Newbie-UARS/Catathrenia-using AirCurve VAuto

[esme17]

Hi! I’m new here and new to PAP therapy; only on my third night. I’m struggling some but very motivated! Hope I can get some help.

I chose a bilevel machine after a ton of research as it seemed best for my particular issues. Mainly flow limitations, RERAs, a few OSAs, fewer centrals, catathrenia, snoring on my side with my mouth closed (so talented!), autonomic nervous system dysregulation/complex PTSD, LES dysfunction/GERD. 

During my sleep study I was prescribed a pressure setting of 6 on an APAP. Long story short, I was not compliant due to constant congestion (caused by the machine) and gave it back. I no longer have a sleep doctor as I had 2 already and neither were willing to work with me or help me when I struggled. So, I’m doing this on my own. I bought my current machine and here I am.

My settings are as follows:
Max IPAP: 25
Min EPAP: 6
PS: 3
Ti Max: 4
Ti Min: 0.3
Trigger: Med
Cycle: High

My main issue is the inhale. I feel like I’m fighting the machine during inhale. I feel like it’s breathing for me; feeling it filling my lungs. I played around with the settings and PS 0 feels nearly perfect. Like I’m breathing normally. Is this crazy? What does this mean for my therapy? Can I leave it this way or is there a happy medium? 

The other issue I’m having is only as I’m drifting off to sleep is there a very distinct “drop” at the end of my inhale (where there would be a natural pause between inhale and exhale). It almost feels like suction, and it immediately jolts me out of actually falling asleep. It happens multiple times as I keep drifting off and is very jarring and annoying.

Thank you for any help!

[Gideon]

Welcome to the forum, we can and will help you.

Hi! I’m new here and new to PAP therapy; only on my third night. I’m struggling some but very motivated! Hope I can get some help.

I chose a bilevel machine after a ton of research as it seemed best for my particular issues. Mainly flow limitations, RERAs, a few OSAs, fewer centrals, catathrenia, snoring on my side with my mouth closed (so talented!), autonomic nervous system dysregulation/complex PTSD, LES dysfunction/GERD. 

During my sleep study I was prescribed a pressure setting of 6 on an APAP. Long story short, I was not compliant due to constant congestion (caused by the machine) and gave it back. I no longer have a sleep doctor as I had 2 already and neither were willing to work with me or help me when I struggled. So, I’m doing this on my own. I bought my current machine and here I am.

My settings are as follows:
Max IPAP: 25
Min EPAP: 6
PS: 3
Ti Max: 4
Ti Min: 0.3
Trigger: Med
Cycle: High

My main issue is the inhale. I feel like I’m fighting the machine during inhale. I feel like it’s breathing for me; feeling it filling my lungs. I played around with the settings and PS 0 feels nearly perfect. Like I’m breathing normally. Is this crazy? What does this mean for my therapy? Can I leave it this way or is there a happy medium? 

The other issue I’m having is only as I’m drifting off to sleep is there a very distinct “drop” at the end of my inhale (where there would be a natural pause between inhale and exhale). It almost feels like suction, and it immediately jolts me out of actually falling asleep. It happens multiple times as I keep drifting off and is very jarring and annoying.

Thank you for any help!

You say you have [size=small]"mainly flow limitations, RERAs, and snoring"  These are best treated with PS/Pressure Support, so I do not like PS of 0.

Your Timing, Ti Max and Ti Min look way off.  This is why you are having 
Set Ti Maax =2.0 instead of wide open 4, 
Ti Min =1.0 instead of it's .3
Cycle = Med


Do post a set of Daily charts

[esme17]

Welcome to the forum, we can and will help you.

You say you have [size=small]"mainly flow limitations, RERAs, and snoring"  These are best treated with PS/Pressure Support, so I do not like PS of 0.

Your Timing, Ti Max and Ti Min look way off.  This is why you are having 
Set Ti Maax =2.0 instead of wide open 4, 
Ti Min =1.0 instead of it's .3
Cycle = Med


Do post a set of Daily charts

Thank you for your welcome! I really do appreciate your help.

I received advice about the Ti min/max from another place. It definitely was not working out for me. On your suggestion, I set my machine to Ti min 1.0 and Ti max 2.0, and cycle on medium. What a difference! 

My PS is still at 3. I realize a PS of 0 is not right for me. I was just giving the example of what felt good. 

My inhale still “tops off” even with your suggested changes. It goes a little too high or in too deeply. It doesn’t stop when I stop breathing in. I feel my lungs filling too much because I’m not naturally breathing in that deeply. It’s obviously a very small sensation, but I can feel it if I let my breathing get away from me and when I do I tend to over breathe and feel like I’m hyperventilating.

I’ll give all the changes a go tonight and see if I can get a decent chart posted tomorrow. I’m new so I can only get 3-4 hours use at a time. Thanks again!

[Gideon]

My To Min is .3
Try that I know mine is unchanged