[Treatment] TheBinarySon's Treatment Thread

[Deborah K.]

I'm so sorry. I don't think anyone here knows how to read your charts. This reply will bump you to the top and I'll pm someone who is the most likely to be able to help you. I hope it works out for you.

[Sleeprider]

All I see is CPAP pressure at 8.0. I f your Luna is capable of exhale pressure relief, iBR or whatever they call it, it may help. For all that you went through to get qualitfied for CPAP with a diagnostic test, titration test, your provider is a S.O.B. for ensuring you have a cheap Chinese knockoff CPAP, available on an EUA (emergency use authorization) instead of a quality Resmed Autoset.

[Sleeprider]

If you can zoom in on the flow rate at a 3-4 minute segment, that will show whether there is flow limitation, or respiratory issues that we can work on. I'm not a big fan of the BMC Luna device, but a better view of your respiration at a very zoomed level may reveal something the big-view can't.

[TheBinarySon]

Deborah K. - thanks for your responses. I appreciate you bumping my thread and messaging some folks. I've seen another thread that's active with another user who is using the same machine and software I am, so I may message the people helping him and see if they can help.

Sleeprider - thanks for reaching out and I'm sorry for incurring your anger about this machine and its lack of OSCAR support. I will say despite my shared dislike of everything being made in China instead of the USA, I do like the machine and it seems thus far to be doing its job - the problem is me not being able to get good sleep, and thus get good data (albeit on an inferior software platform).

I'm working now but I got some sleep last night so I will try to post the zoomed in data you suggested to see if we can get a better look at why there seems to be such variance in amplification of my flow chart despite no listed events.

[Deborah K.]

I notice that your pressure range is 4-8. Four is much too low for most adults. I suggest that you raise your low-pressure setting to 7 and your high-pressure setting to 12. This should help with your therapy and comfort. Best of luck!

[TheBinarySon]

Deborah K. - thanks for the idea!  4 is just where the machine starts at - my prescribed therapeutic pressure is 8.0.  I'll clarify that in my profile to avoid confusion.


Here is last night's sleep - went to bed early and got up early.  Felt ok I guess but nothing special.

I also took a screenshot of an example of high amplification variance in my flow chart and have attached that as well.  If there's a specific time you want me to zoom into, let me know.

   

   

[PeaceLoveAndPizza]

I agree with SleepRider that your provider is not working in your best interest by giving you this machine. As it is what you have for now, we have to work with it. You can often find a low hour used ResMed for a reasonable price on Facebook Marketplace or Craigslist, and the suppliers listed on our site frequently have sales. Something to consider.

What are the exact settings on your machine? From what I see a fixed pressure of 8 is not optimal. To find the proper settings you need to start with a wide range that we use as the baseline. 

Something like:

Min pressure 8
Max pressure 15
Reslex 2

That gives the machine a range of 8/6 (8 inhale or IPAP, 6 exhale or EPAP) to 15/13. It should adjust the pressure accordingly based on flow limitations. Without being able to use OSCAR we are limited in what we can see, but we will give it a good try with what is available.

[TheBinarySon]

Thanks for the response!  As for the machine, I can reach out to the sleep center and ask them why I was given this machine instead of a resmed.  I mentioned Resmed when I went in to get the Luna, and the tech that set me up said something but I don't remember what she said.  But as you stated, it's what I have and I'd like to try and work with it.  Short of the sleep center replacing my luna with a resmed, and my insurance covering it, I don't foresee having the budget to buy even a used one any time soon.

As for your question, my settings are as follows:  CPAP mode on (as opposed to Auto CPAP-the machine is capable of both), initial pressure of 4, ramp 60 mins (it takes me a long time to get to sleep if I sleep at all lately - I will reduce this ramp as my sleep returns to me) to the therapeutic setting of 8, Reslex off, SmartC off, Humidifier set at 1, and heated tubing off.  Let me know if there are any other settings I forgot to list, but basically the Doc seemed confident that my SA could be treated with a relatively low, constant pressure of 8.  Of course, it's hard for me to judge, as I am struggling to sleep the last 2.5 weeks (last night was another wide awake night for some reason), whether or not 8 is sufficient or not, or if I need a different pressure and/or a switch to APAP.  That said, I can try the settings you recommend, but I still have the problem of not sleeping.

[Sleeprider]

Just to clarify, my "anger" (more accurately frustration), about dispensing a BMC Luna is not directed at you, but at the provider who did this for their convenience and profit. The Luna costs less, but an insured consumer pays the same for either machine. In fact, I'm sure the DME does not discount for anyone. The rest of the advise seems spot on. Higher minimum pressure will help rather than starting at 4.0. I assume that is just a ramp setting since you appear to be using fixed pressure at 8.0.

On your machine, the exhale pressure relief feature is called Reslex and can be set from 0 to 3 with higher numbers representing more difference in pressure between inhale and exhale. The use of this feature can be very helpful to therapy, and requires some experimentation to see what works/feels the best. Reslex generally works best in auto CPAP mode so that the machine can automatically compensate for the lower exhale pressure if needed. My suggestion would be to switch from CPAP or fixed pressure to auto CPAP and use a minimum pressure of 8.0 and maximum pressure of 11.0, and try Reslex at setting 2.

[TheBinarySon]

No worries - I appreciate your passion for making sure people get proper treatment and your patience with a newbie like me.  I just sent a message to my doctor using their online portal asking why I was given a Luna vs a ResMed, just to see what he says.

Depending on if/when I can actually sleep over the course of this week, I'll give the APAP and Reslex settings y'all have suggested a try and report back.