Switched from ASV to CPAP, finally getting some sleep.

[foxfire]

Here are the photos my DME gave me.

Starting from the xPAP end there is a Respironics Whisper Swivel II exhalation valve.
Next is 1 to 3 sections of Corr-a-flex tubing depending on the amount of EERS desired, 50mL per section.
Next is a Fisher & Paykel non-rebreathing valve.
Then there is another short section of tubing to attach to the mask, or in the case of masks like the Airfit N20 which already have a short section of tubing, the F&P valve would connect directly to the existing tubing.
Last you plug up the vent holes on the mask with silicone putty which is sold in drug stores as ear plugs.


   
   

[Sleeprider]

Very interesting, and all the parts are easy to find, and cheap compared to the cost of ASV. It might be interesting to do an article on EERs since there is generally low awareness of it, and I can see how many with therapy onset complex apnea could be helped by this. I can only suspect that relatively few doctors are up on this approach. I assume you have a prescription for your specific setup?

[foxfire]

Yes I have a prescription for this, and my insurance covers the parts.

[DeepBreathing]

EER? EERS? Please explain?

[foxfire]

EER?  EERS?  Please explain?

 Enhanced Expiratory Rebreathing Space

explained in this article

http://www.sleepmedicineusa.com/UserFile...(EERS).pdf

[DeepBreathing]

Thanks

[Sleeprider]

Foxfire, I appreciate your post and I'm going to bookmark this discussion for follow-up.  The solution has the ingenuity of a MacGyver, so I have a lot of appreciation of your doctor's problem solving skills.  In thinking about the design, the antiasphyxiation/saftey valve and connector 5983 could be omitted from nasal masks and pillows, but would be required in a FFM configuration.  All he is doing is creating a larger dead-space by moving the mask vent to a position further down the tubing toward the xPAP machine.  Without adding the Corr-a-Flex segment, the nasal mask tube (16-inches x 15 mm) provides about 70 mL of dead space. Standard Corr-a-Flex is in 6-inch (15.24 cm) segments which has about 58 mL of dead space. (The volume of the tubing is V = Pi * r squared * length and 22 mm diameter tubing has about 3.8 mL/cm with 15 mm diameter tubing being about half (1.7) of that).

Thanks again for this discussion!

[foxfire]

Foxfire, I appreciate your post and I'm going to bookmark this discussion for follow-up.  The solution has the ingenuity of a MacGyver, so I have a lot of appreciation of your doctor's problem solving skills.  In thinking about the design, the antiasphyxiation/saftey valve and connector 5983 could be omitted from nasal masks and pillows, but would be required in a FFM configuration.  

Agreed, in fact I found the antiasphyxiation/saftey valve to leak a little bit, which makes the rest of the EERS volume less effective, so I've removed it in my set up.

[Stom]

So would this method of treatment imply that to a lesser extent the current larger dead space in FF masks vs nasal pillows might have a different treatment effect on centrals based on the CO washout levels? Or would the flow rates and washout levels of regular FF masks have too negligible a level of CO2 build up to make a difference?

[Sleeprider]

Storm I was going to refer you to this thread. This could have a significant impact on your results, or maybe not. I think it certainly has great possibilities for therapy onset complex apnea like yours. The EER is easy to build and it is sure better than the BS your RT is giving you now. “Don’t worry about it and it wil go away.”