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+--- Thread: I'm back, tired, and hopeless. But is Bilevel the answer ?? (/Thread-I-m-back-tired-and-hopeless-But-is-Bilevel-the-answer)
RE: I'm back, tired, and hopeless. But is Bilevel the answer ?? - weuw - 05-18-2023
Hi there
I continue to struggle with CA events (while I lowered pressure support) :
https://imgur.com/a/YLnCSQb (imgur thinks it is erotic pictures
)Any improvement to my therapy could help me ?
Strangely I don't feel so bad today. But I now take Carbamazepine against (light) bipolar disorder, maybe it can explain so much CA ??
Thanks
RE: I'm back, tired, and hopeless. But is Bilevel the answer ?? - Sleeprider - 05-18-2023
I don't see any correlation between PS and the number of CA events. Normally we expect to see events reduced with lower PS. I just can't get over the fact your European model Vauto does not have the trigger sensitivity setting, and assume it must have something to do with the approval of units sold in France or Europe. We could reduce or eliminate the CA with that feature. Since CA events have been persistent and unresponsive to manipulation of the device settings, I'm left with the recommendation to consider using ASV.
RE: I'm back, tired, and hopeless. But is Bilevel the answer ?? - weuw - 05-18-2023
Ok but I have to explain that I need asv to a doctor it can take time. What can I do in short time ?
Fix pressure ?
RE: I'm back, tired, and hopeless. But is Bilevel the answer ?? - weuw - 05-18-2023
Unhappily doctors don’t read Oscar datas.
RE: I'm back, tired, and hopeless. But is Bilevel the answer ?? - Crimson Nape - 05-18-2023
Are these the same doctors that use leeches to control blood pressure?
- Red
RE: I'm back, tired, and hopeless. But is Bilevel the answer ?? - Gideon - 05-18-2023
Printout your Oscar reports.
Highlight the issues. In other words.
Highlight the high PS.
Highlight the lower PS and not significantly. Changed. Show him, thal him through it put your fingers on the paper when you are talking about it. Do it quickly.
Now show another set. Same as above.
Next present as many different examples
Now show many different nights showing the same thing. 20+ if you can to show persistence.
Then hand home your laptop with all your data on it. Preload it to a current page and zoom into a 3-minute view and offer to let him pick a night.
Tell him your understanding is that ResMed specifically recommends the ASV for this.
Also go into the clinical menu and look for the trigger setting and if it is there set 8t to high, use it then repost your charts.
RE: I'm back, tired, and hopeless. But is Bilevel the answer ?? - Sleeprider - 05-18-2023
It is very important to communicate to your doctor how you feel. Then connect your fatigue, sleepiness and other symptoms to the fact you have persistent central apnea. Demonstrate through examples the changes in pressure and pressure support you have attempted as a solution to the persistent CA events. Use the Resmed Sleep Lab Titration Guide, which has protocols for all types of machines and apnea to show how ASV is the recommended solution for your problem (see page 28-34). https://document.resmed.com/en-us/documents/products/titration/s9-vpap-tx/user-guide/1013904_Sleep_Lab_Titration_Guide_amer_eng.pdf
RE: I'm back, tired, and hopeless. But is Bilevel the answer ?? - weuw - 05-18-2023
Ok thanks. But no short term solution ? I remembered to use 10 fixed epr 1 with low ca but without actual meds. As I said no trigger settings in my model of aircurve. Strange but old model I think.
RE: I'm back, tired, and hopeless. But is Bilevel the answer ?? - Sleeprider - 05-18-2023
The equivalent setting to the fixed 10 cm EPR 1, is to use EPAP 9.0, IPAP 10.0 in S-mode.
RE: I'm back, tired, and hopeless. But is Bilevel the answer ?? - weuw - 05-18-2023
(05-18-2023, 11:24 AM)Sleeprider Wrote: The equivalent setting to the fixed 10 cm EPR 1, is to use EPAP 9.0, IPAP 10.0 in S-mode.
Ok I just had a look at my device and there is a CPAP mode with EPR, no difference I think with your settings ?