Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

Auto SV settings and Periodic Breathing in REM
#1
Hi. 

After weight loss, I no longer have many obstructive apneas as I did some years ago, but I do have some centrals. In particular, I seem to go into periodic breathing during REM sleep. This doesn't cause significant O2 desaturations, but I wake up feeling pretty beat up and unrested, and that's the only abnormality I can see. 

I have a tendency to hyperventilate as well during REM, with the breathing rate getting shallower and faster; I'll often wake up sweating in the middle of a dream, and the cpap data will show I had been hyperventilating for awhile. Actually, the better part of a decade ago I had to quit bilevel therapy because it would induce rapid-deep breathing and give me extreme hyperventilation, 30 deep breaths per minute.

Just lately I've acquired a bipap Auto/SV to see if it might enable me to smooth out the periodic breathing... which isn't dramatic but is very visible as a waxing/waning pattern...to see if that might allow me more IQ points in the daytime.  And clearly it did smooth out the PB flow on the first few nights I used it. And it does not drive me into hyperventilation like a regular bipap will. 

But after a few days it seems as though the algorithm is now just adding pressure support to every breath, whether there is PB or not. This makes for a very high pressure if a high max PS is set, and doesn't even out the PB.

So I am now trying PS set to Min:0 and Max:3, just to keep from getting discomfort and mask leaks from a lot of pressure support I don't need. But it isn't compensating for the PB.  Any thoughts from you periodic breathing experts out there?

thanks
Post Reply Post Reply
#2
Hard to say, but maybe increase the PS max in increments. Your could try turning off BiFlex and using a rise time of 0. This will give you a faster onset of pressure support all the time, but it might help with periodic breathing by making the machine faster to instill IPAP. That is a comfort feature, and you can set rise time from 0 (fast) to 3 (slow). Trigger sensitivity is settable on some machines, but I'm not sure about yours. Higher trigger sensitivity decreases the amount of air needed to trigger IPAP. The default is 6 mL. With a more sensitive trigger, IPAP is started with less spontaneous volume, and this can help some people get into the IPAP faster.
Post Reply Post Reply
#3
Thanks, increasing the PS in increments is exactly what I'm trying first. My actual EPAP is fine set at auto from 4-5.5. Tonight I'll use a PS range of 0-4, up from 0-3 last nite.

I tried it with flex off the other day - and found that I'm pretty spoiled, it was some effort breathing against the pressure, and I tend to have a hard time falling asleep. I even added .5 PS as the minimum, but it still seemed hard to breathe against, which surprised me.  So the flex is back on at 3.

This is a new machine for me, but I'm not sure I can adjust rise time while keeping it on the AUTO settings. I'll see. I don't think "trigger sensitivity" is something built into this machine, it's not mentioned in the stuff I've read. 

all good logical advice, I'll play around with it... thanks.
Post Reply Post Reply




Possibly Related Threads...
Thread Author Replies Views Last Post
  Nasal congestion Humidifier settings larrygreg 3 37 56 minutes ago
Last Post: srlevine1
  Disturbing breathing patterns? Please help. mRFstro 18 548 10-22-2017, 09:55 AM
Last Post: bonjour
Question Training Yourself to stop Mouth Breathing? SuperSleeper 84 53,860 10-21-2017, 10:43 AM
Last Post: Sheepish
  Help with comfort settings Phillips DreamStation Annie66 7 258 10-19-2017, 03:55 PM
Last Post: KSMatthew
  [Pressure] EPR settings David T Hopkins 5 182 10-12-2017, 03:19 PM
Last Post: PaulaO2
  Mask Settings On Machine DPerretta 12 323 10-10-2017, 08:24 PM
Last Post: DPerretta
  Return to treatment - CA's and Periodic Breathing Kev73 11 326 10-02-2017, 03:32 PM
Last Post: Kev73

Forum Jump:

New Posts   Today's Posts




About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.

For any more information, please use our contact form.