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Data analysis
#11
RE: Data analysis
Hi StuartC,
Actually, I have no intention to buy BiPAP as I have to buy on my own. Its the Dr who was pushing it as I told that I am not feeling better after using APAP.

Last night I used the EPR=3, Min=4, Max=10. I have attached the OSCAR report in my last post on this thread. Are you suggesting to change it to CPAP Mode and set fix pressure at 9 & EPR=3? Earlier in the thread someone suggested to change to APAP mode.

which would be the optimum setting?

I surely will try soft collar tonight.
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#12
RE: Data analysis
I simply suggested fixed based on your charts that were fixed CPAP, pressure 6, with EPR off (so EPAP 6). Also a BiPAP titration in a sleep lab would use fixed pressure in most cases, even though a VAuto can do auto with PS of 4 plus.

Your min (or fixed) pressure should always be 4 + EPR, or higher if you need an EPAP above 4. Otherwise the auto mode has to increase the pressure to that to get the full benefit of the EPR that you have set

That said, your flow limits were low for most of the night on APAP with pressure less than 7, i.e with EPR less than 3. So your doctor is possibly wrong about the BiPAP anyway, because EPR as high as 3 may not be so important. Still worth a try though with min pressure at 7.
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#13
RE: Data analysis
T818,

I suggested APAP mode at a fixed pressure of 7 cm because,
1. I was not sure why you were using your Autoset as a fixed pressure CPAP.
2. I started with 7 cm because that is the lowest pressure that will give EPR of 3. I wanted to see if EPR 3 would help with the central apnea. The AirSense 10 Autoset (and I think most, if not all CPAPs have a minimum pressure of 4 cm.
3. I also started with 7 because I wanted to work slowly because of what you said.
[I felt most comfgortable with pressure set to 6. Above that I keep waking up due to access air in stomach.]

Do you feel any better this morning. Did you sleep on your side or back?

Did you change the AirSence 10 settings to full face mask.?
Did you feel you had enough air to breath with your FF mask last night?

---

Your posted test are very helpful.

Your treatment seems a bit odd. You still had events. I would expect to see a range of pressures showing ow well/or not well each pressure setting was.

Do you have other medical issues? I have never seen an upright sleep study before.

Your treatment seems a bit odd. You still had events. I would expect to see a range of pressures showing ow well/or not well each pressure setting was.

I would think the recommendation would be like a BPAP ST - the T because of the Centrals or the ASV, but has more limitation for some medical conditions.

With the recommended BPAP S set to IPAP 10 cm and EPAP 6 cm, you still had events.

------

I would recommend you keep using the face mask.

Set the AirSense 10 to Auto min 7, max 10.5, EPR 3. I know this is a low setting, but since you were not titrated at a higher setting I want to go slow.

Your titration would be more like 9 cm minimum, EPR 3 to give 6 cm minimum of the study. If you can do that pressure then do 9 cm min 10 max EPR 3.

Start taking notes how you are feeling upon awaking up and through the day. How you slept.

For now the goal is for you to get better sleep without increasing Centrals with the machine you have. And following up with other test and talking to the doctors.
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#14
RE: Data analysis
Hi Keepsimiling,
Thanks for your valuable inputs again.
In this part of the world, its very difficult to get qualified sleep consultants, and technicians. In the reports, I could spot a few errors which doesn't make sense.
For now, I have to keep going with whatever service is available.

About your query on health issues, I don't have any other significant issues (I have IBS but don't think it's related) so far diagnosed. Mild deviated septum and a small nasopharyngeal mass is there. ENT doc said it's not causing my apnea. Using nasal spray each night for allergies. Echo, ECG, Spirometry and blood tests are normal. I have attached them. only C02 is little bit higher than reference value and maybe morning cortisol little bit lower though its within the limit.

I have made the changes you have suggested. Using a cervical collar & mouth taping (using full face mask all along but always got bloated stomach). I do feel lot better.
I have attached the reports after modifications. I am seeing clustered CA events. Should I lower my EPR settings to 2 and see if it works better? Let me know if you have any other observations and suggestions.


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#15
RE: Data analysis
In the Comfort settings, there is one parameter Response = Soft or Standard (where the EPR , ramp options are shown). which options it should be ...soft or standard? what does it do?
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#16
RE: Data analysis
It is how fast the CPAP increases to the inhale pressure setting. The "Soft" mode mimics a person's normal inhale pattern. The "Standard" mode can be thought of as launching off an aircraft carrier. Smile Try it out. For the maximum effect, set the EPR to 3. I find it rather uncomfortable.

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Crimson Nape
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#17
RE: Data analysis
T818

Do not post your name, personal info.
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#18
RE: Data analysis
What kind of mask were you wearing on Fri, Nov 18.

For Tue Nov 22, can you expand the CA clusters.

I suggest 8cm CPAP with nasal mask. EPR off. I want to see the results you get on your machine.

According to the report with 8cm "normal' oxygen levels were maintained. I want to see what results you get.
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#19
RE: Data analysis
Crimson nape,
Understood. Wink thanks.

Keepsmiling,

What kind of mask were you wearing on Fri, Nov 18.
=> Dreamwear full face mask(only mask i have been using)


For Tue Nov 22, can you expand the CA clusters.
=>pls have it attached

I suggest 8cm CPAP with nasal mask. EPR off. I want to see the results you get on your machine.According to the report with 8cm "normal' oxygen levels were maintained. I want to see what results you get.
=> They made a mistake in the report. Full face mask was used not nasal mask. I will set to 8cm & EPR off but I dont have any nasal mask. Will share the result.

(removed files showing personal info)


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#20
RE: Data analysis
Keepsmiling,
Attached report after modifying to 8cm fixed pressure & EPR off. Please have a look.
Flow limit has gone really up compared to 7-10.5 & EPR-3 settings.


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