[Treatment] Johnny O's ResMed AirCurve 10 VAuto for severe sleep apnea (61 AHI) and OSA, CSA

[JohnnyO]

Hi! Johnny O. here! Thanks for this great forum!

I had a sleep study in a lab in 2006 and two additional titration studies immediately after. I was diagnosed with severe OSA (total AHI of 51.1, supine AHI of 69.7) and had apnea events lasting up to 64 seconds and oxygen desaturations as low as 74%.

The first titration study was with CPAP, but CPAP was deemed not appropriate for me because the sleep tech was unable to titrate the CPAP to achieve effective therapy without causing CSA events.

The second titration study was with BiPAP, and the BiPAP was more effective than the CPAP.

The doctor's order at that time was for BiPAP with a pressure setting of 10.0/6.0 cm H2O. Since that time, no doctor has ever monitored my PAP therapy or made any changes to the original pressure setting. 

My GP doctor this month ordered a home sleep apnea test, which I just did. The Watermark Medical ARES 620 sleep test device came without the required effort belt to detect breathing effort and CSA events. So, the only current diagnosis I could have received was OSA, even if I had CSA events during the new home sleep study. Regardless, on March 4, 2024, I was diagnosed with very severe sleep apnea and had an AHI of 61.

I just started viewing my ResMed AirCurve 10 VAuto data with OSCAR for the first time, and I noticed many OSA and CSA events most nights and inadequate therapy.

I would really appreciate if you could look at my sleep and titration studies and OSCAR screenshots and let me know if I need a different PAP device or if you could suggest changes to my pressure settings. I have been approved for a new PAP device, but I don't know which device is the most appropriate for me now.

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I've just gathered the sleep study and PAP data and want to post it now. Should I post the 2006 sleep and titration studies first?

[JohnnyO]

I'm trying to post the sleep and titration studies, which are PDFs, but I can't post them. I have OSCAR screenshots that are jpgs.

[Sleeprider]

There are links in my signature with tutorials on Organizing Your Oscar Chart and Attaching Files. I actually prefer the screenshot format to a PDF report. If you're seeing CA events, the Vauto has a kind of hidden feature with the trigger sensitivity we can use to minimize that. Anyway, looking forward to seeing an Oscar chart.

[JohnnyO]

Here are the first three OSCAR screenshots for my ResMed AirCurve 10 VAuto on Feb. 18, 2024.


Additional settings:

TiMax: 2.0 seconds
TiMin: 0.30 seconds
Trigger: Med

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Thanks a lot, Sleeprider!

Here are two more OSCAR screenshots for my ResMed AirCurve 10 VAuto on Feb. 18, 2024.


Additional settings:

TiMax: 2.0 seconds
TiMin: 0.30 seconds
Trigger: Med

[JohnnyO]

Here are OSCAR screenshots for my ResMed AirCurve 10 VAuto on March 4, 2024.


Additional settings:

TiMax: 2.0 seconds
TiMin: 0.30 seconds
Trigger: Med

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Here are three more OSCAR screenshots for my ResMed AirCurve 10 VAuto on March 4, 2024.


Additional settings:

TiMax: 2.0 seconds
TiMin: 0.30 seconds
Trigger: Med

[JohnnyO]

First sleep study in a lab in 2006.

[JohnnyO]

Second sleep study with CPAP titration in a lab in 2006.

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Last page of second sleep study with CPAP titration in a lab in 2006.

[JohnnyO]

Third sleep study with BiPAP titration in a lab in 2006.

[JohnnyO]

Home sleep apnea test on March 1, 2024, without effort belt required to detect breathing effort and CSA events.

[Sleeprider]

Well, you're in luck! Let's get rid of the fixed pressure and see what you need to resolve this, and maybe consider some positional apnea therapy. https://www.apneaboard.com/wiki/index.ph...onal_Apnea Your obstructive apnea tends to cluster a bit, which makes me think your sleep position, pillows or similar issue is contributing to obstruction from cervical mal-alignment. But with fixed pressure, your machine does not have any opportunity to respond to prevent these obstructive events. It's pretty clear your pressure is too low, so I'm thinking Mode Vauto, EPAP min 8.0, IPAP max 15.0, PS 4.0. If you know of a reason you can't tolerate those pressures let me know, but it should give us a clue what you need. Finally, change the trigger sensitivity to high. I'm pretty sure we should see a change in the quality of your therapy and results.