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Just diagnosed but headed back for 2nd study. Advice?
#41
The Respironics BiPAP titration protocol is available on the internet and is pretty simple to follow http://incenter.medical.philips.com/docl...%3d9792335 . Essentially, it starts at a pressure of 8/4, and increases until OA is less than 2/hour. If Hypopnea is present, then pressure support is increased. For the BiPAP Auto, these settings are recommended
• Set MinEPAP at 6 to 8 cm H2O
• Set PSmin at 4 cm H2O or patient comfort
• Set MaxIPAP to 25 cm H2O
• Set PSmax to 8 cm H2O
• Set Bi-Flex to patient comfort

With that said, the BiPAP auto may not increase pressure fast enough to prevent OA, so EPAP would be increased until that happens. At least you would get to find out where the comfort / efficacy threshold is. It's a lot better to wear it with less than perfect results, than to go without the therapy at all.
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#42
Hi,
I am in the same situation as user Piggles was.
My IAH is 48,09 and I just bought a Resmed Autoset S9.
Currently using it on Auto for 4 nights , on day 1 and on day 3 after two hours my cheeks get so full of air I look like a balloon and leaking starts at the top of the mask.
I dont know what pressure settings I should use since the waiting lists to see a neumologist in my home country Spain are endless and my next appointment is for February 7. Could you please help me?
Thanks a lot in advance.
Greetings from Spain,

JUAN
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#43
Nito, bien venido. Your AHI of 48 can probably be well-treated at reasonable pressures, and you have a great machine to help. For starters, set your S9 at a minimum pressure of 8.0 cm, and a maximum pressure of 14. Use the EPR feature if you want. Download SleepyHead and get some data on what your treated AHI is, and the pressure range the machine is using. This will give you a start at lower pressure so you can begin to adapt to the pressure, and will give us information needed to begin optimizing your settings.

Learning to breath through your nose and controlling air pressure is something you can practice when you are awake. Keeping the tongue against the top of your mouth and blocking the throat can really help. Think of creating suction between the roof of your mouth and the tongue, and it will help.

Welcome to Apenaboard and please consider starting your own thread so you can receive individual help.
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#44
Hi Nito,
Look on SleepyHead or on your machine display and let us know what your 90% pressure reading is. I'm assuming your machine is set to a wide open range of 4-20. I suspect your pressure is not set correct.

If you can find your 90% reading, then set the minimum at 2cm below that number and set the maximum to 2cm above the 90% number.

With an AHI of 48, do you know the breakdown? Obstructives, Hypopneas, Clear Airways?

Do you know the leak rate?

It sounds like you are having mask leaks. Try using some mask liners. Don't overtighten the straps.

OpalRose
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#45
I was actually able to get some sleep with the lower pressures (which stayed low for awhile before a lot of events happened). Here is a screen shot. Flow Limit chart for whatever reason was not there so it isn't included. Any thoughts on how I should proceed?

[Image: Ob73jvc.png]
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#46
Pretty cool stuff here. What happened was something I don't see very often. Your machine EPAP stayed relatively low, and PS increased to raise IPAP over 18 to resolve hypopnea. Let's cap IPAPmax at 18 and let everything else ride.
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#47
Thank you. I'm pretty excited about this. I actually woke up in a panic because the pressure was so low that I thought I had turned it off in my sleep Dielaughing. After trying to deal with 20 fixed epap this was a breeze.
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#48
Well, really all you did was to start the titration over again "by the book". Great move and well done! It's always fun to beat the pros by going back to basics.
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#49
Here are my last two days charts. I thought I had capped IPAP at 18 but for whatever reason the setting didn't save. I didn't notice until reviewing the charts. I've made sure the change has been made going forward.

[Image: lTFxS36.png]
[Image: YIcZ741.png]

Things are looking pretty good AHI wise.
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#50
Well dang! It's going to be hard to keep up with that! How are you ever going to explain this to the people that titrated you at 24/20.

time to update your profile.
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