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ResMed AirCurve 10 CS Pacewave therapy - need help
#1
ResMed AirCurve 10 CS Pacewave therapy - need help
Hello everyone!

First I want to thank you for having such a helpful community. 
I am no patient but I found apneaboard.com  while searching for help for my uncle, we are not living in the same town, he does not speak english, so I will try to be his windows to the world.

My uncle just started AVS therapy after 6 months of hard times on CPAP. He is 61 years old, in his twenties he had motorcycle accident in which he lost his right arm and today his right lung has no function, and after COVID his left lung is limited capacity.

For months he was on CPAP therapy and was feeling horrible, as he could not ventilate properly and oxygen levels were dangerously low, he could not concentrate, barely able to speak and speaking nonsense at times. His doctor recommended Phillips Dreamstation autoSV, but as it was not available because of the foamgate, thanks to this board we got him replacement machine ResMedAircurve 10 ASV.

He started therapy 3 weeks ago and immediately he got better, in the mornings he could speak, and clarity of the mind came back, I guess that now ASV titration allows him to breath out properly and get rid of CO2.

 I would like to use this thread to track his progress and find out if there is room for improvement in his therapy and comfort.

After initial setup on 7th June, week later doctor checked sleep data once, did not alter any settings - said he is doing fine - and set next check for 30 september.  

He is a backsleeper, still searching for the right mask, he is switching between f20 FF and f30i, he is going tomorrow to try f30 maybe small will suit him better than medium size of current masks. 

I talk with him over phone every morning and we agreed that he will tell me how he is feeling so I can give you more information.

Last night was bad, in the morning he has a pain in his lung while trying to inhale.

I will attach 3 screens from OSCAR 1st day of therapy, worst day of current week and last night after which he felt really bad (lungs hurt in the morning while inhaling, dry mouth, low energy)


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#2
RE: ResMed AirCurve 10 CS Pacewave therapy - need help
skyman77,
I'm bumping your thread up in hopes that someone here can help with advice for you and your uncle.
OpalRose
Apnea Board Administrator
www.apneaboard.com

_______________________
OSCAR Chart Organization
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OSCAR - The Guide
Soft Cervical Collar
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Mask Primer



INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE.  ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA.  INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#3
RE: ResMed AirCurve 10 CS Pacewave therapy - need help
Attempt 2

See the clusters of hypopneas on all 3 charts.
This is indicating likely positional apnea, likely tucking the head toward the chest.. It can possibly be fixed via pillow modification, 1 vs 2 pillows or a flatter, less firm pillow thus promoting a straighter neck or more likely with a soft cervical collar. Read the wiki article linked in my signature.
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#4
RE: ResMed AirCurve 10 CS Pacewave therapy - need help
Thank you so much OpalRose and Gideon for your replies.

My uncle visited his doctor this morning and doctor adjusted (lowered) the pressure and also suggested him to sleep more flat.

The pain that he is feeling in the morning is his diaphragm pushing the stomach - at least that is how I understood from my uncles words as doctor explained to him. I guess there are some exercises he will have to do to for diaphragm to regain strength.

I asked uncle about his sleeping habits and he said that he sleeps only on the back, and also he tends to sleep bit more upright! as he watches TV - as it is more comfortable for him to manage the pain in his right arm and shoulder.
So there is great chance that chin tucking is the problem.

Thank you Gideon for everything you are doing, I actually did found out about positional apnea reading documentation on Oscar and recognized clusters in first chart example on wiki.

I informed my uncle of your reply which is aligned with his doctors advice, so hopefully he will understand he has to make some changes to improve his condition. 

He has crooked neck so in the case that collar does not work for him are any alternatives?

I will post more reports in the future to track progress, he is on therapy since 7th July (not June), generally his AHI oscilates arround 10, best days are somehow on weekends, worsenes during the week.

I am attaching trend for you to see and zoomed in example of cluster starting, comments are welcome.

Many thanks for all your input.


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#5
RE: ResMed AirCurve 10 CS Pacewave therapy - need help
Hello everyone!

Thanks to your advice, my uncle is doing much better and his condition improved as he started to wear neck collar during the sleep.

His AHI went from 5-15 range to 1-5. I am attaching worst and best day of the last week.

Now his 95% pressures both IPAP and EPAP went down for 1 or 2 points (my guess is because with the collar airways are not kinked any more) so he has a feeling that he is not getting enough air, often in the night when he pauses and restart machine. I told him to turn of ramp off or at least to set it from 10 to 5min, 

Qouestion is : Are his lungs going to adjust to lower pressures over time? or improvement could be gained by adjusting  pressures?

Many thanks in advance.


       
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#6
RE: ResMed AirCurve 10 CS Pacewave therapy - need help
An EPAP of 4 might be a bit difficult to breathe with... he can try a minimum of 5 to see if that's easier (8cm min IPAP).

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