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The main people are still the same but the company is different. I have a better understand as to what happened, I am not sure of the truth. I found out that some original people that I liked were part of a new company, different from the horrid service I received. It would take over a month to get cushions or any supplies. Service went down the tubes, it was horrid, awful in every sense of the word.

Outstanding customer service.Ī few years ago there were hospital mergers, buy outs, changes in the service providers. I put my own SD card in it and use it with SleepyHead.Įverything changed a few years ago, at one time I thought the people at the medical supply company were terrific, the company and the people were great. I mentioned that I have poor service were I live, and ask what happens if it doesn't connect. He said it connects to the internet via the cell tower. When I picked up my Resmed the tech told me it didn't come with an SD card, I was sure it was supposed to. My original Fisher-Paktel you had to bring the stick in so they could down the data. It seems to me that if someone cannot achieve an AHI of less than 5 and the main issue is CA events, then it is time to consider an ASV like the ResMed AirCurve 10 ASV rather than a BiPAP. I recall one study that found in 60% of the cases CA got worse when the patient is moved from an APAP to BiPAP. I think a BiPAP is more for someone that has air flow issues (smoking, COPD, asthma, lung issues) than it is for treating airway collapse and CA. One can end up with the worst of both worlds (more OA and more CA) using a BiPAP to treat CA. The lower the EPAP the more obstructive apnea you get. The higher the differential you use, the higher that IPAP has to go compared to the EPAP.

Again this is not necessarily an advantage in treating CA. The BiPAP machines can provide much more, and adjust it automatically during the night. A ResMed APAP can give you a 3 cm difference with EPR. The second difference is the ability to produce a higher differential between inhale and exhale pressure. But the higher pressure is not an obvious advantage in treating CA. First the BiPAP can go up to 25 cm for maximum pressure while the APAP is limited to 20 cm. There are two main differences in a BiPAP compared to a APAP. This is an example of how I use SleepyHead.

My conclusion is that if anything the pressure may be too high, not too low. For this night my total AHI was 3.31, with 1.66 CA, 0.25 OA, and 1.40 H. If they are central, then more pressure may make it worse. If the hypopnea events are obstructive in nature one would benefit from more pressure. Where the rubber hits the road is when you are trying to decide what to do about it. This is an example of why I more or less lump in my hypopnea events with the CA events as part of the same problem.

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The final event is classed as a hypopnea, but I would say almost for certain it is just a CA event that did not go to full loss of air flow. If something upsets it, it starts to cycle as can be seen most easily with the minute ventilation. For whatever reason my breathing control system is not stable.

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This was really the starting point of the event series and it is due to my issues with breathing control that cause central apnea. If you look at the minute ventilation you can see that the flow was cycling prior to these events, and really started about 2:33.45. You will see there is a series of events RE, CA, CA, CA, H. Here is an example from last night to look at zoomed in. My suspicion is that most of my hypopnea events are central in nature rather than obstructive. However, they can actually be due to reduced effort to breathe which is a central effect. Hypopnea is generally assumed to be a flow reduction due to restriction of air flow, or obstructive in nature. I suffer from CA events, and then hypopnea events next. If you want to zoom in on events to expand the scale and look at them in detail you can form your own opinion as to how accurate the classification is. However, they are a good indication of what is going on. Yes, the machine can make mistakes, and the event classifications should not be considered as absolutely correct. It is the machine that determines the types of events.

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All the software does is display the data that the CPAP/BiPAP machine has captured. My first thought is that this is not a OSCAR or SleepyHead issue.