+- Apnea Board Forum - CPAP | Sleep Apnea (https://www.apneaboard.com/forums)
+-- Forum: Public Area (https://www.apneaboard.com/forums/Forum-Public-Area)
+--- Forum: Main Apnea Board Forum (https://www.apneaboard.com/forums/Forum-Main-Apnea-Board-Forum)
+--- Thread: New patient. Have been having horrible nights. (/Thread-New-patient-Have-been-having-horrible-nights)
RE: New patient. Have been having horrible nights. - Sleeprider - 11-19-2017
For fixed pressure, you have reached the low-end limit. As you can see, there are some obstructive apnea appearing, so your CPAP pressure is around 8.0. The sooner you can be prescribed ASV, the better. It is the correct therapy for your condition. Here is a link to the Resmed ASV titration guide. https://www.resmed.com/epn/dam/documents/products/titration/s9-vpap-tx/user-guide/1013904_Sleep_Lab_Titration_Guide_amer_eng.pdf
On Page 27 it describes what patients this machine is intended to treat (you), and the titration protocol is on page 30. You will see that recommended settings for ASVauto mode are EPAP minimum 4.0, EPAP maximum 15.0, PS minimum 3.0 and PS maximum 15.0. These settings work for most people starting ASV, and we frequently help them to fine-tune the settings to improve even further. If you were able to obtain a prescription Rx for ASV, these would likely be your starting settings. The guide linked above has a lot of good information that you can use when discussing this with the doctor.
RE: New patient. Have been having horrible nights. - Josephdfco - 11-19-2017
I have ReScan, and you're right; it's not as straightforward as Sleepyhead. Do you have any advice on the best way to package data from it to send to my doctor?
RE: New patient. Have been having horrible nights. - Josephdfco - 11-19-2017
I'll keep you posted on what happens with my phonecon tomorrow. God, I hope this isn't the beginning of yet another epic struggle with obtuse doctors. I've had a few in recent years, and I'm burnt out from them. I'm so tired of feeling lousy. I have a few other conditions (no cardiac ones, fortunately) that have obviously been exacerbated by the sleep apnea.
RE: New patient. Have been having horrible nights. - Boodmaster - 11-19-2017
I feel you, man! I have to make the exact same phone call tomorrow. We’ll see who gets on the right path first. At least we aren’t alone ???
RE: New patient. Have been having horrible nights. - Sleeprider - 11-19-2017
As far as packaging the information, I would begin with the doctor's diagnosis of severe complex central/obstructive apnrea. Follow on that with your results from the Aircurve 10 Vauto showing 38 central events per hour. Use either Sleepyhead or Resscan, but he is more likely going to believe the resscan data since it is OEM. Any detailed report that shows the number of events, type and duration of apnea should be pretty impressive. The image of the apnea from Sleepyhead is pretty good. Let him know that you have tried removing pressure support and still have unacceptably high event rates.
Take in the Resmed product information for ASV that I linked to above. He should know this information, but show him you know too. The question for your doctor is, how do I get on ASV therapy as soon and economically as possible? Don't negotiate. This is the therapy you need, ask for it. Your doctor's diagnosis already supports it, and your bilevel results show there isn't a viable alternative.
RE: New patient. Have been having horrible nights. - Josephdfco - 11-19-2017
Thanks, Sleepridlso,er! Could you tell me how to take a screenshot of the most pertinent data in ResScan? Also, based on the data of the last 3 nights, would you suggest any further experimental changes, or just staying where I'm at now?
RE: New patient. Have been having horrible nights. - jaswilliams - 11-19-2017
I suggest you open rescan go view data select summary data and a date range of the last 7 days get the data displayed on screen then click reports and produce a pdf of the summary data that will show your ahi and compliance etc. Then when you like what you see print it out the summary text at the top will show a break down of the ahi as CA’s OA’s and Hypopnea. The ahi scoring will show amount of ahi and the type the summary graphs will show compliance usage etc.
Jason
RE: New patient. Have been having horrible nights. - jaswilliams - 11-19-2017
If you don’t have 7 days of data you can select custom date range and specify start and end date
RE: New patient. Have been having horrible nights. - Sleeprider - 11-19-2017
Good answers by Jaswilliams. ResScan gives you Acrobat PDF reports. I'm sure you can find what you need there. Most screenshots are pretty crappy resolution, and Sleepyhead actually prints a full resolution image file through software. PDF files are great for printing. Make sure you get a report of the night with the ridiculous 38 CAI rate. The fact you can get lower apnea rates with fixed pressure does not fix the problem...don't let anyone tell you it does.
RE: New patient. Have been having horrible nights. - Reznik - 11-19-2017
Hi Joseph,
I'm very new here, but I wanted to start by saying that the very first thing you should consider when getting used to CPAP is humidity.
If humidity is wrong, this can cause nasal congestion, and nasal congestion can screw everything else up. When I first got my machine, I assumed that more humidity is better since most of the materials that I've read say that too little humidity can cause congestion.
But, in my case, it was just the opposite. My nasal passage love cool, dry air. Once I turned off the heated tube and turned the humidity way down, my nasal congestion problem went away completely.
Try wearing the machine for a couple of hours at night before you turn in, and see if the machine is causing any nasal congestion. if it is, try adjusting the humidity until it doesn't. Until you get that issue under control, nothing else matters.