Need help with husband's therapy.

[Deborah K.]

I need help figuring out how to improve my husband's pap therapy.  He has way worse apnea than I do, somewhere in the mid-90s.  He has been using his bilevel machine a couple of years longer than me and has been happy with his therapy.  But now that he has retired I notice that he falls asleep in front of the TV several times a day, so I think maybe his therapy can be improved.

As he uses a bilevel machine I don't know enough about what his setting ought to look like, so I am hoping you folks can help me choose the best settings for him.  Here are a few recent reports including a couple of bad nights.

[Gideon]

If it were me I would try more PS, set Min PS=3. that is very mild for a bilevel.
Also I assume you are aware of the Philips Recall which includes that model of machine?

[Deborah K.]

Gideon, thanks for your response.  Yes, we know about the recall.  He received a brand new bilevel directly from Phillips many months ago.

I don't understand about the pressure.  His Epap is 17 and his Ipap is 25.  I guess I thought those were his pressures.  But I do see Ps set at 0.5 to 6.5  I can easily bump those up.  Is 3 to 6.5 high enough?

He also has lots of Leaks, Periodic Breathing, and Variable Breathing.  He sleeps with a chinstrap, but I'm guessing that doesn't work very well.  He doesn't like the idea of wearing a neck collar, but maybe I can get him to try one.  Perhaps he needs mouth tape too.

What does one do about Periodic Breathing and Variable Breathing?  I don't understand these at all.  Are these things that can be corrected by changing some settings?

[mesenteria]

Deborah, I would caution you about the assumption that his TV slump is related to the quality of his PAP tmt.  I have averaged 0.6/7 AHI the past four years (it's creeping upward with the progression of AFib), so I'm in the 97%ile for efficacy/success.  But just in the past two years, finally (I've just turned 70), I slump pretty solidly for about 20 minutes or more, most often mid-afternoon or just after supper and we're catching up on recorded programming.  I'm pretty fit, a wonky heart notwithstanding, and my treatment is solid.  But, I still have a heavy need to drift off until I do that deep five-minute fog-out and then come back to the living.

I would be very surprised to find a middle-aged male who doesn't need to nap close to most days.  I managed without for decades, but now I am manacled and can no longer be good company to the missus each evening and commiserate with her about what we are (supposed to be) watching.

Ps- (added) I make an assumption myself about his age, but....

[Deborah K.]

mesenteria, Alan just turned 70 in August, so maybe you are right.    I'm still hoping to learn how to improve his treatment anyway.