Another set of questions about the Aircurve 10

[DeepBreathing]

Looking at the charts I see awakenings immediately following some of the high pressure events. I think the machine is applying close to maximum pressure support (PS) to overcome hypopneas and prevent them turning into full-blown apneas. It's this very high PS which is causing the disturbance.

I agree with Dave's approach, but I'd be a bit more aggressive - raise the minimum EPAP to 8. Set MinPS to 3.0 and maxPS to 10. My guess is that you'll have a few more hypopneas and perhaps some apneas, but a far more relaxing sleep overall. Remember - the objective is not to get low numbers, the objective is to get a good night's sleep!

Try these values for a few nights then review.

[sjlowens]

These are really useful ideas from the whole group - I'm very grateful.  I'll start playing with the PS values in the next week.

Meanwhile, I understand what the IPAP and the EPAP variables are for, as they have been used in previous machines.  Could someone explain or point me to a reference for what the PS variable is, and how it affects everything else?

Many thanks,

Steve Lowens

[DeepBreathing]

PS is simply the difference between IPAP and EPAP. It's the additional pressure applied as you inhale. EPAP + PS = IPAP.

[SarcasticDave94]

PS stands for Pressure Support. When you are running the machine in ASV Auto mode, all 3 sets of pressures (EPAP Min-Max, PS Min-Max, and although hidden to user IPAP Min-Max) are continuously variable according to machine analysis. EPAP + PS = IPAP whatever is the current machine chosen number within those ranges that are set in the clinician menu for EPAP and PS. IPAP equals the sum of those two.

[Sleeprider]

This simple titration protocol flow-chart may help explain how we use the settings:

[sjlowens]

I've had several nights with my new settings:

Min EPAP 5.0 (unchanged)
Max EPAP 8.0 (was 10.0)
Min PS 3.0   (was 0.0)
Max PS 11.0  (was 20.0)
Max IPAP 19.0 (was 30.0)

I'm not being awakened by high pressure any more, am sleeping much more soundly, have AHIs averaging under 5, and the fatigue seems to be reducing, though still variable.  I'm very pleased and grateful for the recommendations from this group.

Also still waiting for a return message on this issue from my sleep therapist, which I sent on August 25.

Steve Lowens
Alameda, CA

[SarcasticDave94]

OK sounds like a step in the right direction. Congrats. You could post up some OSCAR data from this if you'd like. Maybe there's fine tuning to be had. Nevertheless, try these for a few days and evaluate how you're feeling.