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

[Diagnosis] Clear airway questions
#11
RE: Clear airway questions
burping, aerophagia, is more common with higher pressures. after 8 years the ca is obviously not treatment emergent. could be pressure induced, but again after 8 years, not likely. I would be amazed if you don't find better treatment & comfort with a lower exhale pressure. others will help you with settings suggestions.
Post Reply Post Reply






Donate to Apnea Board  
#12
RE: Clear airway questions
I'd agree with sheepless. Aerophagia can be addressed by a lower pressure, as well as adding comfort. Treatment emergent CA possibly does not apply, but it's not entirely ruled out just lower on the probability scale with you using CPAP for 8ish years. I believe comfort is the ruler by which you edit pressures, with events being second in your case. For comfort and aerophagia, I'd consider changing over the VAuto mode.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply
#13
RE: Clear airway questions
Mratliff, I have looked at your charts, and it's my opinion we need to completely start over with a new titration in Vauto mode. You are way over-pressurized and and this is resulting in a lot of discomfort and aerophagia.  What I'd like to do is to set you up on Vauto mode at a much lower starting pressure, using some pressure support and see if we can resolve your fragmented therapy, comfort issues and learn where you need to be in pressure.  Your current settings are essentially CPAP with no pressure relief or pressure support, so we haven't learned much yet other than you have no obstruction or flow limitation at CPAP 20.  if you want to try my approach, take the red pill, but if you'd rather remain in this unpleasant ignorant status, just take the blue pill.  The red pill follows:

Mode: Vauto
EPAP min: 9.0
Max Pressure 20.0
PS 3.0
Trigger: high
Cycle: medium
Ti Min 0.3
TiMax 1.8

These settings will allow pressure between 12/9 (IPAP/EPAP) and 20/17.  I have suggested the trigger sensitivity at high to help resolve your minimal CA events. It simply makes the transition from EPAP to IPAP a little more sentistive. The Cycle sensitivity is default as are the time of inspiration settings.  If you try these settings, we will quickly learn your toleratnce for pressure support which is conservatively set at 3.0 cm, and will learn what pressure threshold you need to avoid obstructive apnea.  We will learn from your experiment what settings are optimal.

You're welcome to take the Blue Pill and I will leave you alone and we can forget this was ever suggested. Please choose wisely.
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.
Post Reply Post Reply
#14
RE: Clear airway questions
Thank you to Sheepless, Sarcastic Dave and Sleeprider for the great information.

To Sleeprider, I am seriously considering following your recommendations for new
tritiation.  I am going to wait one night, as I was unable to download data from 
last night and want to make sure I can do that before trying anything drastic,
as we will of course need to look at the results...

One thing I should have mentioned, I do wear an oral device (Tap 2) which I
have worn all these years...  I don't know if this changes your opinion on anything..

thanks again for all your help.....
Post Reply Post Reply






Donate to Apnea Board  
#15
RE: Clear airway questions - follow up
I have a follow up question.....  To those of you who have looked at my numbers,
do my results show a person who is sleeping well?  I have very low AHI, but I
do not think I am sleeping well.   I admit that I have no idea how to read the flow
charts or respiratory charts or the others that indicate quality of sleep...

Any help or comments will be greatly appreciated....  thanks again...
Post Reply Post Reply
#16
RE: Clear airway questions
Mike, where did the original setting of fixed 18 come from? Was that recommended by a doctor, or just something you decided to try for yourself? Do you still have your original sleep study report? It might help if you could share that.

The fact you're burping could be caused by swallowing air during the night - this is called aerophagia. Constant high pressure could be a factor in aerophagia.

One of the members more experienced in VAuto machines might want to jump in here, but I'd like to propose an experiment...
  1. Put your machine into VAuto mode.
  2. Set max IPAP to 20
  3. Set Min EPAP to 10
  4. Set PS to 5

My hope is that the machine will run at a generally lower pressure (but can go up to 20 if necessary), giving you a more comfortable sleep so you can keep the mask on for longer periods. As an adjunct to this, consider your sleep hygiene - you mentioned earlier that you're frequently woken by the phone - turn it off! Make sure your room is adequately dark, turn off any distracting gadgets (phone, TV, IPad, whatever).

Let's see if these suggestions bring some relief.
Post Reply Post Reply
#17
RE: Clear airway questions
I know sometimes our recommendations often conflict with each other, and I greatly respect Deepbreathing, however I would never start anyone with PS 5 without first trying lower PS. Other than that we're mostly in agreement, however please keep your introduction to Vauto mode to PS 3.
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.
Post Reply Post Reply






Donate to Apnea Board  
#18
RE: Clear airway questions
No worries SR - I was hoping you or Fred would jump in right about now...

Mike: SR and Bonjour are the bilevel gurus around here and I'll defer to their experience with this type of machine.
Post Reply Post Reply
#19
RE: Clear airway questions - changed mode
Thanks to all the members for your help....

In the middle of the night last night I changed my settings to VAuto mode and 
put he pressures at 20 Ipap and 16 Epap.  Once I did this no more CA's and AHI of 0.  Wow...

The respiratory rate changed drastically also.  I attach this from last night.  Can anyone tell
me if this is close to normal?  What should the rate be?  thanks again for the help.


Attached Files Thumbnail(s)
   
Post Reply Post Reply
#20
RE: Clear airway questions
To my untrained eye, the right half probably represents your spontaneous breathing rate or close to it. The left half looks like respiration driven by the machine.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply






Donate to Apnea Board  


Possibly Related Threads...
Thread Author Replies Views Last Post
  [Diagnosis] High Clear Airways PB1974 5 244 07-29-2020, 09:06 AM
Last Post: rebirth
  Clear Airway Apneas philthyphil 7 632 06-15-2020, 11:42 PM
Last Post: philthyphil
Question New to CPAP, dx'd OSA, lots of clear airway events assistcontrol 5 382 04-11-2020, 07:20 PM
Last Post: SarcasticDave94
  [CPAP] 1st time APAP user. Lots of Clear Airway events? Anyway to improve without ASV? wwsleep 20 1,275 04-06-2020, 12:40 PM
Last Post: wwsleep
  Central Apnea vs Clear Airway Eishan 8 487 02-22-2020, 03:54 PM
Last Post: Sleepster
  Can Clear Airway Apnea not be Central Apnea? tomko44 18 11,305 01-21-2020, 05:05 PM
Last Post: sleepyp
  [CPAP] In OSCAR....What is the difference OBSTRUCTIVE AIRWAY " OA" vs HYPOPNEA "H" robertpsimpson 16 1,101 12-03-2019, 08:13 PM
Last Post: Dogjudge


New Posts   Today's Posts






About Apnea Board

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