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CPAP - BiPAP Help Needed
#11
RE: CPAP - BiPAP Help Needed
(08-22-2017, 10:55 AM)Sleeprider Wrote: Pressure has maxed out and obstructive apnea is not responding.  You need to get a soft cervical collar and correct the physical obstruction that is occurring to your airway.  This happens with some people when the head and neck are out of alignment, and the airway becomes occluded.  Your charts tell us this is what is happening as flow limitations, snores (choking), and OA all correspond with maximum CPAP pressure.  You must correct this positional apena which can occur on your side or back by using something that supports your neck in alignment, and prevents you from tucking your chin.  A proper fit for the collar is a circumference that lets you easily slip a couple fingers between the collar and your neck, and a height that applies gentle pressure to your jaw, but is not uncomfortable or rigid.  

This thread by another Apneaboard Monitor (Melman) back in February this year is an example of how correcting this problem can have amazing results cutting AHI that looks like yours, to very low or even zero.  http://www.apneaboard.com/forums/Thread-...ght-s-Data


Hello

Tried the soft collar. slept with a PS 6.0 and woke up after few hours because of pressure... changed the PS to 4.0 and slept again. tried sleeping sideways also...

have a look below:

[Image: EIEIO.png][/img]

(08-22-2017, 11:19 PM)trish6hundred Wrote: Hi addicted,
WELCOME! to the forum.!
Hang in there for more responses to your post, good luck with CPAP therapy and getting it fine-tuned to meet your needs.

Thanks. lucky to be here..
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#12
RE: CPAP - BiPAP Help Needed
I have problems with positional Apnea. I use a collar and it helps. I also found that I had to change to a lower height pillow. I've tried both a Wheat Hull pillow and the "My pillow". Both help to keep your head lined up with your body to avoid pinching off your airway. You might want to try switching pillows. As far as the CPAP not helping, you could blow a fire hydrant down my throat when it's pinched and not open it up.
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#13
RE: CPAP - BiPAP Help Needed
I expected better results. Remember in your case EPAP is what controls OA, not pressure support or IPAP. Your strategy needs to be to increase EPAP minimum pressure. The IPAP is just there for comfort or hypopnea reduction. You may want to increase EPAP min to 12.0 and take that 20 cm limit off the IPAP pressure and see if that reduces events. Your machine is capable of higher pressure that may be needed to help here.

Keep trying the cervical collar, but if it does not make a difference pretty soon, then it might be you need to discuss this problem with the doctors.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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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.
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#14
RE: CPAP - BiPAP Help Needed
(08-23-2017, 10:54 AM)Sleeprider Wrote: I expected better results.  Remember in your case EPAP is what controls OA, not pressure support or IPAP.  Your strategy needs to be to increase EPAP minimum pressure.  The IPAP is just there for comfort or hypopnea reduction. You may want to increase EPAP min to 12.0 and take that 20 cm limit off the IPAP pressure and see if that reduces events.   Your machine is capable of higher pressure that may be needed to help here.  

Keep trying the cervical collar, but if it does not make a difference pretty soon, then it might be you need to discuss this problem with the doctors.

Hi Sleeprider

Thanks for the update

So what shall i set the IPAP to?

EPAP 12
IPAP 16
PS 4

Sorry for being so dumb Sad
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#15
RE: CPAP - BiPAP Help Needed
It appears you have the S9 VPAP Auto. That machine is capable of IPAP up to 25 cm IPAP pressure...use it. I am suggesting
Mode Vauto
EPAP 12
IPAP 25
PS 4.

We have several members who need more than 20 cm to get the therapy they need. In Vauto mode, your pressure will start out at 16/12, and has the potential to increase to 25/21. If that does not break the obstructive apnea, we need to get you back to the doctor.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
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#16
RE: CPAP - BiPAP Help Needed
(08-23-2017, 03:03 PM)Sleeprider Wrote: It appears you have the S9 VPAP Auto. That machine is capable of IPAP up to 25 cm IPAP pressure...use it.  I am suggesting
Mode Vauto
EPAP 12
IPAP 25
PS 4.

We have several members who need more than 20 cm to get the therapy they need.  In Vauto mode, your pressure will start out at 16/12, and has the potential to increase to 25/21.  If that does not break the obstructive apnea, we need to get you back to the doctor.


Awesome......got an AHI of 8 on the machine....will.upload SH later
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#17
RE: CPAP - BiPAP Help Needed
Hello Sleeprider

Thank you so much for the support

Last night I tried sleeping on side with the collar...woke up after an hour and then continued. attached are reports combined and separated

what do you think?

http://i.imgur.com/3S9FIFd.png[/img]][Image: 3S9FIFd.png]

http://i.imgur.com/5hgnIGj.png[/img]][Image: 5hgnIGj.png]

http://i.imgur.com/AEBOVSJ.png[/img]][Image: AEBOVSJ.png]
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#18
RE: CPAP - BiPAP Help Needed
You did respond positively to the increased pressure. Its really high and you still have considerable apnea, however the improvement is encouraging. What was the result of your sleep studies and titration, and has your doctor ever discussed your obstructive apnea? Have you ever been evaluated by an ear, nose, throat (ENT) specialist? Do you have any known respiratory issues (COPD, asthma, restriction)?

Your respiratory stats look pretty good with good tidal volume and relatively slow respiration rate. We might want to increase the Ti max setting. When you get a chance let me know what your Ti min and Ti max settings are at. Since these settings are new and high pressure, I think we should avoid changes for a few days and see how this settles in. Also, would like to see some close-up views of your respiratory flow rate so we can see what the timing and wave-form look like.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
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#19
RE: CPAP - BiPAP Help Needed
This is a chart on setting Ti min and Ti max FYI

[Image: YYAYv90h.png]
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
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#20
RE: CPAP - BiPAP Help Needed
(08-24-2017, 07:42 AM)Sleeprider Wrote: You did respond positively to the increased pressure.  Its really high and you still have considerable apnea, however the improvement is encouraging.  What was the result of your sleep studies and titration, and has your doctor ever discussed your obstructive apnea?  Have you ever been evaluated by an ear, nose, throat (ENT) specialist? Do you have any known respiratory issues (COPD, asthma, restriction)?

Your respiratory stats look pretty good with good tidal volume and relatively slow respiration rate.  We might want to increase the Ti max setting. When you get a chance let me know what your Ti min and Ti max settings are at.  Since these settings are new and high pressure, I think we should avoid changes for a few days and see how this settles in.  Also, would like to see some close-up views of your respiratory flow rate so we can see what the timing and wave-form look like.

Hi Sleeprider

I can recall the results shows severe apnea. as I explained earlier...after  my sleep study i didnt purchased the machine. test was done approx 5 years back
i dont have any respiratory issues

please check full data of the machine here : https://www.dropbox.com/s/4mb558qu9yerool/S9.zip?dl=0

Settings:

Ti Max 2.0
Ti Min 0.3
Trigger Med
Cycle Med
Max Ramp 10 min
Start EPAP 8.0
Mask Full Face
Tube Slimline
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