(08-24-2017, 05:33 PM)Sleeprider Wrote: Spy Car, if we were trying to resolve hypopnea, I'd be very supportive of the idea that a bilevel might help.  If you want to resolve CA, the correct machine is an ASV.  In your case you are probably marginal for getting insurance coverage of ASV due to low events, but i'm confident that if you had it, your events would be near zero.  

The trial of the Aircurve 10 will be interesting, but I agree with Walla Walla that pressure support is more likely to increase central events.  Anyway, the bilevel works to maintain your EPAP to prevent obstructive events, then can apply pressure support for hypopnea, flow limitations and other inspiratory obstructive events.  I will be interested to see the difference (if any) in how it responds to your needs.

(08-24-2017, 07:03 PM)Sleeprider Wrote: Bill, regardless of how this trial works out there is hope.  Recently several member report a big change using 02 supplement with CPAP, and we can help you find and get setup on ASV which will resolve all these events.  As I said, you won't get it through insurance, but I have gotten people in need connected at an affordable cost.  Sometimes the "numbers" on AHI don't tell the whole story, and I think you probably need some relief that normal CPAP and bilevel may not offer.

(08-24-2017, 09:11 PM)Sleeprider Wrote: I have no idea how he intends to setup the bilevel. I'd say let him do his thing and give it your best shot.  Your job is easy...sleep as best you can.  The problem of disrupted sleep and central apnea will probably be there, and if not, you win.  If the problem continues on bilevel, then that would be the time to discuss the feasibility of ASV titration or evaluation.  

I'm sure if your doctor is interested in seeing recorded oximetry, he can arrange that.  Your doctor can consider your history, failure to tolerate CPAP, and other issues to give you his best opinion on how to proceed.  That is preferable to going out on your own at this point.   Let's take this one step at a time and give it a fair chance.  If you have question as you go through the evaluation I'll try to give you an answer that is fair to you and the doctor.  As long as he is working with you, I'm not going to interfere with that avenue of progress.  If it dead-ends, then I might have some suggestions on where to go with that.  The objectives here are really simple; get a good night of sleep consistently with PAP results that support your good health and help you feel rested.  No miracles, just some good sleep.

(08-25-2017, 08:21 AM)Sleeprider Wrote: Go with his suggestion the first night and let's see where that takes us.  His proposal is actually an auto bilevel suggestion and is just fine.  The increased pressure support will give us some indication of how you respond to the greater PS.  I actually don't expect your pressure to rise much.  

Looking back through your posts, you don't have an extraordinarily high AHI, your respirator rate, tidal volume, I:E ratio are all normal (good).  You have had event rates as low as .5 (11/17/16), which showed you're capable of very good results with low leaks and minimal events, flow limits etc at a pressure from 10/8 to 16/14 with EPR 2 http://www.apneaboard.com/forums/Thread-Best-Night-Yet-And-a-Few-Questions?pid=182514#pid182514  At that time you suggested you were going back to EPR 3, but your results with that higher EPR were consistently worse http://www.apneaboard.com/forums/Thread-Please-Help-Getting-AirFit-P10s-to-Work-For-Me-Higher-AHIs?pid=186661#pid186661  

One thing we don't have from you is a close up of your respiratory flow chart.  It might help to see that so we know the shape and timing of your respiration a bit better.  Also, let's get a look at your Statistics page with prescription history.  Please use the "huge thumbnail" option on Imgur.  For some reason your images are kind of small and low resolution.  While your event rate is not very high you seem troubled by chronic fatigue.  I'm not sure we can attribute all of that to your CPAP therapy, but we'll do our best to optimize.