New Sleepyhead Chart?

[RLSdss]

New machine: first night with sleepyhead. Don't know what it all means. Most interested in if there are centrals and percent of total apneas? Also genteral idea of how to read data. Please use small words as I've had too much education to be able to think clearly.

[Sleeprider]

Hi RLS, it is not uncommon to have some centrals when adapting to a new CPAP therapy. What we have here is a Respironics Dreamstation BiPAP Auto set to BiPAP S fixed pressure mode of 14/10 with a fixed pressure support of 4.0 cm. Your current results have a mixture of both central and obstructive events, and we can probably limit those by using the auto bilevel algorithm.

My suggestion would be to set the machine to BiPAP Auto mode, EPAP min 9.0, IPAP max 15.0, PS min 2.0 and PS max 4.0. The lower minimum PS will help to limit the centrals, and using auto mode will allow the machine to titrate out obstructive events. You previously were issues an ASV machine, but that was traded in, based on a decision you don't have central apnea. The chart you posted above makes that conclusion look a little questionable. If this isn't complex apnea, the suggested auto settings will work for you.

[Walla Walla]

I agree with everything that Sleeprider stated above except for one thing. I think I would set the max PS to 3. The reason I say that is the first thing to respond to flow limitations is the IPAP rising to a PS of 4. It will also be the last thing to drop after an event. I think keeping the PS at or below 3cm will give a better indication if the CA's can be controlled by PS.

[RLSdss]

Would it be possible to talk on the phone. My deal is complicated.

[RLSdss]

Maybe previous post not appropriate. Here is my problem. My sleep studies are inconclusive because I rarely sleep more then an hour and a half. I had sleep studies done by an unethical lab and they RX the ASV which I have. I changed to a new Dr. which I trust but he is having trouble figuring out my situation because I don't sleep very long during the studies. Anyway he did not think I have centrals so he RX the bipap machine which I have on loan so Medicare only knows about the ASV I have. I want to keep this machine as it can be set to set to any mode. There were a few days when I only had the ASV and the DR. did not care how it was set so I set it at: Mas p 14, Max EPAP 11, Min EPEP 8, Max PS 3 Min PS 0 BPM off. I got a whole night with AHI of 3. Also my >88 was 0. So then I got the Bipap machine with current settings. Bottom line I would like to keep the ASV so I am going to leave current settings as is. So I guess I don't have any questions except I don' t understand much of Sleepyhead.

[Walla Walla]

Here's a link to Beginners Guide to SleepyHead. http://www.apneaboard.com/wiki/index.php...SleepyHead

[Sleeprider]

I have some suggestions for you concerning the ASV

I set it at: Mas p 14, Max EPAP 11, Min EPEP 8, Max PS 3 Min PS 0 BPM off. I got a whole night with AHI of 3

.
Your settings were EPAP min 8.0, EPAP Max 11, PSmin 0, PSmax 3, IPAP max 14, BPM off.   That would not resolve centrals or most other central and complex breathing issues.

My suggestions for ASV are EPAP min 6.0, EPAP max 11.0, PS min 2.0, PSmax 12.0, IPAP max 20. BPM auto or your normal respiration rate minus 2.  If you know you need EPAP min 8.0 to stop obstructive apnea, then that is acceptable, but your previous pressure support range was incapable of dealing with centrals.

The previous recommendations for the BiPAP auto are intended to minimize centrals by limiting pressure support.  You obviously have a lot of issues at PS 4.0, and using the auto range, with lower PS should help. Walla is correct, about PS Max at 3, however, I didn't expect the machine to increase your PS to 4 anyway.   Your settings on the ASV where you got a AHI of 3, tells us we're both wrong. Set PS min to 0 and PS max to 2.

If you have complex apnea we can resolve it with the ASV.