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Abletree's Therapy Thread
#51
RE: Abletree's Therapy Thread
You should try the current machine for at least a couple months before even considering making an argument for bilevel... Doing so now is premature and the only thing you will be successful at is annoying your doctor.

CPAP takes months to adapt to fully and you are barely getting started, this early in the game many users are still getting worse sleep then they were pre CPAP (due to the noise, air venting, body not being used to the ventilatory assistance etc). Your settings with EPR of 3 look good, I would run with them for a month before considering any other changes. I would turn off ramp, all it is doing is slowing your adaptation to your current settings.
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#52
RE: Abletree's Therapy Thread
Thank you for your input. I appreciate it & I will bare your comments that in mind - I have ramp at 10 minutes - will go to 5 - then off

I tried without EPR last night. I could NOT handle the exhaust pressure. Fought it for about an hour - it gave me an intense headache - which I am not prone to
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#53
RE: Abletree's Therapy Thread
Hello :Smile Last night 11/7 was different. My ramp is set to 10 minutes - as usual without any problems, but I turned off EPR for the first time. 

I struggled terribly with exhale pressure, having to work hard to push air out with my lungs. I could exhale for the first part of the breath, but then it was like pushing against a brick wall. I developed a considerable headache (I never get headaches) and I wondered if I was somehow rebreathing CO2.

I finally gave up after an hour or so and I turned EPR back on. I was able to breath comfortably after that. I would like to be able to use the machine without EPR because of the reasons mentioned by Gideon earlier in this thread.

I am attaching my OSCAR daily sheet and also a 3 minute view and another view that might capture the part where I switched from EPR on to EPR off

Any suggestions are appreciated.


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#54
RE: Abletree's Therapy Thread
What is your immediate goal?
If it is BiLevel your doc has to make the changes, not you, otherwise you are proving that you are good.
You just proved that you do not need a BiLevel, that EPR resolves your issue.

VAuto Automatically adjusts pressure in response to flow limitation, snore and obstructive apneas; Pressure Support (PS) is fixed throughout the night and can be set by the clinician. It Treats OSA, non-compliant OSA

Intolerance of therapy is the primary reason for non-compliant OSA.  As you said above you could not tolerate the therapy (without EPR, you don't want to tell the doc that.)
You want the doc to note that you are having big time issues with your therapy, then you want HIM to fix it.  If he puts you on EPR fine, the question is are you still not tolerant, improved but not enough?  If so you let your doc know.  Your numbers will NEVER show how you feel.  We want the doc to discover the BiLevel solution for you.

Now if you just want to be treated with your AutoSet, you already know we are very good at that.
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#55
RE: Abletree's Therapy Thread
Thank you for your wise words. The truth is I don't know what I need yet - but I don't want to end up stuck with an apap unit if I truly need a bipap

I realize I am probably too early in my use of the machine to know a lot of things  - and I don't understand a lot of things

I recall you saying that EPR should be avoided because it can throw off some pressure numbers that a bipap would not. So I thought I would try it without, and I quickly discovered last night I definitely can't tolerate no EPR. But if having EPR ON is messing up pressures that would be better with a bipap, I'll hope to eventually end up with the a bipap if that is the best solution

For now, I'll keep the EPR on, see how the next couple of weeks unfold. Maybe have a better idea of how I am feeling & a have better understanding

Thank you again Smile
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#56
RE: Abletree's Therapy Thread
IMHO your AutoSet can provide you all the treatment you need. What it cannot do is go to EPR levels greater than 3. At least that is the one thing that hits you.

for the record I did not say "I recall you saying that EPR should be avoided because it can throw off some pressure numbers that a bipap would not." I may have said others say that, but I don't because I see otherwise.
Maybe use of EPR would prevent you from getting a BiLevel.
You asked if a BiLevel was better, I said yes because it was more flexible. It can deliver PS in 0.2 increments and provide up tp PS=10 ve EPR=3. You MIGHT, just might use a PS =4 or 5 but 3 seems to work very well for you.
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#57
RE: Abletree's Therapy Thread
Thanks again for everything. I apologize if I mischaracterized your words with my own misinterpretation

Absolute truth - I am currently feeling oppressive fatigue - even at this moment - despite over 7 hours of sleep and bunches of sleep time over the weekend. I'm overwhelmed with brain fog - so I am not functioning on all cylinders yet

I'll ride out tonight with EPR on, ramp down & see what tonight brings  Bigwink
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#58
RE: Abletree's Therapy Thread
Bilevel should have never been discussed as an option yet. We are weeks into treatment, there is no obvious flow limitation or apnea issue and imo there is zero indication a bilevel is necessary or warranted.

Your treatment appears adequate with EPR at 3 and now you need to give body time to adapt to PAP.

I would like to see more of your sleep study data (rather than just the summary) as there are a couple interesting things that would be worth looking into but we would need the full report (post a redacted version). If you don't have full report should ask doctor for a copy. It should be multiple pages and have tables and graphs with more data.
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#59
RE: Abletree's Therapy Thread
Here's my Nov 8 OSCAR data & a 3 second view for your viewing pleasure. Rolleyes No changes in settings

Anything noticeable?

Still daytime fatigued. Comfortable breathing during the evening

Thank you


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#60
RE: Abletree's Therapy Thread
Daytime fatigue can take time to relieve.
keep in mind that old farts like me tend to have more of that than we had before we caught this thing called being old.

please use the standard charts but this flow rate is pretty good. A few minor flow limits a minor touch of untimed hypopnea but overall very good. stick with these settings.
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