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How to stop FOT arousals?
#1
How to stop FOT arousals?
Hello,

I am a young male suffering from Upper Airway Resistance Syndrome (UARS). I have been treating this with a ResMed AirCurve 10 VAuto and have been experiencing mild improvements, but because I want to fix this problem permanently I just had an MSE (Maxillary Skeletal Expander) appliance installed to improve my sleep and breathing. 

Looking at the Flow Rate, there are times where I get a lot of FOT. My guess is I would be developing a Central but the machine uses FOT to prevent Centrals from happening. I've managed to get rid of most of the flagged events with my current settings but my sleep is still not completely restful and I think the FOT is partly to blame. 

Does anybody know how to get rid of or reduce the FOT? I was thinking it's possible the machine could be "over-ventilating" from too high of a Pressure Support. I'm running 14 IPAP/10 EPAP right now but was thinking about lowering the PS from 4 to 3 and see if this helps. 

Thoughts?


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#2
RE: How to stop FOT arousals?
Need more details. Post zooms of the full data, not just your mask pressure chart.

The only way to get rid of FOT is to get rid of the obstructive or central pauses in breathing causing FOT to trigger. You have to fix the problem, not the symptom.
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#3
RE: How to stop FOT arousals?
Here is my data from the last few days.

I got rid of most of the flagged events, partly because I started sleeping regularly with a soft cervical collar to reduce positional Flow Limitations. But I still get a lot of FOT and my sleep is not always restful.


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#4
RE: How to stop FOT arousals?
Show some of the zoomed in examples where FOT if present (like the first views you posted but including the other graphs).
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#5
RE: How to stop FOT arousals?
Here is a few examples of what was going on when I was having the FOT.


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#6
RE: How to stop FOT arousals?
I don't think the FOT has anything to do with your sleep quality.

I am not sure that these are even apnea related, they appear to just be long slow exhalations.

Looking at your previous thread you are using very high trigger and sounds like you found some improvement with that. Have you tried adjusting cycle and what is it set at?

You can try a PS of 3 to see if it has any effect on this stuff.
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#7
RE: How to stop FOT arousals?
I'd be curious to know the time between the sharp rise in mask pressure and the start of the FOT. Is it consistent? And is there a respiration rate setting in the clinical menu, or a Te-max setting?

I really should get a Clinicians manual for the VAuto, because I think I'd like to have a VAuto.
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#8
RE: How to stop FOT arousals?
I'm wondering if PS down to 3 would help. A direct answer to the FOT...I think if you run S mode, there's a setting pertaining to the FOT (edit... Easy Breathe option off supposedly turns off FOT) But...I don't think that's your issue. I'm not saying I know what exactly is or isn't the problem, but I'm thinking a very limited group have issues with FOT.
Dave

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#9
RE: How to stop FOT arousals?
(06-26-2021, 04:59 PM)Geer1 Wrote: I don't think the FOT has anything to do with your sleep quality.

I am not sure that these are even apnea related, they appear to just be long slow exhalations.

Looking at your previous thread you are using very high trigger and sounds like you found some improvement with that. Have you tried adjusting cycle and what is it set at?

You can try a PS of 3 to see if it has any effect on this stuff.

I'm going to try PS of 3 tonight just to see what happens and how it goes in the Oscar data. Bringing Trigger up to Very High got rid of more Centrals but I still have Cycle set to Medium. What do you think I should try changing Cycle to? I'm probably just going to change one setting at a time and track how I feel night-by-night. I think one thing that is impeding progress/recovery is I usually mouth-breathe but I'm hoping as I continue to expand with MSE my nasal breathing will really improve.
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#10
RE: How to stop FOT arousals?
No Te max (which would effectively be backup rate). You can adjust trigger and cycle sensitivities (how early the pressure changes for inhale/exhale) and min/max inhalation times but most of those won't affect this. Cycle sensitivity might have an effect if it gets exhalation in sync with spontaneous exhalation better (most people prefer a lower cycle sensitivity but in this case perhaps a higher/faster one may be preferable). All he can do is try adjusting it to see if it has any effect.

If the FOT is having any effect it is kick starting the next inhalation. Doesn't appear to be causing any arousals in the examples given so not likely to be causing any symptoms.
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