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] Experimenting with CPAP titration for my wife
#21
RE: Experimenting with CPAP titration for my wife
(10-17-2019, 08:48 PM)WillSleep Wrote:
(10-17-2019, 08:16 PM)walkingdead Wrote: You got it, see attached. I had to break out the MS Paint skills because my screen is too small. Cool

Very well done.   

And now the Event recorded 9:13 is is clearly not a "True CA".  

From 9:13:22 to 9:13:35
  • The Respiratory Rate was pretty good, around 14-15 breaths per minute and slightly increasing throughout.
  • Tidal Volume was reasonably strong though-out.  
So maybe that period was combination of a continuation of the flow limit seen 10 - 20 seconds earlier and / or a Leak, each not big enough for the ResMed machine to report them.  

You saw SuperSleepers confirmation that the Autoset for Her looks like a good path.   I think that settles it.  


In the interim while awaiting that new machine any more questions for us?

WillSleep

Thanks, WillSleep. I have another chart from this morning that's a little more eventful.

Daily View
   

2 min. waveform for RERA event
   

2 min. waveform for CA event
   
Post Reply Post Reply






Donate to Apnea Board  
#22
RE: Experimenting with CPAP titration for my wife
(10-18-2019, 03:34 PM)walkingdead Wrote: Thanks, WillSleep. I have another chart from this morning that's a little more eventful.

Daily View
2 min. waveform for RERA event
2 min. waveform for CA event

Happy Friday!  

2 min. waveform for RERA event 
Usually for a RERA the first questions I ask are 1) how repetitive has this been (so how big a deal) and 2) should I try to raise pressure  (or do something else) to solve it.
  • How repetitive has this been? - So far RERA's looks pretty rare and the chart looks so good I would not be too worried about this one isolated RERA.   
  • Should I try to raise pressure to solve it?    The charts look so good I might let these roll for a few days to see what issues consistently appear and which I should ignore.  .. If I was feeling in a perfectionist mode then I would normally lift pressure a little and see if that helped.  On an Autoset I might try that in two steps.   First night or nap raise Min EPAP by 1.0. and assess what changed (good and bad).   Second step would be to then raise EPR to 3 and assess what changed (good and bad).   Then conclude on my setting going forward.
2 min. waveform for CA event   
I see this is a very low risk Clear Airway event.
  • The CA occurred just after big lung movement to recover from a flow limitation (~22 Resp Rate * ~400 Tidal Volume = Min Vent Rate = ~8.0+ ) so would not expect this short period to have caused any dangerous desaturations and the big breaths just prior might explain why it happened (big breaths just prior might have caused a CO2 wash out that caused a CA event).
  • The rest of the OSCAR charts do not confirm a CSA (Resp Rate = ~12 and Tidal Volume = ~600 = Min Vent = ~7.2L/min (7200ml/min) during the same period) which makes me suspect the accuracy of the Autoset's data reporting right then.   Makes me wonder if there is a Leak so small it is not getting reported but it is affecting the Autoset's algorithms.  
What might I do about it.. 
  • If she is using a Full Face mask I might set my iPhone by her head while she Naps and turn a Sleep recording app like Pillow to catch noises in detail at these times to help better understand what is going on.
  • If she is not using a Full Face Mask I would correct the machine's settings so smaller leaks get reported by the AutoSet.  Even if she is using a Full Face mask I might try a Nasal Mask setting for a Nap just to see if more Leaks get reported.
  • If she is not using a Full Face mask and there is any chance she is mouth breathing might try a collar, and some paper medical tape to taper her lips shut during a nap or have her use a chin strap.
  • Lastly, sooner or later (like for the RERA above)  you will try other Autoset settings.   I would assess what changes each tested setting had on these CA events.
Finally, there are many really good coaches in community who know the Autoset better than I do so seek the input of many voices as you work this forward.  

WillSleep

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
#23
RE: Experimenting with CPAP titration for my wife
Many thanks, WillSleep! Her new machine will here on Monday and this is exactly the information I needed to make adjustments for the first few weeks if the events happen more frequently. She's using a full face mask right now but I did order the P10 pillow for her to test as well so it's less obtrusive on her petite self.

I'll be sure to provide an update on how she's responding in a few weeks. If you don't hear from me sooner, you can assume things are going well!
Post Reply Post Reply


Possibly Related Threads...
Thread Author Replies Views Last Post
  Looking to get a biPAP. Is titration necessary? AlgebraicMisery 13 307 10-09-2020, 08:21 AM
Last Post: Johnnyde94
  FOUND ASV titration instructions, deep readings with the real testing gear... racprops 0 97 09-30-2020, 08:38 AM
Last Post: racprops
  Titration Issues hart1026 17 442 09-04-2020, 02:40 PM
Last Post: Sleeprider
Ohmy [Treatment] Wife just started CPAP! JamesW 3 235 09-03-2020, 09:57 PM
Last Post: staceyburke
  How can I perform a sleep titration study, on myself? NoddingHacker 7 230 08-24-2020, 08:40 AM
Last Post: bonjour
  My wife first day on the CPAP - Any feedback welcome ericmsilver 20 777 07-04-2020, 03:28 PM
Last Post: Sleeprider
  DreamStation tube noise wakes up wife if I disconnect. mjrPdqkLguUgGLE 7 629 05-16-2020, 04:05 PM
Last Post: mjrPdqkLguUgGLE


New Posts   Today's Posts






About Apnea Board

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