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High CA in PSG and with Bipap
#11
RE: High CA in PSG and with Bipap
I don't know why my doctor prescribed BIPAP vs CPAP.
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#12
RE: High CA in PSG and with Bipap
Thanks so much for the info!
I understand EPAP and IPAP, but I don't understand PS and how it relates to EPAP and IPAP.
Could you explain?
Also, I think my settings are locked by my provider.  
I have an appointment on 12/3/17, so I can discuss it then.  If there is a way to changed the PS on my Dreamstation that I am unaware of, please let me know.
This site is a Godsend.   Providers are not interested or able because of time constraints to help new users adjust to CPAP.
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#13
RE: High CA in PSG and with Bipap
Go to the private files and download the provider guide. In the mean time you can access the therapy settings by pushing in the Round button in the front and the ramp button on top at the same time. It takes about 5 sec for it to pop up. Go to PS Min and set 3. Than go to PS Max and set 3. That will will reduce your pressure support to 3 and keep it at 3. Pressure support is the difference between EPAP and IPAP.
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#14
RE: High CA in PSG and with Bipap
Hello Dave,

How did you resolve your high CAs?

Thanks,

Joe
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#15
RE: High CA in PSG and with Bipap
Hi J Duffy. Walla Walla described pressure support well, and I apologize for throwing so many acronyms at you. The Forum Wiki has a list of acronyms can can help you interpret some of what I write. http://www.apneaboard.com/wiki/index.php?title=Acronyms

On the chart I posted last page, you can look at the pressure graph. You will see a red line which is the inhalation pressure, and there is a green line (mostly invisible) along the 4 cm line on the graph which is exhale pressure. The space in between IPAP and EPAP is the pressure support. You can also see in the statistics that IPAP and EPAP pressures are reported in the median, 95% and maximum columns, and those statistics show your pressure support is mostly 4-cm, but goes as high as 6-cm.

The reason that is important is that by having a higher inhale pressure, you use less effort to breathe, and your ventilation rate actually increases. This tends to remove CO2 from your bloodstream, and it is the reduction of CO2 from pressure support that causes the centrals. It seems you probably did not have a titration study done to set your machine pressure settings. My impression is that your best results would result from the following settings:
Mode: Bauto
EPAP min: 5.0
EPAP max 8.0
PS min: 2.0
PS max: 4.0

This would increase your minimum exhale pressure by 1-cm and help ensure obstructive apnea do not occur. The pressure support will resolve hypopnea and flow limitation in that range of 2-4 cm, without causing the central apnea that occurs at higher pressure support. All of this should still be comfortable, and much more effective.
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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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#16
RE: High CA in PSG and with Bipap
Thanks for the tip on changing PS and how to do it!
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#17
RE: High CA in PSG and with Bipap
[Image: o9ArFSz]https://imgur.com/o9ArFSz
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#18
RE: High CA in PSG and with Bipap
Lots of CA events.  I'll be interested to see your results with the suggested changes.

[Image: o9ArFSz.png]
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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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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#19
RE: High CA in PSG and with Bipap
Will do!  Thanks, SleepRider!
Do I keep the Min IPAP and Max IPAP the same?

Joe
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#20
RE: High CA in PSG and with Bipap
IPAP is simply the sum of EPAP + PS, so once you have set the minimum EPAP (5.0) and the minimum PS (2.0) the IPAP min (7.0) is set. Only max IPAP is set to prevent the machine from going too high, which is not a problem for you. Is there an IPAP min setting? Just leave IPAP max at 14 and that's good enough.
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.
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