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Feedback, please
#11
RE: Feedback, please
A pressure of 4.0 cm is only 0.05 PSI. It is basically no pressure at all, and it is the lowest threshold of pressure the machine can produce. Flow rates are low and may not meet your needs. Your Tidal volume is 440 mL, which is average, but your pressure is exceptionally low and I think this is contributing to your high respiration rate.

Even at 7.0 cm, you get less than 0.1 PSI, but at least it is something. The system is pressurized and can better supply your respiratory needs during inspiration. Higher inspiratory pressure reduces inspiratory effort. Breathing is easier, and you will probably see an improvement in tidal volume and minute vent, which in turn may reduce the respiration rate. Higher pressure, especially during exhale improves oxygen uptake. With higher pressure, a higher EPR or pressure support (difference between inhale and exhale pressure) can be delivered. This improves ventilation. I can cite many references, but this is pretty basic non-invasive ventilation principles.
Sleeprider
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#12
RE: Feedback, please
To put it simply as I can, at a minimum pressure of 4 (though you machine says you are at 6?) you can breathe more air than the machine can supply, so people feel air starved.
I feel as if I am choking at 4.
I think if you were to put your pressure up to 7.5 or 8 it would be a lot easier for you to breathe and get some sleep.
For a start the pressure will not rise so quickly or suddenly and disturb your sleep, this though you might not waken, your brain and body knows there has been a big change i.e. if it were to go from 4 to 12, that is quite a rise in pressure and though you might stay asleep, it might have almost the same affect where your brain wakes you up just enough (previously to make you breathe) and now because of the rise in pressure wakes you just enough to adjust to the pressure.
So, if you raise the pressure, not only will you stop a lot of the problems happening in the first place, you will not notice the rise in pressure the same.
If on the other hand you are fighting to breathe out when the pressure rises, you may need to turn on pressure relief.  I think they call it "Flex" or "C Flex" on Philips Resperonics machines.  This will drop the pressure and allow you to breathe out a lot easier, though it has a slight impact on your therapy, I wouldn't worry about it as long as your machine can rise in pressure if it needs to.
I am NOT a doctor.  I try to help, but do not take what I say as medical advice.


Every journey, however large or small starts with the first step.

Sleep-well
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#13
RE: Feedback, please
(07-05-2018, 09:04 PM)Sleeprider Wrote: <snip>
…  Higher pressure, especially during exhale improves oxygen uptake.  With higher pressure, a higher EPR or pressure support (difference between inhale and exhale pressure) can be delivered. This improves ventilation.  

Sleeprider, that seems backwards to me.  It seems that we would want lower pressure to make exhaling easier.  So does the pressure slow the exhale and let more O₂ be absorbed?   Thinking-about
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#14
RE: Feedback, please
Oxygenation is related to "PEEP" Positive End Expiratory Pressure. This is the same as the EPAP on your machine.  Higher PEEP results in higher oxygenation.  Higher pressure support results in greater ventilation and lower CO2.  http://www.jonathandownham.com/mechanica...-pressure/   Remember higher EPAP does not mean you cannot also use pressure support. Pressure support starts from EPAP and adds up to 3-cm in your case with EPR, or can add much more with conventional BPAP So look at EPAP/PEEP as a separate issue from Pressure Support (PS). Lots of information on PEEP and PS in mechanical ventilation if you want to search.

For your graduation exercise, we will now dissect and observe the effects of ventilation and PEEP on some animal lungs. Smile



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#15
RE: Feedback, please
I reset the bottom end of my pressure to 8 cm last night and here is my data. I woke up twice and both times had to use the restroom fairly urgently. Hard to know if that is the apnea waking me up or the bladder waking me up. I suspect it is the apnea. 

Thanks for all of the amazing info about respiratory rates. I wish my doctor had the time/interest in reviewing this stuff with me. I have learned that I have to be my own advocate, and this information is helping me a lot.
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#16
RE: Feedback, please
Hopefully you found the higher minimum pressure to be more comfortable. I'm a little lost how you got started on such low (4-cm) pressure, and it is not really in a comfortable or therapeutic range. Your latest results show some improvements in VS, FL and H, and there is a bit more OA. I think try this a few nights before drawing any conclusions, but it looks pretty good.
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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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#17
RE: Feedback, please
Is the data I posted showing that my pressure was at 4 last night? I want to make sure I am reading it correctly.
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#18
RE: Feedback, please
The minimum pressure is set to 7cm.
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#19
RE: Feedback, please
Okay, thanks. I went in and checked the settings. It looks like the ramp was set at 7.
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#20
RE: Feedback, please
I was thinking about another post and forgot to correct or edit when I saw the pressure was higher. Walls can verify it happens to me sometimes.
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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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