Free CPAP Advice and Sleep Apnea Treatment Help Board • View topic - Advice needed
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tjwoody
Unread post  Post subject: Advice needed  |  Posted: Wed Nov 15, 2017 2:47 pm

Joined: Wed Jul 19, 2017 3:18 am
Posts: 21
Location: The Villages, Fl
PAP Mask: Resmed Airtouch F20, Amara View (primary mask)
PAP Machine: Philips Respironics Dreamstation autoSV
Humidifier: Dreamstation humidifier
Pressure Setting: Max ipap - 28.0, Epap 8.0-15.0, PS 0-20

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I've been on therapy for 2-1/2 months now and it seems to be effective, but maybe not as effective as it might be. MY AHI is averaging around 10, ranging from a low of 5.5 to a high of 13.5 in the last 30 days. I can't use Sleepyhead because my machine - Phillips DreamStation AutoSV is not compatible. I average around 6 hours a night - my normal sleep even before the BiPap machine - but I wake up fewer times at night and I am having more REM sleep. I know I am having more REM sleep because I am remembering more dreams.

Now to the the AHI. My initial Study had an AHI of 53.8. My average AHI for the last 30 days is 10.2. Looking at the daily numbers using the DreamMapper app on my iPad obstructive and clear airway apneas are nearly equal each night,flip-flopping from one being greater than the other depending on the night. Hypopneas are usually between being equal to the combined sum of clear and obstructive apneas to double that amount. Thus, normally hypopneas usually make up at half or more of the AHI.

My machine settings are - Ipap 28 max, Epap 8 min 15 max, PS 20. Machine reports 90% epap pressure of 12.2 for the last 30 days.

My last visit to my sleep doc was a wham, bam, thank you ma'am sort of visit. He hadn't looked at my numbers until he stepped into the exam room with me. When he looked at the AHI and my compliance - every night since I got the machine - he was satisfied and saw no reason to make any changes. I mentioned my concern about the hypopneas and he explained them to me, but did not mention any changes that might bring them or the AHI down. It just felt as if he was being lazy and didn't really want to take a close look at the results of my therapy. At this point I don't think I could change sleep Drs. and I've got the correct machine to treat my complex apnea, but I'm not super happy with my results.

I'd like to know if any of you with experience might have any suggestions for changes in the settings for my machine that might bring down my AHI. I'm also a little skeptical of the hypopnea numbers as I'm not at all sure I'm getting desaturations every 5 to 10 mintes throughout the night.

A last question - should I get an oximeter to measure my oxygen saturation overnight. Even though I can't use sleepyhead I have options on my iPad to look at the numbers and graphs over the night.

Thanks in advance for any advice you can give.


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Pugsy
Unread post  Post subject: Re: Advice needed  |  Posted: Wed Nov 15, 2017 4:55 pm

Joined: Wed Aug 02, 2017 8:01 pm
Posts: 329
PAP Mask: ResMed AirFit P10 or DreamWear Gel nasal pillows
PAP Machine: ResMed AirSense 10 AutoSet for Her
Humidifier: ResMed AirSense 10
Pressure Setting: Depends on the machine as I actually have more than one

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Do you have a Windows computer by chance?

What are the PS minimum and maximum settings?

Without seeing the detailed reports and when the events are getting flagged....and assuming that you aren't spending large amounts of time awake with the machine and mask on....maybe more EPAP minimum to see if it will deal with the obstructive stuff a little better.


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tjwoody
Unread post  Post subject: Re: Advice needed  |  Posted: Wed Nov 15, 2017 8:04 pm

Joined: Wed Jul 19, 2017 3:18 am
Posts: 21
Location: The Villages, Fl
PAP Mask: Resmed Airtouch F20, Amara View (primary mask)
PAP Machine: Philips Respironics Dreamstation autoSV
Humidifier: Dreamstation humidifier
Pressure Setting: Max ipap - 28.0, Epap 8.0-15.0, PS 0-20

Offline
Pugsy wrote:
Do you have a Windows computer by chance?

What are the PS minimum and maximum settings?

Without seeing the detailed reports and when the events are getting flagged....and assuming that you aren't spending large amounts of time awake with the machine and mask on....maybe more EPAP minimum to see if it will deal with the obstructive stuff a little better.


PS 0 min, 20 max

Sorry, I don’t have access to a windows machine or I would use encore.

Some nights I may have as much as 1/2 hour awake with mask on. On these nights if I check ahi on the machine I notice that it drops from the time I awaken until I give up and get up and start my day.


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Pugsy
Unread post  Post subject: Re: Advice needed  |  Posted: Thu Nov 16, 2017 7:11 am

Joined: Wed Aug 02, 2017 8:01 pm
Posts: 329
PAP Mask: ResMed AirFit P10 or DreamWear Gel nasal pillows
PAP Machine: ResMed AirSense 10 AutoSet for Her
Humidifier: ResMed AirSense 10
Pressure Setting: Depends on the machine as I actually have more than one

Offline
Do you have anything showing you what your PS is running on average on the LCD screen?

Odd that they don't have built in PS right from the start with the PS of 0.

If it were me I would think about adding more PS which will end up increasing IPAP...and maybe do a better job of dealing with the obstructives and the centrals....and if that didn't help then more minimum EPAP.
Like changing the minimum PS of 0 to 4 which is a very commonly used PS in situations like this.


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