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+--- Thread: afib and sleep apnea (/Thread-afib-and-sleep-apnea)
RE: afib and sleep apnea - Sleeprider - 05-17-2018
The image you sent by email should easily attach to the forum. Just save the image and use the forum attachment feature. Looks great.
RE: afib and sleep apnea - Hojo - 05-17-2018
(05-17-2018, 07:40 PM)Sleeprider Wrote: The image you sent by email should easily attach to the forum. Just save the image and use the forum attachment feature. Looks great.
Sleeprider: I think you missed one area of great concern on that Sat profile, Pete's weight, looks like he needs to eat.
RE: afib and sleep apnea - Sleeprider - 05-17-2018
(05-17-2018, 08:10 PM)Hojo Wrote:(05-17-2018, 07:40 PM)Sleeprider Wrote: The image you sent by email should easily attach to the forum. Just save the image and use the forum attachment feature. Looks great.
Sleeprider: I think you missed one area of great concern on that Sat profile, Pete's weight, looks like he needs to eat.
Good point! He is wasting away to nothing, and ASV will likely blow him away.
RE: afib and sleep apnea - SarcasticDave94 - 05-18-2018
Well, there is the fact he's a little short guy too. 0 feet tall.
RE: afib and sleep apnea - poppypete - 05-18-2018
(05-17-2018, 09:20 PM)Sleeprider Wrote:(05-17-2018, 08:10 PM)Hojo Wrote:(05-17-2018, 07:40 PM)Sleeprider Wrote: The image you sent by email should easily attach to the forum. Just save the image and use the forum attachment feature. Looks great.
Sleeprider: I think you missed one area of great concern on that Sat profile, Pete's weight, looks like he needs to eat.
Good point! He is wasting away to nothing, and ASV will likely blow him away.
Thanks for the light entertainment this morning, after some
moments yesterday trying to get this oximeter program working properly.The night before, I decided to sleep with only the oximeter, no CPAP...and the analysis report is attached...now with height and weight included.
Sadly, last night the oximeter malfunctioned, but I used the CPAP...because these 2 nights' use of the oximeter gave me the info I needed to see...that CPAP in its present use form (until ASV becomes an option), is assisting my desaturation issue, even if not totally.
I had a few drinks (1 beer stubby; 2 glasses white wine) before going to bed...not my best night, but the numbers are still reasonable for me...so don't put too much store on these 3rd night results.
Thanks guys...poppypete
Ps...I'm corresponding with Kevin Cooper now regarding his oximeter recommendations.
RE: afib and sleep apnea - Sleeprider - 05-18-2018
Pete, what are your thoughts about ASV therapy? It's a relief that you don't have severe oxygen desaturations, so no emergency here, but I don't see your event rate as becoming predictable on CPAP.
RE: afib and sleep apnea - poppypete - 05-18-2018
(05-18-2018, 03:22 PM)Sleeprider Wrote: Pete, what are your thoughts about ASV therapy? It's a relief that you don't have severe oxygen desaturations, so no emergency here, but I don't see your event rate as becoming predictable on CPAP.
Sleeprider...
I'm leaning very much towards this as my answer, but another 10 days wait will see that my heart either is up to it or not.
I've managed to get the oximeter working again, and I'll need to spend some time studying how to interpret and then compare against what SleepyHead is telling me...so over these 10 days I should be much better understanding what is really happening while I slumber.
Preliminary efforts attached, and from there I can home in on particular areas of SleepyHead data...
...best I can do for the moment.
Stay tuned!
Cheers...poppypete
RE: afib and sleep apnea - Sleeprider - 05-18-2018
Second by second detail...maybe overkill?
RE: afib and sleep apnea - poppypete - 05-18-2018
(05-18-2018, 07:36 PM)Sleeprider Wrote: Second by second detail...maybe overkill?
Yeah...
...realised that after I sent it.
Still looking into how to change the parameters...slow learner!
Cheers...poppypete
RE: afib and sleep apnea - poppypete - 05-22-2018
Sleeprider...
Back on April 21 you comprehensively replied to my issue, and so as I'm seeing my cardiologist in 5 days, I've been reviewing the thread overall, including this comment:
"The ASV (adapative servo ventilator) was specifically designed to treat complex, central apnea and Cheyne-Stokes Respiration. The ASV can use auto-adjusting EPAP pressure to stabilize the airway against obstructive apnea during exhale cycle, and can trigger intelligent, VARIABLE pressure support when needed, as needed to support inspiration and volume. In other words, the pressure support can be zero or 2-3 cm for comfort, but can rise as high as 15 cm to cause a breath during central apnea or support a breath during hypopnea or Cheyne-Stokes. This levels out the respiratory volume, stabilizes periodic breathing and resolves the kinds of issues you have. The problem is that a large study (SERVE-HF) found a significant risk of sudden cardiovascular death in subjects of the study that had left-ventricular ejection fraction less than 35%. The recommended practices for prescribing ASV then added a safety factor, and the current guidelines for prescribing ASV require patients to be screen for LVEF% and that they have greater than 45% LVEF. The SERVE-HF machine was done using a prior generation of ASV devices that did not have Auto EPAP and zero-PS capability; rather they more closely approximated current ST machines. The most recent evaluation of the SERVE HF study is reevaluating findings in light of the technological advances and some problems in the original study design. https://aasm.org/resources/practiceparameters/asv.pdf Currently there is no ASV therapy for individuals that fall in the risk group (<45% LVEF), however new studies are underway to try to evaluate if the original study can be verified or refuted based on changes in the technology or by modifying parameters of the original cohort compliance and titration efficacy."
I've gone to the study (quoted link), and have printed it out to show my cardiologist. along with relevant/printed pages from this thread...for discussion in particular, about my LVEF%.
I've also printed out previously, the Cleveland Clinic material:
"make sure you get echocardiogram to determine LVEF. This automatically qualifies you for ASV if LEVF is greater than 45%. https://my.clevelandclinic.org/health/di...n-fraction
This will take the wind out of the sails of any sleep specialist trying to keep you from the treatment you need. If your cardiologist will write an opinion that you are in good enough health and it is her opinion you will benefit form ASV therapy, then that would be check-mate."
Finally:
"I went back and checked from the beginning of this thread and your AHI has been all over the place and seems to have no relationship to the pressures we set. At every pressure, high or low, your AHI has ranged from 11 to 30 and it has nothing to do with settings.
At this point you need ASV and a bilevel ST machine is a distant backup choice in the event your heart health does not support the ASV. What is your diagnostic AHI from your original test? If it is lower than the treated AHI, you should quit CPAP and seek a different solution. If CPAP is reducing your AHI, continue use, but invest in a cheap oximeter. That will either your are okay, show the need for supplemental oxygen, or press the need to move to ASV. You cannot continue to let your doctors play with your health. It's not entirely your choice, but you can somewhat control the outcome."
I'm attaching a couple of screenshots from the oximeter readings, and will email you a copy of correspondence with my supplier and clinician of recent days.
It's a pity I can't get this oximeter data into SleepyHead or ResScan at present, but that may improve as I understand over time.
Cheers...poppypete