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+--- Thread: [Equipment] Longtime BiPAP w/ centrals needs new machine advice (/Thread-Equipment-Longtime-BiPAP-w-centrals-needs-new-machine-advice)
RE: Longtime BiPAP w/ centrals needs new machine advice - sheepless - 09-18-2020
SDave, I just can't imagine what you're going through. I'm sure you have your moments but I truly admire your ability to stay positive, keep your sense of humor & help others. we don't know til tested but I seriously doubt I would handle the cards you've been dealt with the grace you project here. I keep you & other folks here coping with such difficult ailments in my thoughts...
RE: Longtime BiPAP w/ centrals needs new machine advice - SarcasticDave94 - 09-18-2020
Thanks sheepless.
Without sounding like I'm preaching, the back issue and really any other thing I've had to face is not doable on my own. I have God walking beside, carrying me at times. Reminiscent of the Footprint in the Sand poem. I pray and get the help I need. Happy Friday AB land.
RE: Longtime BiPAP w/ centrals needs new machine advice - memeuro - 09-20-2020
(09-18-2020, 12:44 PM)SarcasticDave94 Wrote: Sorry for the delay, OK back pain can be a big pain.I'm really distressed to hear about your situation SarcasticDave. That is bloody awful. My stimulator trials did nothing for me. Tried the high-frequency Nevro & then the medtronic unit. Very very disheartening but I knew going into it the chances of success were slim.
I don't remember all the medical names for all the back issues I have. I do know this, I have chronic lumbar nerve damage, have had ruptured disks with ongoing degenerative disk disease, was on Prednisone for about 4 years which setup osteoporosis, have broken all 5 lumbar vertebrae and at least one in the thoracic area, weaned off Prednisone and did the diagnostic to prove medical necessity for Ablation - a medical surgery to burn the nerves in the lumbar that sense pain, and then I went for a Spinal Cord Stimulant implant. I also had Kyphoplasty done on lumbar vertebrae L2 and L4 to reshape the bones that were otherwise crushed. I needed psychiatry doctor interview to permit the SCS and then a trial twice for the SCS due to request for a different brand. The second SCS trial lesser invasive failed as T10 thoracic vertebra was invading epidural space. New and invasive trial included laminectomy of T10 and implant of the electrodes. A week later was the SCS implant part 2.
Sorry for thumbnail sketchy info. Anyway, all the stuff that occurred had me at a back pain level of 10+++++++++ for over a year. Opioid style pain meds were of zero effect. I once was stuck on the couch where I had slept overnight for about 6 more hours because I could not move off the couch myself. The ambulance crew picked me up to transfer to the stretcher, rode to ER. The SCS implant does work well as my pain is a manageable 4-6 of 10. I do have a rollator/4 wheeled walker I use every day as my left leg may collapse at any time, dumping me on the floor. I have a massive rehab power wheelchair insurance bought if I need it. I am on no pain pills with the SCS doing its job well. Normally, I must sleep in my hospital bed with air mattress at the house. And yes absolutely, back pain can disrupt sleep and interfere with PAP therapy.
Back pain is a real pain.
I am on a journey for restful sleep like most on here. If I can get just 10% better or get something in Stage 3, as opposed to the 0% recorded, I will be happy.
I am really looking forward to getting my Aircurve ASV.
RE: Longtime BiPAP w/ centrals needs new machine advice - SarcasticDave94 - 09-20-2020
FWIW my SCS implant brand is Boston Scientific. I have 2 therapy programs running at the same time, one that feels like TENS tingling and a non-tingle variant. The tech edited the settings some so that tingling is a minimum but I can still feel it some. I have therapy from the SCS mid-back to toes.
Anyway, your AirCurve ASV will do great. And it takes very little setup time to get it working well. That is the machine type I had until late last year when the COPD caught up to the central apnea.
We'll give you any pointers we can to help make it a success. Feel free to post questions about ASV therapy and I can do my best to help out.
RE: Longtime BiPAP w/ centrals needs new machine advice - memeuro - 10-14-2020
Hi guys,
After dealing with Supplier #2 as suggested I can only say I have had a wonderful experience. They found me the exact model I wanted as recommended here and then found a unit with less than 65h AND held ot for me for 5 weeks as I waited for my FSA card to kick in. Just thrilled with their service. Everything has come super clean with new climate line heated tubing and a new non-heated tubing pack. The film hadn’t even been taken off the screen or dial.
Anyways... some help if you guys can... and thank you so much to SuperSleeper for the clinician manual.
If you could answer some questions I would be grateful:
- I switched to the Resmed Airfit F30 a couple months back. Would this be considered “full face” in the options since it’s definitely not nasal pillows and also not nasal? Sorry if this is a stupid question.
- Do I choose ASV or ASVAuto?
- Other than the annoying messages about Airplane mode and asking me do I want to turn it back on, is there any reason to turn it on? I don’t have a DME so the modem is of no value. Can I just disable it completely?
Had high hopes for the AirTouch F20 with the foam surround to stop my skin breaking out but it presses down too firmly on my prominent nasal bridge.
Even just bought the Fishar & Paykel Vitera after reading positive reviews in these forums, but the bridge of my nose was almost rubbed raw with this one too. Just my anatomical problem. Not the mask. Glad they have a return policy for this one.
Will be really interesting to see my OSCAR results after a month of use.
I learned something new the other day I had never heard anywhere before... always have your CPAP machine lower than your bed so moisture runs back down with gravity. Before I complained to my new sleep doc that I’ve woken for the last 5 yrs with a dry mouth and throat even though I have the Respironics set to 5, he went in and turned off some auto setting in the clinician menu and hallelujah moisture! Too much! Lol. My unit was gurgling and spitting up water. Turned to 4 and also put unit in bottom shelf of nightstand and that solved the loud gurgling and puddling problem. I’ve seen people printing clips on their 3D printers to hook their hoses up above their beds and wondered if this is an issue for them which is why I thought I’d share it here.
Thank you so much folks.
Stay safe and healthy
RE: Longtime BiPAP w/ centrals needs new machine advice - SarcasticDave94 - 10-14-2020
OK let's go through the list. BTW glad you got the ASV you did.
1. Full face for F30 mask.
2. Let's go with ASV Auto mode. The difference between ASV and Auto modes is ASV gives static EPAP, your exhale pressure where Auto makes EPAP a range with Min and Max. I'm going to look back on this thread to see what we've had pressure wise. I would say an almost titration default unless I see red flags saying not to. Make it ASV Auto mode, EPAP Min 6, 7, or 8 Max 14 PS Min 3 Max 15. I may edit this or pressure gurus may suggest other then do that.
3. No DME then you may keep Airplane mode active. It will bug you about the Off status.
Settings:
Mode ASV Auto
EPAP Min between 6-8
EPAP Max 14
Pressure Support Min 3
Pressure Support Max 15
Post OSCAR and tell us how you felt during and after therapy. If the ASV blows hard and startles, Blow Back. Literally, blow back through the mask when it does this. The ASV will back off.
Pressures aren't set in stone. We can get you to adjust via feedback from you and the data.
RE: Longtime BiPAP w/ centrals needs new machine advice - memeuro - 10-14-2020
(10-14-2020, 08:38 PM)SarcasticDave94 Wrote: OK let's go through the list. BTW glad you got the ASV you did.
1. Full face for F30 mask.
2. Let's go with ASV Auto mode. The difference between ASV and Auto modes is ASV gives static EPAP, your exhale pressure where Auto makes EPAP a range with Min and Max. I'm going to look back on this thread to see what we've had pressure wise. I would say an almost titration default unless I see red flags saying not to. Make it ASV Auto mode, EPAP Min 6, 7, or 8 Max 14 PS Min 3 Max 15. I may edit this or pressure gurus may suggest other then do that.
3. No DME then you may keep Airplane mode active. It will bug you about the Off status.
Settings:
Mode ASV Auto
EPAP Min between 6-8
EPAP Max 14
Pressure Support Min 3
Pressure Support Max 15
Post OSCAR and tell us how you felt during and after therapy. If the ASV blows hard and startles, Blow Back. Literally, blow back through the mask when it does this. The ASV will back off.
Pressures aren't set in stone. We can get you to adjust via feedback from you and the data.
Wow! Just wow Dave. Such a quick and detailed response. I am so grateful. Awesome stuff.
I will be so happy to come back once I’ve got some data.
Thanks again Dave.
RE: Longtime BiPAP w/ centrals needs new machine advice - SarcasticDave94 - 10-14-2020
Welcome and best to your success.
RE: Longtime BiPAP w/ centrals needs new machine advice - Sleeprider - 10-15-2020
I though I'd post the Resmed ASV titration protocol. For ASVauto, the default starting point is EPAP min 4.0, EPAP max 15.0, PS min 3.0 and PS max 15.0. It is common for us to recommend a higher EPAP min, especially if CPAP has shown a need for higher pressure to prevent OA. You're in good hands with Dave.
RE: Longtime BiPAP w/ centrals needs new machine advice - memeuro - 10-26-2020
Hi Guys!
I have been using my new unit for just over a week and think it is working well. Lots of confounding factors that muddy my ability to say positive things with great probability, meaning in terms of sleepiness and waking feeling rested. I was wondering if the parameters for the Resmed are calibrated differently than the Respironics, even though I assume they are reporting the same raw data. Only reason I say this is I have gone from an AHI varying from 4 to 10 on the Respironics to around 1 on the Resmed ASV. Does this seem realistic or is it an anomaly?
Would love to hear your guys opinions.
Also, I have noticed I am burping a bit as I think I am gulping air. Which setting should I decrease to try and minimize this?
The attachments are labeled:
- Respironics 01.jpg
- Resmed 01.jpg - standard
- Resmed 02.jpg - advanced
I am very grateful for any insight from the OSCAR ninjas on here.
Many thanks
