen significantly better results in people using the Resmed Aircurve 10 ASV compared to the Philips BiPAP Auto SV Advanced. Try to move your doctor and supplier in that direction for the prescription.

[DeepBreathing]

G'day SleepRider. Australian health insurance isn't the same as in the States and that progression of "failing" a machine to progress to a higher level doesn't apply. The insurance funds will pay out a small sum (typically only $300 to $700) regardless of the type of machine. If the OP does in fact need an ASV (which looks likely) he will be out of pocket for thousands.

This is what happened to me - my therapist actually did everything she could to get fixed pressure or APAP to work before we finally decided that ASV was the only thing which would give me a good outcome.

When I got my machine (a little over 3 years ago) the VPAP Adapt cost the same in Australia as in the States and came with a 5 year warranty, so I bought locally.

I would say though that a lot of so-called sleep doctors think all apnea is obstructive and don't know how to treat centrals.

[DeepBreathing]

I've had a quick look online and the retail price of the Resmed Aircurve ASV is similar in Australia to the States. However Supplier #2 has a gently used machine at a very substantial discount. I haven't done the sums but it looks like it would cost about the same as an Autoset in Australia.

[Sleeprider]

DB, I missed that Kijabekid was from AU. Yes, I think we may need to help him source an ASV, either the Resmed S9 VPAP Adapt, or Aircurve 10 ASV. I'm sure we can help him dial it in on the forum saving the cost of an expensive ASV study. Unfortunately, it won't be cheap, but that price on Supplier #2 sounds very encouraging.

Thanks for getting in here and explaining how it works there.

[KijabeKid]

wow, thanks Sleeprider and Deepbreathing, I would have been completely lost without the help of you and everyone on this forum.

Last night I decided to go into the clinical setting of the machine and change it from constant to auto with a range from 6-10.  It was the best sleep I have had in years (despite waking twice as the airtube was gurgliing with water when I was inhaling).  When waking today the machine showed that I had a 0.5 event for 7.5 hours of sleep.  It had been 17 the night before when using a constant pressure of 7.  I will download data into sleephead tonight, however have a few questions first.  


1. The SD card in the machine has Resmed written on it, is this designed only to work on resmeds program for downloads (downloads cost $35 each at my DME)
2. If I can use it in sleepyhead and download my results, will this delete the data off the card for the previous nights (I have a follow up appointment next week and will need the result to still be on the card)?

Thanks again!!    

[eseedhouse]

1. The SD card in the machine has Resmed written on it, is this designed only to work on resmeds program for downloads (downloads cost $35 each at my DME)
2. If I can use it in sleepyhead and download my results, will this delete the data off the card for the previous nights (I have a follow up appointment next week and will need the result to still be on the card)?

Thanks again!!    

Sleepyhead will work just fine.  The Resmend SD card's I've tried have been rather cheap and failed mechanically after setting them to read only and back a few dozen times.  Also they don't have that much storage space.

Resmed tries to tell you only their cards are safe with the machine.  Well, I've been using other brands for over three years with no problems.  Currently I am using a 16 gigabyte wireless enabled card from Toshiba and have been for about two years with no problems.

[DeepBreathing]

1. The SD card in the machine has Resmed written on it, is this designed only to work on resmeds program for downloads (downloads cost $35 each at my DME)

There's nothing special about the Resmed branded card. You can use any type of SD card (eg out of a digital camera). And the Resmed card will work fine with SleepyHead. What do you get for your $35? If it includes an analysis and advice that's good value. If it's just a "download" (presumably for forwarding to the doctor) then save your money and take in your SleepyHead results.

2. If I can use it in sleepyhead and download my results, will this delete the data off the card for the previous nights (I have a follow up appointment next week and will need the result to still be on the card)?

No - Sleepyhead doesn't do anything to your card. However your operating system (eg Windows 10) might write index files to the card, which shouldn't be a problem with your machine. (It used to be a problem with previous models). As a precaution, lock the card before putting it into the computer.

Last night I decided to go into the clinical setting of the machine and change it from constant to auto with a range from 6-10. It was the best sleep I have had in years (despite waking twice as the airtube was gurgliing with water when I was inhaling). When waking today the machine showed that I had a 0.5 event for 7.5 hours of sleep. It had been 17 the night before when using a constant pressure of 7.

That's a fantastic result! I would be really interested in seeing your SleepyHead charts, especially in light of our discussion about central apneas. If you can achieve an AHI of 0.5 on an APAP then our talk of using an ASV may be moot. Much as I love my VPAP Adapt, it is an expensive machine best kept for those people (like me) who just can't get an improvement with any other type of treatment.

[KijabeKid]

1. The SD card in the machine has Resmed written on it, is this designed only to work on resmeds program for downloads (downloads cost $35 each at my DME)

There's nothing special about the Resmed branded card. You can use any type of SD card (eg out of a digital camera). And the Resmed card will work fine with SleepyHead.  What do you get for your $35?  If it includes an analysis and advice that's good value. If it's just a "download" (presumably for forwarding to the doctor) then save your money and take in your SleepyHead results.

2. If I can use it in sleepyhead and download my results, will this delete the data off the card for the previous nights (I have a follow up appointment next week and will need the result to still be on the card)?

No - Sleepyhead doesn't do anything to your card. However your operating system (eg Windows 10) might write index files to the card, which shouldn't be a problem with your machine. (It used to be a problem with previous models). As a precaution, lock the card before putting it into the computer.

Last night I decided to go into the clinical setting of the machine and change it from constant to auto with a range from 6-10.  It was the best sleep I have had in years (despite waking twice as the airtube was gurgliing with water when I was inhaling).  When waking today the machine showed that I had a 0.5 event for 7.5 hours of sleep.  It had been 17 the night before when using a constant pressure of 7.

That's a fantastic result! I would be really interested in seeing your SleepyHead charts, especially in light of our discussion about central apneas.  If you can achieve an AHI of 0.5 on an APAP then our talk of using an ASV may be moot. Much as I love my VPAP Adapt, it is an expensive machine best kept for those people (like me) who just can't get an improvement with any other type of treatment.

Hi Everyone,

I have downloaded my first sleepyhead report.  I will post three reports.  20 March show recording using the H&P Eson mask at a constant 6 pressure. 21 March records using the DreamWear Mask at constant 7 pressure.  22 March is again using the DreamWear mask but having switched the machine to auto with a range of 6-10.  Interesting results.  Can the machine/sleepyhead recognise central apneas?

20 March attached to the post, I will attach other results in following posts

Than,s

---

21 March

[DeepBreathing]

You might find you run out of attachment space - there's a fairly low limit. If you refer to SleepRider's signature (and some other members) you'll see how to use a site like Imgur and link to your images.

The first image you've posted clearly shows that a fixed 6cm is not treating your apnea at all. I'm amazed that your titration study indicated that you got good results at this pressure. You also only had a couple of central apneas - everything else was obstructive, which is expected at this pressure. In answer to your question - yes the Autoset does recognise central apneas. Looking forward to seeing your chart in APAP mode.

[Sleeprider]

That first chart shows huge obstructive apnea, and the snores and flow limitations to confirm the results are real. I sure wouldn't want to see that kind of result often, or ever.

As Deepbreathing said, the second link in my signature describes how to use Imgur to hose your image files.