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+--- Thread: Cheyne Stokes Respiration ? (/Thread-Cheyne-Stokes-Respiration--27308)
RE: Cheyne Stokes Respiration ? - Geer1 - 02-11-2020
Do these places charge you for home sleep study etc or is it like most places here in Canada where their price for the machine is high because they are building in costs for all the services they provide with it?
I can't stand this practice, I think they should be forced to sell machines at retail and then charge for sleep studies etc as required.
RE: Cheyne Stokes Respiration ? - Mal777 - 02-12-2020
The home sleep studies and hospital ones are funded fully by Medicare if you meet their criteria , which is not difficult. The price of machines here is ridiculous
RE: Cheyne Stokes Respiration ? - jaswilliams - 02-12-2020
Most machines are now made In singapore and shipped around the world
RE: Cheyne Stokes Respiration ? - wesozzzz - 02-13-2020
(02-11-2020, 08:14 PM)DeepBreathing Wrote:Sleeprider Wrote:the term "bogan" is only something I know from the internet and may be unintentionally insulting.
From Wikipedia:
Bogan (/ˈboʊɡən/ BOHG-ən) is Australian and New Zealand slang for a person whose speech, clothing, attitude and behaviour are considered unrefined or unsophisticated. Depending on the context, the term can be pejorative or self-deprecating.
Typical bogan attributes include:
- Employment in mining, construction or transport (ie truck driver)
- Has no higher education qualifications
- Loves a beer, but not a craft beer
- Has a girlfriend named Sharon (Shazza) and a bull terrier. (Loves the bull terrier more).
- Lives in a very large house on a tiny block with barely enough room to park the boat and jet-ski
- Struggling to meet his mortgage payments now that the mining construction boom is over
- Drives a V8 Commodore sedan or (even better) twin-cab ute.
None of this describes me - I'm more of an urbane, sophisticated man-of-the-world, rather like Sean Connery as James Bond.
Had a friend, born in the Rocks area of Sydney, his greeting would go like this: "ow yer goin mate? Aw right?"
RE: Cheyne Stokes Respiration ? - Sleeprider - 02-13-2020
I live in Pittsburgh, PA and we're know to have some slang an at.
RE: Cheyne Stokes Respiration ? - Mal777 - 02-16-2020
(02-11-2020, 09:14 AM)Sleeprider Wrote: I checked the chart and EPR is at 2. Note how poorly mask pressure tracks inspiratory flow in this segment. When you re at peak flow and descending into limitation after the peak, the pressure support is practically stuck at EPAP. You can really see this better if you move mask pressure right below Flow rate, and change the scale on the y-axis to 10- 15.
In this section of the chart your respiration rate is actually 15 BPM which is perfectly normal, however inspiration is extremely flow limited and the inspiration / expiration ratio is inverse with much longer inspiration time. The solution to this is much more pressure support, and the deciding factors on whether Vauto or ASV would be better is contingent on your response to the machine and whether higher pressure support would increase your CA rate significantly. Pressure support will treat the hypopnea and flow limitation, but may increase CA. It's sure worth a try.
Hi Sleeprider
Last night I decided to try an experiment to solve my fast, erratic RR. I have always used the Airtouch F20 full face mask, and last night tried the Resmed P10 pillows, together with a cervical collar. I was amazed this morning when I looked at my results to see my RR had gone from up to 50 , back to a reasonably normal range.
It appears my severe flow limitation has now been at least improved, if not solved.
I'm not sure if its the mask or the cervical collar helping, so will try them separately over next few nights to see results. (still have to work out the large leak rate though)
This morning I ordered an Aircurve vauto from Supplier #33, which should be here within a week. I expect it to improve my results even further when I get settings worked out
At the moment I'm usually running pressure at 10-15, or 10-14, and EPR at 3, which I'd like to reduce if I can tolerate the pressure.
If you could please give me your suggestions for what settings to use to start on my vauto when it arrives, it would be very helpful
Have included a screen shot of last nights results, together with a close up
thanks so much for your assistance and guidance. (another donation is coming to this marvelous Apnea Board)
Mal
RE: Cheyne Stokes Respiration ? - Sleeprider - 02-16-2020
Really interesting results and chars. With the Vauto, we can increase sensitivity for triggering IPAP and decrease sensitivity to cycle to EPAP. that may help to normalize the odd form of flow limitation that you seem to have. As far as settings, I'm going to go with EPAP min 8.0, PS 4 Max pressure 18.0 with Ti Min 0.7, Ti Max 2.0, Trigger sensitivity high or very high, and cycle sensitivity Low. We may try higher PS, but will take it one step at a time. The immediate goal is to support and sustain the spontaneous inspiration which is currently a bit weak.
RE: Cheyne Stokes Respiration ? - Mal777 - 02-19-2020
Well I finally got the results of my Bilevel sleep study which I have attached for comment. please
The centrals were only when I was put on a lower pressure of 11/4 and 13/5 and in S mode. For the last 4 hours of sleeping I had no apneas (obstructive or central) when on a bipap machine with pressure at 15/6, in ST mode with a RR of 10bpm
On this basis I have been recommended an ST machine. I have already ordered a Vauto which I expect to be delivered this week, which can be returned for 100% refund if the box is unopened (supplier 33)
A few questions please
(1) Is it worth trying the vauto to solve my eratic breathing issues and improve my AHI's. (If I use the machine I can return it within 30 days and receive 30% of what I paid) I was thinking it may be worth the gamble, as I had trouble on the sleep study tolerating the ST as it wouldn't let me complete a full breath ...very uncomfortable, whereas Vauto has Easy breathe, and may still solve my issues
(2) If I go for the ST, should I spend a little more and get the ST-A which has i-VAPS
(3) does my sleep study show that my erratic breathing is hyperventilation?
(4) is the PLM of significance? If so is there any treatment?
many thanks once again
Mal
[attachment=20164]
RE: Cheyne Stokes Respiration ? - Mal777 - 02-19-2020
sorry, I receive 70% of what I paid if I returned the vauto (used), within 30 days
RE: Cheyne Stokes Respiration ? - Sleeprider - 02-19-2020
You need a backup rate that the Vauto can't provide. Considering the financial hit for trying it, I would not open the box.
Do not buy the ST. Get ASV. You were treated at a pressure of 15/6 which is a pressure support of 9.0 cm on every breath. Using ASV, you can use an EPAP pressure of 5 to 7 to bracket this result, and select a pressure support of 3 to 15 cm. The ASV will then deliver pressure support for comfort, and will add pressure when needed to resolve CA and H events. The ST will deliver 15/6 on every single breath.
I'm going to link to Resmed's titration manual which describes the INTENDED use of all the machines. The ST is intended to treat COPD, NMD, OHS and other restrictive/obstructive respiratory conditions. The ASV is for Central or mixed apneas, complex sleep apnea, Periodic Breathing (PB). If you buy the ST, you are buying the WRONG machine. Read all about ST and ASV here https://www.resmed.com/us/dam/documents/products/titration/s9-vpap-tx/user-guide/1013904_Sleep_Lab_Titration_Guide_amer_eng.pdf ASV pp 28-31, ST pp 37-41. ST is an obsolete technology that is being replaced by the ST-A with iVAPS.
Please do not make this mistake. Either machine will cost quite a bit of money, and the retail prices are very similar. Get the ASV. With ST, your study shows you still have a RDI of 11.3 per hour and you still had 12 hypopnea events at 15/6. I promise that if you buy the ST, you will have consistently inconsstent results and much less comfort than if you get ASV. Do not make this mistake.