What causes this pattern of tidal volume?

[SarcasticDave94]

Yes, you might as well give the consultation a shot. I don't know about you, but anything that leads to the medical answer was something to look forward to getting. It may bring you to a resolution.

[Geer1]

That is the unfortunate thing about an ASV trial. Since the Philips Respironics recall they are not readily available and prices have skyrocketed. The only way you can probably get one for a reasonable price is getting lucky and finding a decent one used. Can try dotmed mentioned previously, I also almost bought one off Craigslist but it wouldn't turn on (always test if buying used)...

[AmirKas]

Hey guys I'm back after a short hiatus. 

I've been using the same settings of 7 - 15cmH2O with a PS 4 with either no improvement or worsening of sleep quality and daytime fatigue. I have been consistently using the BiPAP machine every single night, throughout the whole night, for over a week and am yet to notice any improvements.

I've contacted another sleep specialist in my area to take a look at my graphs in detail with me and make some suggestions, but that appointment won't happen for another few months. In the meantime, are there any other changes that can be suggested (Cycle, PS), etc that I should try for a bit? Lowering my trigger seems to significantly exacerbate central apneas and worsen my sleep quality. 

Please let me know if I should upload anymore screenshots.

[Crimson Nape]

Please post some days that are representative of your problems.

[Geer1]

What are you currently using for trigger sensitivity? If you compare flow rate chart to mask pressure chart do you see primarily single pressure supplies per breath and in time with breath or does anything look odd to you (if so post examples). The odd bit of strangeness is normal but if there are regular occurrences we might be able to fine tune sensitivities further.

Would be good to see a couple recent results. I would also be curious to see your overview charts showing TV and MV since you started.

[selfcoacher]

Hi everyone, have been quite busy with life and haven't had time to get on the forum. I'm still experiencing the same symptoms (obviously     ) 

I wanted to post a screenshot of my sleep stages during my titration study and watchpat test. It seems that I hit REM sleep around an hour after I fall asleep. Not sure how that affects your judgment regarding my breathing issues, but for reference, my AHI was more than doubled during REM sleep vs Non-REM sleep according to my watchpat. 

I went to a pulmonologist today who was absolutely useless in helping me figure this out. If you have any recommendations for doctors in the bay area that are great and consider UARS in their treatment, please let me know.

Watchpat:




Titration:

The data shows that watchpat is not useful as it presents normal total REM, while based on clinical presentation you have disturbed REM stage and have trouble staying in REM.  

Based on the lab study, you might try forcefully avoiding supine, as the few times you entered and briefly maintained REM were not supine.

[mper6794]

_ that is, Self, from my case and maybe hundredhts here in this Forum: runnning smooth through REM stages,  without arousals/awakenings, interruptions, trips do toilet, etc looks a rather and challinging task for so many fellows.
_ from my four-year own experience, trying a solution for such drawback, I think I learned (see my post # 25, above): 1_ CPAP, APAP, or even ASV does not help; 2_ Bilevel PAP would be the best approach, in my modest opinion; 3_ tailored parameters for the Bilevel could be reached by using the Resmed protocol (S-mode); it takes some 15 days to get those parameters; 4_ even after getting correct pressures and other parameters, one may end up with FL zero (p95) and maximum < 0,1, however still with respiratory efforts (not flagged at all) leading to arousal/awakenings (kind of Geer's type two UARS), REM interruptions, and so on; 5_ in my case (UARS and RLS, PLMS maybe also), I do know Clonazepam 0.4 mg  bed time (currently I stopped it; stop when I want, simply; no such thing as addiction, etc), helps a lot; 6_ still struggling with the REM stages, always punctuated by recurrent same style nightmares, yet doing rather well in 95 % all the nights and days; 7_ so grateful to this Forum.

all the best and good luck for all of us.

[quiescence at last]

checking in, hope you have gotten some results that are better.

QAL

[YouTakeMyBreathAway]

In fact, for my full year-to-date data with F30i and P30i with PS/EPR ranging from 0-4.4 there is a strong positive correlation between PS/EPR and Med TV of 0.54 and 95%TV of 0.57. These are some of the highest (Pearson) correlations I have found in my data. See the first two rows here.

Very curious to know how you were able to calculate these correlations across your entire data, I'd love to try the same!