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[rfaircloth40]

Overview and Statistics attached, this is going to take time to document, are there any other changes that are recommended for the short term?

Richard

[Gideon]

You are on an Auto BiPap in Manual mode. Is there a reason why?

Reduce your PS to 3, then re-evaluate.
In the so-called balancing act between Obstructive and Central events (even though you show no obstructive events) It is important to critically evaluate how you feel. The doc's call the off-feelings symptoms.

Post redacted copies of your full sleep studies including the tables and charts, or don't just to make sure we have your full name, SSN, address, mother's maiden name and various other info that is (NOT) critical to your therapy. Seriously NEVER post that kind of info in a public forum.

This will tell us the state of your apnea when you started and likely provide more justification for an ASV.

[rfaircloth40]

Unfortunately, I do not have a copy of the Sleep Study, I will ask for one the next time I see the Doc.

The machine was configured almost 3 years ago, I will make the changes.

Richard

[rfaircloth40]

I am sorry, what setting are you calling PS?  According to mob Machine Settings, my PS Min and Max is set to 3.  How do I get out of Manual mode?  I am not familiar with all the terms.

[SarcasticDave94]

PS equals pressure support, and according to the March 4th chart, PS was 5 with Flex being 3. I'd consider taking flex to off then lowering PS to 3.

Manual versus Auto referenced here is going to be Mode in clinical settings. It may be one of the settings near the top.

[rfaircloth40]

Here are my current settings.

[Gideon]

Here you are seeing obstructive events starting to come back. This is expected. As PS goes down obstructive events tend to increase (happening) and central events tend to decrease (not happening). This is the ballancing act I was referring to.

The next step is to turn flex off. This is because pressure changes from flex often increase central events.

You have done a good job in changing from. Manual mode to auto mode. Don't do this now, you only want to make 1 change at a time, and causing pressure changes and/or higher pressures tends to increase central events. To best use auto mode to treat obstructive events you want to increase your max ipap pressure to provide room for your machines algorithims to increase pressure. Again, don't do this now.

Note: you reduced your PS to 3 and saw an increase in central events. Granted that this may be because centrals tend to be consistently inconsistent, but they increased and this is part of the narrative you are putting together to justify ASV.

So turn Flex off.

[Sleeprider]

Your pressure is currently fixed because the range for EPAP min and IPAP max is equal to the PS min 3 and PS max 3. I'm interested in seeing if lower pressure may further reduce CA events. The settings I'd like to have you try are:
Mode AutoB
EPAP min 9.0
IPAP max pressure 16.0
PS min 3.0
PS max 3.0
Flex off

These settings will allow the machine to automatically adjust pressure, but starts at a lower range. The reason I think you can tolerate the lower pressure is that while you had two OA events flagged, that is still very low and there are no snores or other good indicator of corresponding obstruction. As much as anything else, we need to see your response to lower pressure to verify a need for higher pressure if it exists.

[rfaircloth40]

They replaced my machine since it would not pass the Performance Test, now it is working good, I think.  For some reason I have a lot of leak, I have a full mask.  Could it be breathing through your mouth?  Anyway new charts.

Again thank you for all your help, I will continue to log my progress and meet with the DR when ready.

Richard

[rfaircloth40]

I was able to get a copy of my Sleep Study, sorry this is the best picture I could get.  There are several pages. this is the only one that is readable.  

Please let me know if there is anything else that will help from the study,

Again, the information here is invaluable, I would not be using my machine if it was not for the information from this forum.  FYI

Last night I had a AHI of 4.20, CA 18, Hypo 5, OB 1, PP 26, RERA 5, 5:42 Hours and I feel good,

Thanks again


Richard