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More EPAP, IPAP or Pressure Support?
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Sleepster Offline
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Posts: 4,989
Joined: Feb 2012

Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #11
RE: More EPAP, IPAP or Pressure Support?
(11-28-2015 07:36 PM)Cookie Wrote:  I made a second change to EPAP 10 IPAP 18 and pressure support to 4-8.

Do you mean a min EPAP of 10 and a Max IPAP of 18?

Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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.
11-28-2015 08:44 PM
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Cookie Offline

Members

Posts: 17
Joined: Aug 2015

Machine: resprionics system one 760 P
Mask Type: Full face mask
Mask Make & Model: mirage quattro
Humidifier: resprionics system one
CPAP Pressure: 10-18.0 PS 4-8
CPAP Software: SleepyHead

Other Comments:

Sex: Female
Location: Sebago Maine

Post: #12
RE: More EPAP, IPAP or Pressure Support?
Yes. Sorry that wasn't very clear.
11-28-2015 09:06 PM
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Cookie Offline

Members

Posts: 17
Joined: Aug 2015

Machine: resprionics system one 760 P
Mask Type: Full face mask
Mask Make & Model: mirage quattro
Humidifier: resprionics system one
CPAP Pressure: 10-18.0 PS 4-8
CPAP Software: SleepyHead

Other Comments:

Sex: Female
Location: Sebago Maine

Post: #13
RE: More EPAP, IPAP or Pressure Support?
Last night I increased my min EPAP to 10.5 and my max IPAP to 19, my pressure support remained at 4-8.

I do not feel that I slept sound last night. Looking at sleepyhead I had a significant number of RERA's but some of that I can attribute to an unrelated pain issue.

Even though I raised my max IPAP to 19 I still reached that max.

I did see a significant increase in CA's. Does that mean that I raised my pressures too much?

Should I have narrowed my pressure support to 6-8 from 4-8 and left my pressures lower? I have seen a trend since my last 2 changes that my AHI is high almost every night for the first 2-3 hours and then tapers down. Is this because my pressure support has not risen enough to take care of the obstructive events?

Not sure I made the right change, any advice is appreciated.

As I have said in the past I am not always quick to adjust to changes even though they may be small. So understanding that one night doesn't provide a trend or all of the answers here is a look at last night's chart.    

I am willing to leave these changes in place for the week to see how the week goes unless it seems that I am moving in the wrong direction.

Thanks to all who take the time to read and offer advice
11-29-2015 10:14 AM
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Sleeprider Online
Wiki Editor
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Posts: 3,318
Joined: Dec 2014

Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Where they make Respironics

Post: #14
RE: More EPAP, IPAP or Pressure Support?
Your latest results indicate that you have reduced OA events, but may have replaced them with CA. I use the same machine, and find it takes some time to let new settings settle in, so it may be best to stand pat, however I have a recommendation.

Return your EPAP min to the previous setting of 10.0, leave IPAP max at 19, reduce PS MAX by 1.0 to not exceed 7.0. You are experiencing CA when the PS increases to the maximum allowed, while still allowing some H and OA to get through. I'd rather see the EPAP increase automatically, but for some reason it is flat-lining at your minimum setting of 10.5.

CA in your case seems driven by excess pressure support. Limiting PS should avoid over-ventilation and cause the machine to increase both EPAP and IPAP as necessary to deal with flow limitations. It's too early to pass judgement on RERA, but I think reducing the range of PS may be the ultimate solution. If RERA seems to continue when PS is near the bottom of its span (4.0), then narrowing the span to 4.5 or 5.0 to 7.0 might be the answer. Take it slow.

______________________________________________
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11-29-2015 11:05 AM
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Sleepster Offline
Wiki Editor
Moderators

Posts: 4,989
Joined: Feb 2012

Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #15
RE: More EPAP, IPAP or Pressure Support?
Cookie, I cannot raise my PS much above 4.4 as it elevates my CA index. Although this is not a common condition, I have seen documentation of it. It happens to some people.

Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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.
11-29-2015 02:30 PM
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