VAuto Journey

[lbl82]

   
   
Friday night my IPAP was 25 and EPAP was 10. PS was 4.  My AHI was 9.91 and I slept for 9 hours and 41 minutes. Last night my IPAP was 20 and EPAP was 15. PS was 3. As you can see my AHI was 7.27 and I slept 8 hours and 7 minutes.

So my numbers were a little better, but I also didn't sleep as long.  Any suggestions on how I could get my numbers lower?

[OpalRose]

It's not likely you will be able to treat your Central Sleep Apnea with a VAuto. You will probably fail at this machine and should talk to your doctor about an ASV.

In the meantime, you could check the Trigger setting and set it at High or Very High. This has been known to bring down the CA's. It may or may not help, but worth a try.

It also would be better if you would keep your therapy questions to one thread. It makes it hard for folk to jump around looking for previous threads to see what has been suggested or tried in order to give you more accurate advice.

[Gideon]

Continue to lower your PS. I would also go with the EPAP of 10 for now.
Set PS = 2, we get to PS = 0 before we are done.

Higher PS improves/increases your breathing efficiency, This improves/raises your O[sub]2[\sub] sats and decreases your CO[sub]2[\sub] sats. When your CO[sub]2[\sub] reaches your apneic threshold you have central apnea, at least one form of it. Lowering your PS (and pressure) are measures to see if we can control this cause and effect. While it usually works, this is what we need to know to suggest the best treatment for you.

Central apnea is always consistent, in an odd way. It is consistently inconsistent!! This means that it often can and does jump all over the place, you need to see what happens over a week and the same settings to see if settings actually have an impact. We can get an idea that it is working but cannot tell for sure until we see the results over a week period. In the meantime, we want to see what happens as we gradually lower your PS. Just because we lower it and you see a jump in AHI does not mean it is not working when looking at single daily screenshots.

[SarcasticDave94]

IMO Ramp is another addition to the pressure swings that will encourage CA events. I think you should turn it off if at all possible so as to help reduce the chance of CA events. As was mentioned, you will likely fail sooner or later with this machine as only the ASV will really help combat these CA. I'll also suggest a symptom/complaint diary on the discomfort and continuing CA events that needs presented to doc as evidence that an ASV is not just an option but the only true answer.

Note, if we're trying to demonstrate how many CA events the VAuto permits, then that path requires another very different approach. However, no matter what we do with the VAuto, eventually it's therapy is going to fall short as I see it.

[drmaestro]

In the meantime, you could check the Trigger setting and set it at High or Very High.  This has been known to bring down the CA's.  It may or may not help, but worth a try.

To my understanding, the trigger setting changes the sensitivity of the device to recognize the beginning of the inspiration, so it applies PS earlier. Wouldn't that make easier to breath in, and as a result increase centrals? Am I getting it wrong? I'd expect lowering this setting to low/very low to be effective for decreasing centrals.

[lbl82]

It's not likely you will be able to treat your Central Sleep Apnea with a VAuto.  You will probably fail at this machine and should talk to your doctor about an ASV.  

In the meantime, you could check the Trigger setting and set it at High or Very High.  This has been known to bring down the CA's.  It may or may not help, but worth a try.

It also would be better if you would keep your therapy questions to one thread.  It makes it hard for folk to jump around looking for previous threads to see what has been suggested or tried in order to give you more accurate advice.

So how will people know when I post new data every day?  Should I change the name of the thread?

[Gideon]

There is a school of thought to use EPR only during the ramp because to use it otherwise it MIGHT cause central apnea. Central Apnea, or any other event for that matter, are not reported during the ramp. IF central apnea is a problem post ramp, it is likely a problem during the ramp as well.

[Sleeprider]

A moderator can change the title, just let us know. We prefer that you keep your data in one thread so we can see history and progress.

[SarcasticDave94]

It's not likely you will be able to treat your Central Sleep Apnea with a VAuto.  You will probably fail at this machine and should talk to your doctor about an ASV.  

In the meantime, you could check the Trigger setting and set it at High or Very High.  This has been known to bring down the CA's.  It may or may not help, but worth a try.

It also would be better if you would keep your therapy questions to one thread.  It makes it hard for folk to jump around looking for previous threads to see what has been suggested or tried in order to give you more accurate advice.

So how will people know when I post new data every day?  Should I change the name of the thread?

We see new entries on the threads as a bold title. And you'd not be able to change the title yourself once the thread is created. The main reason to keep all in the same thread is for historical necessity so we don't need to review 3, 4, 5 or whatever count other threads are out there to answer questions on whichever is current.

[OpalRose]

In the meantime, you could check the Trigger setting and set it at High or Very High.  This has been known to bring down the CA's.  It may or may not help, but worth a try.

To my understanding, the trigger setting changes the sensitivity of the device to recognize the beginning of the inspiration, so it applies PS earlier. Wouldn't that make easier to breath in, and as a result increase centrals? Am I getting it wrong? I'd expect lowering this setting to low/very low to be effective for decreasing centrals.

I started using a VAuto in January and started seeing many CA's. Prior to that using a Auto Cpap, I did not experience CA's.
I took advice from folk here that have turned the trigger setting to high and their CA's decreased. I can't really explain the why's of it, only that it seemed to work for others and myself.

I keep trigger to high and cycle med.

Everyone is different, and it's only a suggestion for the OP To try.