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Hello, I have been using BiPap for a year and still suffer from aerophagia in the upper range of the prescribed pressures.
Machine is an AirSense 10 vAuto. It's in auto mode currently running at 16/6 with PS=6. The currently prescribed pressures are 19/8 & PS=8, but when the machine auto adjusts to a IPAP > 16 I have more trouble tolerating the pressure.
Given this background, could adjustments to Trigger, Cycle or both allow me more time to exhale and deal with the higher IPAP pressure?
(03-29-2018, 10:25 AM)z counter Wrote: Machine is an AirSense 10 vAuto.
Can you double-check that for us? I have the AirCurve 10 VAuto, is that what you have?
Quote:It's in auto mode currently running at 16/6 with PS=6.
Max IPAP is 16 and Min EPAP is 6? With PS set to 6 your IPAP starts at 12 and goes up to 16 when needed.
Quote:The currently prescribed pressures are 19/8 & PS=8, but when the machine auto adjusts to a IPAP > 16 I have more trouble tolerating the pressure.
If you set your Min EPAP to 4 and your PS to 8 you will still be starting with an IPAP of 12 and it will never go above 16.
Regardless, you might try wearing a soft cervical collar. This may help keep your neck straight and your airway from collapsing so that you don't need as high of a pressure. On the other hand, keeping your neck straight may increase your aerophagia. You will have to try it and see what happens.
Quote:Given this background, could adjustments to Trigger, Cycle or both allow me more time to exhale and deal with the higher IPAP pressure?
I don't know but I would be interested in seeing what others have to say about this.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
03-29-2018, 03:12 PM (This post was last modified: 03-29-2018, 03:16 PM by Sleeprider.)
RE: Aerophagia Question
Without some background on these settings, it's kind of hard to advise. If you can post chart or two it would help to see if the current settings are letting events through or not. PS 8 is relatively high. Do you know why this was prescribes? Do you require the respiratory assistance, or were these settings prescribed for hypopnea?
Trigger and cycle settings are largely experimental. You can try changing one thing at a time and seeing if you find it more comfortable. Trigger is the change from EPAP to IPAP and setting that to less sensitive might keep you in EPAP slightly longer. Cycle is the change from IPAP to EPAP and more sensitive would cycle to EPAP faster. Ti is inspiration time, and controls the minimum and maximum amount of time that IPAP is maintained. It does not alter the spontaneous cycling in your machine. Again, data would provide a clearer picture.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Quote:Can you double-check that for us? I have the , is that what you have?
My mistake, as you suggested the correct machine is the AirCurve 10 VAuto.
Quote:Max IPAP is 16 and Min EPAP is 6? With PS set to 6 your IPAP starts at 12 and goes up to 16 when needed.
Exactly. That is how the machine is currently set. I have reduced the setting from the DRs prescribed pressure of 19/8 with PS=8 as I cannot tolerate the additional bloating. There is still bloating with the current IPAP of 16, but it is manageable.
Quote:If you set your Min EPAP to 4 and your PS to 8 you will still be starting with an IPAP of 12 and it will never go above 16.
That, of course, is true with the current IPAP of 16, correct?
(03-29-2018, 03:12 PM)Sleeprider Wrote: Without some background on these settings, it's kind of hard to advise. If you can post chart or two it would help to see if the current settings are letting events through or not. PS 8 is relatively high. Do you know why this was prescribes? Do you require the respiratory assistance, or were these settings prescribed for hypopnea?
After discussion and reviewing some charts, the PMD wanted to increase the IPAP to 19. Because of the bloating issue, I expressed concerns about the EPAP ranging higher than it does today. So changing the PS from it's current 6 to 8 is an attempt to keep the EPAP at the lower end of the range & closer to where it is today.
Quote:Trigger and cycle settings are largely experimental. You can try changing one thing at a time and seeing if you find it more comfortable. Trigger is the change from EPAP to IPAP and setting that to less sensitive might keep you in EPAP slightly longer. Cycle is the change from IPAP to EPAP and more sensitive would cycle to EPAP faster. Ti is inspiration time, and controls the minimum and maximum amount of time that IPAP is maintained. It does not alter the spontaneous cycling in your machine. Again, data would provide a clearer picture.
When submitting data, what is the preferred method? A PDF copy of relevant reports, or?
Instructions for organizing and posting a chart are in my signature. If you have Sleepyhead working it is as simple as pressing F12 to get the screenshot. If you absolutely cannot use software, I could provide a way for you to upload the SD card, but it's not my preferred approach.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
My apologies. I obviously did not read your entire signature block.
I use ResScan instead of SleepyHead, but I believe that I have approximated the desired formatting for the data. Creating .png files from the screen prints generated too many files for me to upload, so I combined them into a single .pdf. Please advise if you'd rather I process the data differently.
The .pdf is attached for your review and suggestions.
Sleepyhead works better for those here to follow. It's a free download on the link below. I'm trying to follow what your Doctor is doing and to tell the truth I don't have a clue. Looking at your chart your tidal volume is 600ml on average. So your getting more than enough air exchange. In fact it's probably too much because the high pressure support is triggering Clear Apnea events.
Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
The charts I sent were from a typical night - where the AHI is not particularly close to the desired "treated" range. The Dr is recommending increasing the pressure to try and get the AHI down into the treated range, although in the couple of times that I have tried the increased pressure, in addition to burping myself awake, the CAs seem to go up as well.
My normal respiration pattern is a relatively low rate consisting of deep breaths. (This is probably the result of being a vocal music major many years ago and the required thousands of hours of breathing/vocal exercises). I do feel that the machine is causing my respiration rate to increase over what is normal for me, but I have not attempted to quantify this.
So, any suggestions on how to proceed? Or should I move forward with the experimentation of Trigger and Cycle as Sleeprider suggested?
Looking at your events instead of increasing the pressure I'd buy a soft cervical collar for around $10 to $15. It looks like you have a lot of clustered obstructive events. This is caused a lot of times by positional issues like dropping your chin and cutting off your windpipe. If in fact that's the case than the collar will prevent that from happening and you won't need such high pressures. You can get a soft cervical collar at any drug store or on-line.
Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
