pressure plateau

[Gideon]

We are at 2 months of treatment. The ROT says that 2-3 months should reduce centrals. I'm not seeing that.
Did I miss a sleep study? If so point me to it, if not post them redacted of course, and the full studies, not just the summaries. I especially want to see your diagnostic study to see what it indicates about central apneas.

My hunch is that you are heading toward an ASV.

[milboltnut]

I'm googling definitions of these terms but still having trouble understanding how they correlate.


Minute ventilation..... volume of air is increased as therapy progresses?

Tidal is basically the same as minute vent?

How is flow rate compare to volume?

Inhale time and exhale time......? what does the scale represent?

Time at pressure.....

Respiration rate.....

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We are at 2 months of treatment.  The ROT says that 2-3 months should reduce centrals. I'm not seeing that.
Did I miss a sleep study?  If so point me to it, if not post them redacted of course, and the full studies, not just the summaries.  I especially want to see your diagnostic study to see what it indicates about central apneas.

My hunch is that you are heading toward an ASV.

I will call my Dr. and see if I can get it. Do you think I've been proactive enough with due diligence to improve Fred? 

[milboltnut]

We are at 2 months of treatment.  The ROT says that 2-3 months should reduce centrals. I'm not seeing that.
Did I miss a sleep study?  If so point me to it, if not post them redacted of course, and the full studies, not just the summaries.  I especially want to see your diagnostic study to see what it indicates about central apneas.

My hunch is that you are heading toward an ASV.

Gotcha ... My Dr. said the same thing at my last visit.

[Gideon]

You are learning.
On the sleep studies we want the charts and tables. All too often we see large differences to the stated diagnosis and the data in the details.

Volumes mean little unless we see something that is grossly off. Generally, we ignore them for CPAP and 'normal' BiLevel use.
ResMed ASV maintains Minute Volume.
PR ASV maintains Tidal volume.

In general exhale times are twice as long as inhale times, with a great deal of variation.
Above the zero line on flow rate is inhalation, below is exhalation, The areas on both sides of the zero line should be nearly the same. If it's not we need to ask why?
Minute Vent is the volume of air processed per minute, Tidal volume is the volume processed per breathe.

Time at pressure, I ignore. I look at the stats in the left sidebar to see what pressures are doing

Respiration rate has a wide range, we just look for something abnormal. When we see something of interest we go back to the flow rate to explain it.

[milboltnut]

wasn't able to get sleep study by email..... I go friday for a visit to possibly get Bipap and will get my sleep study.

[milboltnut]

I forgot to address the FL you were asking about, as pertaining to being a left panel statistic vs a graph. I think that's the way Respironics displays the FL. ResMed displays FL as a graph as I recall.

Changing from CPAP to APAP should be helpful. If Sleeprider suggested it, I'd go with it. He's better at seeing things that form that suggestion that I sometimes miss. I'd go with his suggestion over my own.

To me, an APAP introduces adjustable pressure. This can be good for several reasons. Pressure needs can change even in an overnight segment of time. You may need 6 to start, but 3 hours later 8,9,10 may be better. You can't just wake up and edit the pressure, so have a machine that can do the adjustments. These settings are not suggestions only discussion examples.

EPR on the ResMed would give a limited of up to 3 PS BPAP. This can be helpful to some. However, I am a bit concerned about the dominant event count of CA for you. In cases like this, pressure swings can make this worse, so it needs to be monitored closely.

I don't know what level of machine is best for you, but I do believe a ResMed in any flavor will serve you better than Respironics.

PS bonjour touched on an aspect, I suggest noting all comfort and complaint issues, present it to doc and say a ResMed up to VAuto would help tremendously. Myself, I would not accept this therapy you're showing on OSCAR past yesterday.

clarification..........

Res Med... up to V auto?.......... Bi Pap ?

V auto is a Bi Pap?

[SarcasticDave94]

At the time I posted that, I don't think ASV was mentioned, that's point one.

The phrase up to indicated I did not know where on the machine family tree you'd land. A VAuto is a BPAP, but the BPAP is not automatically going to be a VAuto machine.
ResMed has a CPAP/APAP which is under the AirSense name group, then on to BPAP (I think it's BPAP S) then VAuto, ST, ST-A, ASV, each is higher up in the chain with the name group AirCurve.

[milboltnut]

Ok so...I just got off the phone with a gal from my Dr's office about questions I had before I scheduled and appointment this friday... to talk to the Dr about another PAP machine. She said I have to have a Titration study done to determine what machine I need.

I was suppose to have it done BEFORE I was issued this APAP PR dreamstation. Go figure. The Insurance company declined the second study and basically wasted my time taking the easy way out... can you cure CA's with a APAP? guess not in my case. Maybe I need a better explanation. Hypoxemia..... ah, know I got it.

Hypoxemia is an abnormally low level of oxygen in the blood. More specifically, it is oxygen deficiency in arterial blood. Hypoxemia has many causes, often, and can cause tissue hypoxia as the blood is not supplying enough oxygen to the body.

Hypoxia deficiency...tissue lacking efficient levels off 02.....what is the result of tissue being deficient? To the brain? as far as cognitive?

some of my symptoms... memory, cognitve, concentration, problem solving, irritation etc.....

Scary... I've been suffering for years, bummer !

Anyway.. we'll see how it goes.

[SarcasticDave94]

Not to split hairs, but CPAP can't cure apnea period. It can offer therapy. With CA, a CPAP can sometimes be used, but it depends on how the patient responds. Some of us with CA must use an ASV, as CPAP can't give enough comfort or reduction in events. Then in turn, the regular BPAP will likely increase CA events. That is what would happen to me if I tried either CPAP or BPAP.

[milboltnut]

Not to split hairs, but CPAP can't cure apnea period. It can offer therapy. With CA, a CPAP can sometimes be used, but it depends on how the patient responds. Some of us with CA must use an ASV, as CPAP can't give enough comfort or reduction in events. Then in turn, the regular BPAP will likely increase CA events. That is what would happen to me if I tried either CPAP or BPAP.

You're not spliting hairs, trust me. I just don't know what I'm talking about! I'm just aggravated that my Ins. Co. didn't listen to my Dr.... cheap, is what they are, or my Dr. told them "it may work or it may not".....  

This is deep stuff.. and I'm just scratching the surface