EXHAUSTED--Trying to get AHI down

[zimm4er]

Changed to ivaps. Did the learning module in machine. Will see what happens to my ###

[raisedfist]

asks for suggestions, ignores questions and suggestions.

[zimm4er]

Sorry slow to respond, Lots of life isues. My back up rate is 10. My IPAP is already 19.2.

[zimm4er]

ressp rate 12.8-28. with 95%--17.
When I initally started my CPAP journey and had a home CPAP study. They asked if I took off my monitoring equipment, because they had a hard time registering my numbers because when I got to sleep, I don't breath deep, imagine that

[raisedfist]

sorry for earlier comment, am having a very bad day woke up at 1AM and could not sleep again.

can you find the patient triggered breath % value on your sleep report screen on the device itself? if you have a weak breath, maybe a trigger setting adjustment would be of benefit.

i'd first suggest to just use Spontaneous "S" mode and see after a night what happens to CA index.

[zimm4er]

? Spont t 31%
Or sport c 39%

[zimm4er]

Do you think only one night of s mode is enough? I feel like my numbers jump around for no good reason. I will try it tonight. Did 2 nights of ivap as suggested by someone earlier. The first night my ahi was 3, and very few hypopneas. 2nd night, last night ahi 5, losts of hypopneas

[ajack]

first off, I doubt your MED tidal volume is really 200 and your minute vent is 2.6
your mask is leaking or you are mouth breathing or a glitch in the way your breath is seen. That needs to be fixed first, before anything else. If you have a nasal mask, I would switch to a FFM for now and be clean shaven.

I would also get a $10 foam cervical collar to see if you are positionally obstructing your airway, eg tucking your chin to chest. you are running high pressures and there may be other issues.

If you want to continue to use the ivaps, I found you need to do more than just the learning mode. That was an indicator for me and my final adjustments were different. Put up your ivaps chart and you need the ResScan software charts, as well as sleepyhead. You need to decide what mode you want and stick with it to resolve. swapping back and forward won't help.

[*]started tweaking my numbers because my ahi was running 7-10. On bipap because original dx was central sleep apnea.

The Resmed ST-A iVAPS isn't a "bipap", it's a specialized machine for people with lung conditions, and doesn't work well for people with ordinary central sleep apnea.

Running it in St mode isn't going to give the best results.

Just to clarify. The ivaps is a bipap/bilevel machine.
If you were dx with CA, running in ST pressures you were given after the sleep study with the machine. Or ivaps properly set up is the correct modes for now. It may not be the best machine for you in the end. If it's mainly CA, an ASV may be considered, which is also a bipap machine. Specialised to CA, if no other serious lung issues are involved and the OA/H resolved.
They are probably cheaper than an iVAPS, so there may be other factors in your sleep study. refer back to your doctor and post the study.

[zimm4er]

[*]i will try to get my ivaps charts up. This is not an easy task for the semi literate computer person. I do wear a ffm, and am clean shaven most days. Lol. I am female.
Not sure what you mean about reamed info though.
Do agree that I can't be bouncing around with different settings

[ajack]

This is what I would do
I would go back to S for now and stay there till you sort out the basics. epap15 ipap20 (if S mode and pressure is what the doctor set by the sleep study)
do you have a clinical manual from apneaboard.

You do have a FFM, I didn't check your sig.
Machine: AirCurve™ 10 S BiLevel Machine with HumidAir™ Heated Humidifier
Mask: ResMed AirFit™ F20 Full Face CPAP Mask with Headgear
Humidifier: REMstar Passover Humidifier with hose

disconnect the remstar humidifier for one night and connect the hose directly up to the resmed. this will take out a variable.

Put the resmed on mask fit and check for leaks with the high pressure.

Get at least a few hours sleep and then put a sleepyhead chart up. to review.

do you have a copy of your sleep study

after the basics are sorted, you can switch to ivaps and set that up properly, It is involved and be patient for now. you will like ivaps. It still would be interesting to see the ivaps with sleepyhead. seeing you already did it.

[palerider]

Just to clarify. The ivaps is a bipap/bilevel machine.

No, iVAPS is not a 'bipap', BiPAP is a registered trademark of Philips Respionics.

By definition, no Resmed machine is a "BiPAP", no where, not on the machine, not on Resmed's web page, not on the manuals does the word "BiPAP" appear.

[zimm4er]

I did not realize, my machine was listed as wrong. I had a Resmed Vpap-STA. It is not even in the list. I do not have my last sleep study. I do not think it would be very valuable, because a large portion of the night I did not sleep. I do have the manual for my machine. I ordeded the neck collar.
Here are the past three nights. The first two were on IVAPS and the last one was just on S mode
https://imgur.com/r7c9xjC
https://imgur.com/yjhA4rk
https://imgur.com/8peAPAk
I cannot get them to download.

[palerider]

I did not realize, my machine was listed as wrong. I had a Resmed Vpap-STA. It is not even in the list.

Put it in the comments on your equipment profile, and remove the humidifier you have listed, it's a different brand, and will just confuse the issue.

[ajack]

Just to clarify. The ivaps is a bipap/bilevel machine.

No, iVAPS is not a 'bipap', BiPAP is a registered trademark of Philips Respionics.

By definition, no Resmed machine is a "BiPAP", no where, not on the machine, not on Resmed's web page, not on the manuals does the word "BiPAP" appear.

selective eyesight?
I wrote, ...Just to clarify. The ivaps is a bipap/bilevel machine.>>
BiPAP is a philips trade mark. common use switches them and also includes the term bpap.
There is one level cpap, everything else is 2 level call it what you like. BPAP/BiPAP/Bilevel and they include the modes, asv, avaps, ivaps, pac, s, st, etc

[palerider]

Just to clarify. The ivaps is a bipap/bilevel machine.

No, iVAPS is not a 'bipap', BiPAP is a registered trademark of Philips Respionics.

By definition, no Resmed machine is a "BiPAP", no where, not on the machine, not on Resmed's web page, not on the manuals does the word "BiPAP" appear.

Just to clarify. The ivaps is a bipap/bilevel machine.

The AVAPS is a bipap/bilevel machine, the iVAPS is not, it's a bilevel machine.

Ask Resmed.