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+--- Thread: Struggling with BiPAP AutoCurve VAUTO--Central Apneas (/Thread-Struggling-with-BiPAP-AutoCurve-VAUTO-Central-Apneas)
RE: Struggling with BiPAP AutoCurve VAUTO--Central Apneas - Sleeprider - 04-14-2019
You have complex apnea with predominately central events. If you have some time, pull up the posts by a member called Spy Car and read his experience. Your AHI is higher. I think ASV will have your AHI at consistently less than 2 and good comfort once you adapt.
RE: Struggling with BiPAP AutoCurve VAUTO--Central Apneas - Paul Massie - 04-14-2019
Thanks. I went through a number of his posts and threads. I would love to be at <2AHI. I think tomorrow I'm going to set up a Dr. appointment to see where we go next and see if with my last sleep results we can still do ASV or whatever. I won't last on this BiPAP. I feel like I sleep better without it, although I'm sure my health will suffer if I don't get this under control. I think I did better on the CPAP even though we couldn't get me below 8AHI on average. I don't like the idea of starting the healthcare monthly rental clock over again, but have come to believe long-term good nights sleep will be worth it if I can get past the aggressive air blasts of ASV. I'll let you know where this goes. Thanks for all you do.
RE: Struggling with BiPAP AutoCurve VAUTO--Central Apneas - Paul Massie - 04-15-2019
As I have learned, a single night does not a trend make... however, 2nd best night since being on BiPAP. I need to consciously relax more when trying to initially sync up with the machine, but if I do I seem to be able to drift off to sleep and keep the mask on longer. However, I kept waking up with the mask-off. Last night I forced myself to put the mask back on each time once I was aware it was off, instead of preferring to sleep easier without it. Had to fight through a few instances where I wanted to take it off and just release some pressure through my mouth. I did set Trigger to Very High and Cycle to Very High. I didn't feel any difference though.
I'm still going to pursue ASV as I would like to sleep through the night rather than keep being woken up.
RE: Struggling with BiPAP AutoCurve VAUTO--Central Apneas - Sleeprider - 04-15-2019
That's pretty good, but my favorite advice for people with complex apnea is that your results will be consistently inconsistent.
RE: Struggling with BiPAP AutoCurve VAUTO--Central Apneas - Paul Massie - 04-15-2019
Yes, so far that has been my experience too. I'm getting ready for a horrible night since I had a pretty descent one last night:-)
Dr.'s appointment pulled ahead to next week. At least this time I will be armed with knowledge and data I didn't have before. He's a pretty good guy, spends a lot of time with me and has been very thorough. He wanted to move me to the ASV, but after my sleep lab tests for ASV I wasn't in favor of it due to aggressive nature of air blasts and aerophagia (I don't think he was either). If we can resolve that and it will resolve my centrals I'll make the change. I'm hoping I can get some kind of loner to try before making the switch financially.
My only problem with the sleep lab is they haven't really taken the time to explain all of this to me or fess-up that my increase in CA's was probably caused by the equipment. Seems like a more proactive strategy and education could have moved me along this journey faster.
RE: Struggling with BiPAP AutoCurve VAUTO--Central Apneas - Technopauper - 04-15-2019
(04-15-2019, 12:06 PM)Sleeprider Wrote: That's pretty good, but my favorite advice for people with complex apnea is that your results will be consistently inconsistent.
I think I may have heard that once or twice :-)
OP - your story sounds strangely familiar, I think the advice being offered is sound
Now that I'm on ASV for a few weeks, everything has settled down (trends), my AHI is most often zero, I'm only wakening once a night around 4 am for some reason and find the ASV by far the most comfortable treatment I've had - keep going .......
Rob
RE: Struggling with BiPAP AutoCurve VAUTO--Central Apneas - Paul Massie - 04-15-2019
Rob, did you have any issues with the pressures, air blasts, aerophagia? The night of my in-lab tests I spent 75% of the night fighting burping, passing gas and couldn't get to sleep even though I took a sleeping pill? I'm not sure my tests really say much probably due to too high a pressure settings they were trying.
What did you do to overcome the initial first few weeks?
RE: Struggling with BiPAP AutoCurve VAUTO--Central Apneas - Technopauper - 04-15-2019
(04-15-2019, 12:53 PM)Paul Massie Wrote: Rob, did you have any issues with the pressures, air blasts, aerophagia? The night of my in-lab tests I spent 75% of the night fighting burping, passing gas and couldn't get to sleep even though I took a sleeping pill? I'm not sure my tests really say much probably due to too high a pressure settings they were trying.
What did you do to overcome the initial first few weeks?
I came off a month with an ST machine with timed breaths and honestly found the ASV a dream by comparison because it finds your rhythm, two or three nights and I was golden. I do have a bit of extra gas and find the first couple of hrs kind of gassy but its honestly the easiest treatment to deal with for me so the transition was easy. Have a look at my thread on it and the difference in sustained higher pressure dropping as it learns what you need. I went rogue and just bought a 2nd hand one and now have a prescription so a new one will follow - the Aircurve ASV is just a wonderful thing !
Rob
RE: Struggling with BiPAP AutoCurve VAUTO--Central Apneas - Paul Massie - 04-24-2019
Had my doctor visit today. Showed him the attached SleepyHead Statistics report which he basically ignored. Using his data he felt the BiPAP machine at lower pressures was doing the trick (which was the suggestion from SleepRider not him). He feels going to PS of 3 with EPAP Min of 7 and IPAP max of 10 will do the trick and address my feeling of lack of air when I first start using the machine at night.
Right now a typical night starts out with me going to bed around midnight and using my BiPAP. After a short while (10 to 30-minutes or less) I take it off as it doesn't seem to keep up with my breathing. An hour or so later I put it back on and keep it on for about an hour then take it back off again. Then around 4 - 5 am I put it back on and can keep it on for 3-4 hours. Problem is I get such poor sleep or no sleep I'm awake until 2-3pm. By the 4-5am session I'm so tired or my breathing is finally relaxed I keep it on and sleep but I'm sleeping in until 10am. When I was working I used to sleep from 11:30pm to about 6am. I would then power through the day with a lot of caffeine and yawning.
My Doctor feels that bumping the EPAP from 5 to 7 will help me get started off better when I first go to bed.
I point blank asked him if I should move to an ASV machine and he said that during my sleep test it didn't help me and I had similar high API events. He said next steps going forward would be either a Mouth guard that eventually would turn into a combo-mouth guard mask that would allow for lower pressures, ENT to consider surgical solutions or some kind of pacemaker like device. Non of which are attractive to me.
Most of the discussion seemed like he was trying to address the causes of obstructive apnea not central apnea. He either couldn't or wouldn't address that the higher pressures might be the cause of my higher Central events. Seems like my central apnea is about 2-3:1 for obstructive at the best.
I am considering looking for a new doctor but hate to leave him as he has helped me through some rough raspatory problems, spends a lot of time with you and listens and is the one that convinced me I might have a sleep problem causing a lot of my other symptoms, but now he does seem a bit stumped.
RE: Struggling with BiPAP AutoCurve VAUTO--Central Apneas - Sleeprider - 04-24-2019
You have never demonstrated an AHI that is considered "treated" below 5/hour. Based on what we're seeing, if you want to further improve results, I would change the Trigger sensitivity to high or very-high. This will cause the machine to trigger IPAP with less effort on your part. I'm in the ASV camp for the long term.