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What's with this newbie data? - Printable Version

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RE: What's with this newbie data? - drgrimes - 11-12-2017

HalfAsleep I'm impressed that your leaks are minimal, especially with FFM.  I would not consider my leak factor as minimal.  I think leaks are the source of many of our woes.  I've decided that as long as my AHI is less than one, i will allow a bit of leakage for the sake of comfort.  When i tighten my gear to get rid of leaks, i wake up with sore nose.  It's just a trade off.  I guess the most important thing is getting oxygen  to the brain so we stay healthy. Oh, and get a good night's sleep. I wish you well on your quest for the right equipment.

Had it not been for this forum in the beginning i would not have know that the machine that i was given was the worst one, no variable pressure and no data.  I stayed on the sleep doctor's case until he relented and wrote the RX for the Autoset Resmed.  I would never have survived with the first machine.  They kept quacking about medicare and insurance and it being a big deal.  My DME told me there was only about $100 difference.  I finally got what i needed but a person shouldn't have to go through what i did.

RE: What's with this newbie data? - HalfAsleep - 11-13-2017

As I prepare to get my sleep center to prescribe me a more helpful machine, could someone please explain the different Resmed Bipap's and which one would be most appropriate in my case?

I'm guessing one of the most important things that needs addressing is my excessive flow limit and lack of relationship between the pressure and the AHI.

I am totally in the dark about what Bipap's do, and thoroughly intimidated by the different types.


Here's  a small thumbnail link for last night in case my data isn't otherwise handy. The setting is 7-15

[Image: 3KI1n0mt.png]

RE: What's with this newbie data? - Sleeprider - 11-13-2017

You have long apneas that are both obstructive an central based on the flags. I think you might be tried on standard BiPAP/VPAP without a backup rate to see if the flow limits can be resolved with pressure support. This may increase the incidence of CA. If so, then the machines with backup rate, below come into play; however if your apnea are not predominately central (something we really don't know), then pressure support from 4 to 6 cm might be a good solution. Either the Resmed or Philips auto bilevels would seem appropriate for that with Resmed being faster to increase pressure for the flow limits and obstructive apnea.

If bilevel without backup is not effective due to presence of centrals, I think your might consider either a spontaneous/timed machine (ST) or adaptive servo ventilator (ASV). You might respond to ST, but my bet is on ASV as a more intelligent and effective solution. This link compares the Auto SV and Resmed ASV reasonably fairly. http://www.masm.wildapricot.org/resources/Documents/2016%20mEETING/13%20-%20Understanding%20ASV%20Therapy%20-%20Morgan.pdf


Most importantly, someone needs to evaluate your sleep disordered breathing and apnea while under pressure to figure out WTF is going on. It remains a mystery to me. Don't let them disregard this as leaks or unimportant, because anyone having 40 to 80 second apneas needs help.

RE: What's with this newbie data? - HalfAsleep - 11-13-2017

Thanks

Thanks, SleepRider. That gives me some starter info so I can investigate those machines (I always like to know what whys wherefores). I'm seeing that there's kind of a decision-making tree as far as machine selection.

I don't plan to get pushed around at my next Sleep Center meeting. I have top notch documentation underpinned by 100% compliance and low leak rate...... All the i's dotted, all the t's crossed. Plus, extra bonus, encouragement from here!

RE: What's with this newbie data? - Apnea Infant - 11-14-2017

Half Asleep

Really willing and willing for you to get the right diagnosis of machine at your next consultation. Let us know you get on.

I scored a BiPAP titration study! - HalfAsleep - 11-17-2017

Woohoo!  She persisted, begged, pleaded, genuflected, and..... the Sleep Center offered me a titration sleep study, first with CPAP, then with B-PAP.  Dancing

Since I'd already tried every single upper pressure 8-16, lower pressure 5-8, and EPR off, 2, 3, I figure the CPAP will fail on the double. Hopefully this will move me ASAP on to Plan B, namely B-PAP.

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Did someone mention (SpyCar and/or Sarcastic Dave?) that it may be a matter of enduring B-PAP for a certain amount of time with gritted teeth if that, too, is a fail?


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Any ideas what B-Pap gizmo I should angle for? I seem to get along well with Resmed, but they make a couple of units in B-PAP. On second thoughts, no worries. I see SleepRider is getting me going upthread. I'll re-read.
Oops, more questions. Am I after a VAuto or an S?  ST must be some kind of extra special device? ASV I can probably figure out.

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Experiences, anyone, with titration study using B-Pap?

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Thank you all for your insistence, coaching, prodding, and encouragement.  Thanks 

Onwards to bury myself in the Wiki!

RE: What's with this newbie data? - ajack - 11-21-2017

Just make sure they can titrate for the CA on a machine with backup breathing, if they are still there on the bpap. Otherwise it will be another titration for a machine with backup breathing. asv/st/vaps

RE: What's with this newbie data? - HalfAsleep - 11-21-2017

(11-21-2017, 12:12 AM)ajack Wrote: Just make sure they can titrate for the CA on a machine with backup breathing, if they are still there on the bpap. Otherwise it will be another titration for a machine with backup breathing. asv/st/vaps

Thanks, Ajack. Great minds think alike. I was just thinking I should get them to titrate for ASV in addition to  BPAP or whatever.

I’m going to have to escalate my case to pull that off. Focus, HalfAsleep, focus....ASV.