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Feeling hopeless
#1
Feeling hopeless
Hello, was referred here from a fb group. I am a 10+ yr cpap/bipap user. I currently have a resmed aircurve10 vauto  I use a full face mask. Sleep dr had my pressures at 9-18 with a ps5. My OA are pretty well in check but every since my dr upped my ps from 4 to 5, my ca has increased. Last night was one of my better nights as of late. AHI of 3.75, CA 2.59% OA .78% I’ve been running a AHI near or over 10 a lot old nights. Not sure where to start. Talked to dr last week and he says stress or season change can cause increase in CA? He doesn’t want to fool with my numbers until I see him next month, but I am open to changing settings myself
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#2
RE: Feeling hopeless
Doctor is not helping. If the increase in PS was for some good reason, like decreasing flow limitation or improving ventilation, then we can still set the trigger sensitivity to high or very-high to lower CA events. Otherwise, I suggest we just back-off on PS to 4.0 and still increase trigger sensitivity to high and start this experiment in a more disciplined and conservative approach. With the Vauto, we don't need to move settings by a full cm-H2O increment, but can modify settings by 0.2 cm.

Let's try to understand better why you accepted this increased PS setting, and in the meantime increase the trigger sensitivity. That will put you at the same settings I have used for many years. We can quiet the CA and get you more comfortable with 9-18 PS 4 Trigger Sensitivity High, and you can thank me in the morning (I don't bill).
Sleeprider
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#3
RE: Feeling hopeless
Thanks, I increased trigger to high last night after an even worse numbers night, so they did come down some. Dr increased the ps from 4 to 5 because I had complained about a feeling of not enough pressure.
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#4
RE: Feeling hopeless
If you want to reduce CA further, and you are now using PS 5, try PS 4.6 and see if that improves results along with the high trigger. You can also try very-high trigger sensitivity. Your CA problem is related to the pressure support and timing of your BPAP therapy rather than any physiologic reason. Higher trigger sensitivity simply means that it takes less flow to trigger IPAP which is often a sufficient queue to terminate what would otherwise be a missed breath (CA). Getting a look at an Oscar detail chart would help us be more concise.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
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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.
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#5
RE: Feeling hopeless
Just seen my results from last night. I backed the ps down to 4 and my ahi jumped back up to 7.2 I’m going to look at the data on Oscar in a few minutes. What all data should I post pics of?
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#6
RE: Feeling hopeless
The Daily screen in the Standard view. The default order of the graphs are displayed by the order of importance. Use the F12 key (Fn+F12 for Mac users) to take the screenshot. This will collapse the Calendar and/or the Right sidebar, if either one is open. Please avoid using the Print Screen button.
Crimson Nape
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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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#7
RE: Feeling hopeless
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#8
RE: Feeling hopeless
When you post your next chart, please include all and only these graphs in a single screen shot:

Events
Flow rate
Pressure
Leaks
Flow limitations
Snores.

You can squeeze the graphs a little by grabbing the gray bars that separate them and pushing them up. Left-click and drag to reorder the graphs.

I think it will also be helpful to your advisors here if you post one or two zoomed-in views of some CAs. Please zoom in to a stretch of about 3 minutes. Be sure to include the time leading up to the CA.
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#9
RE: Feeling hopeless
Mike, I would set the Trigger setting to High, initially.  If the CAs persist, increase it to Very High.   I would also increase the minimum pressure from 9 to 10 cm.   You don't seem to be using the current lower pressure for very long.  

As Dormeo requested, it would be nice to see a zoomed in view of your Flow Rate.  This will help in seeing how effective your PS of 4 is performing.

- Red
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
___________________________________
Useful Links -or- When All Else Fails:
The Guide to Understanding OSCAR
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Apnea Helpful Tips

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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#10
RE: Feeling hopeless
how can i post a zoomed in shot
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