Newbie needing help. CPAP or VPAP?

[filo4u]

Good morning!

Wow this is an amazing forum! robysue and DeepBreathing thank you soo much for the your reply and well written explanation.

I did have issues with aerophagia when I tried the setting PS 4.0 over 8.0-19.0 (cmH2O) so last night I tried PS 4.0 over 10.8-16.0 (cmH2O). I do feel better today but I was hitting max IPAP pressure alot last night so I might need to increase it to 17.

I was able to reduce leaks with DeepBreathing's suggestions

Snore seems to be the trigger in the pressure changes. Sorry I had to delete my previous attachment because I hit my attachment limit.

[robysue]

Wow this is an amazing forum! robysue and DeepBreathing thank you soo much for the your reply and well written explanation.

Your welcome!

I did have issues with aerophagia when I tried the setting PS 4.0 over 8.0-19.0 (cmH2O) so last night I tried PS 4.0 over 10.8-16.0 (cmH2O). I do feel better today but I was hitting max IPAP pressure alot last night so I might need to increase it to 17.

Your AHI last night was 0.99 and the pressure increases were almost all due to some flow limitations and some snoring. If I were you, I'd focus first on making sure the aerophagia is indeed under control even it means tolerating more flow limitations or snoring than some people would say is desirable.

In other words, I'd leave the max pressure at 16cm for a week or so before reassessing whether to increase the pressure or not.

There's nothing wrong, per se, with hitting your max pressure multiple times during the night. Indeed, there's nothing particularly wrong with having your 95% pressure setting being equal to your max pressure setting if the AHI is well below 5.0 and you are feeling well during the daytime. In my case, my median IPAP is often equal to my max IPAP, but I still don't increase it because increasing the max pressure is not going to substantially reduce my AHI, the flow limitations, or the snoring, but it will increase my aerophagia, and with the increased aerophagia comes less sound sleep and feeling much worse in daytime.

Snore seems to be the trigger in the pressure changes. Sorry I had to delete my previous attachment because I hit my attachment limit.

Your data shows that both snoring and flow limitations are likely the causes for your pressure increases. But in your case they are not particularly predictive of future apnea events at these pressures. Hence it is ok to tolerate some snoring and flow limitations with a max pressure of 16cm if that makes the gas problem less. Remember the point of PAP is to feel better with the machine than without it, and getting the aerophagia under control is an important part of feeling better.

[filo4u]

Thank you again robysue!

I wasn't able to see your reply until today and increased my IPAP pressure last night to 17. I also raised the pressure support from 4 to 5 and today I fell really good with less gas compared to IPAP 16 with PS of 4. My pressure graph also looks a lot smoother! Can't wait to get some decent sleep again tonight.

Good night!