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My Journey from BiPAP Auto to Aircurve 10 Vauto
#1
My Journey from BiPAP Auto to Aircurve 10 Vauto
My AHI was the best ever but the leak rate was strange and I had 3 lines on the pressure I don't under stand.  Can anyone shed some light on the data from OSCAR?  What do I need to try to "change"?
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed 
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#2
RE: Newbe First time using APAP mode
If you look at your detailed data on the left, you will see 3 listings, Pressure, EPAP Set, and IPAP Set. These seem to correspond to the pressure graph.
Crimson Nape
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#3
RE: Newbe First time using BiPAP Auto mode
Stacey, I updated your thread title to show this is a BiPAP Auto not APAP.

I had not seen the pressure line on my graphs before in Sleepyhead OSCAR or Encore when I used a Respironics System One auto BiPAP, but in the latest version of OSCAR it is clearly there. I'm unsure of the source of that data and will ask the the Oscar Developer "Sawinglogz" where that come from.
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#4
RE: Newbe First time using BiPAP Auto mode
Your night looks great overall, with just one interval of about 20 minutes large leak -- since you're not seeing tons of large leaks throughout the night, I don't see a big problem. Leaks like this sometimes happen to me when I wedge my face into the pillow a funny way, until I move again. If, on the other hand, we saw lots of large leaking throughout the night with really high IPAP pressures, I'd be more concerned.

On the PRS1 BiPAP machines, the pressure measurement channel appears to be the 2-minute average pressure applied to the mask, which puts it somewhere between the commanded EPAP and IPAP pressure (the EPAP Set and IPAP Set channels). Since inspiratory time (Ti) is generally shorter than expiratory time (Te), the average is usually closer to EPAP than IPAP.

In terms of practical use, it's probably only useful as an indication of your Ti/Te ratio.

(Annoyingly, on non-BiPAP machines the pressure channel appears to more closely track the effective EPAP due to Flex pressure reduction. OSCAR now correctly distinguishes between these two uses. Also, the "leak rate" on your machine is calculated by OSCAR from the "total leak rate" that's reported by the machine itself. I haven't reviewed that calculation's accuracy. Only the PRS1 ASV and ventilators report both total leak and unintentional leak. The "large leak" flag is reported by the machine, though, so that should be accurate.)

So things are looking pretty good to me. How do you feel?
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#5
RE: Newbe First time using BiPAP Auto mode
I wake up several times each night and feel it all day. I am doing better but not good yet. I ordered a double mouth guard and hope that will help with waking up so much. I have tried full face makes but could not sleep with them so I went back to a nose type mask.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed 
Cervical Collar     Dealing w DME     Chart Organizing
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#6
RE: Newbe First time using BiPAP Auto mode
You could consider mouth tape and/or chin straps if they become needed to help with keeping the mouth closed. I don't know much about the tape aspect, and I've yet to use a chin strap. I am considering Supplier #37 for their version of the strap in the future to try again nasal and pillows.
Dave

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#7
RE: Newbe First time using BiPAP Auto mode
Worse night I have had in a month.  2 questions, what is a clear airway (looked in wiki - nothing) 2. I was having a lot of pressure leaks from my mouth, does this chart show mouth breathing also?
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed 
Cervical Collar     Dealing w DME     Chart Organizing
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#8
RE: Newbe First time using BiPAP Auto mode
Stacey, increase the PS min to 4.0. You are having a lot of flow limitation, and leaks are pretty bad about the same time as events. If you are able to post images zoomed to about a 2-minute duration, I'd like to see around 00:40 and 04:30 to get a sense of what is going on. The objective is to get in close enough to clearly see the shape of the flow rate wave-form.
Sleeprider
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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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#9
RE: Newbe First time using BiPAP Auto mode
I hope this is what you need to see..
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed 
Cervical Collar     Dealing w DME     Chart Organizing
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#10
RE: Newbe First time using BiPAP Auto mode
I can see the flow limitation, and it would be even more dramatic a bit closer, thus the request for a 2-minute segment. We usually try to treat that with more pressure support. Your current settings are PS min 3.5 and PS max 5.0. In both these images PS is at 3.5 and it's not enough, so we're going to increase PS min until we can impact the flow limits. Notice how you are getting short-changed on PS with the Philips BiPAP. Pressure is at 11.9 and IPAP at 14.5 which is a difference of only 2.6 PS. This may be a function of BiFlex but it leaves you with a lot of FL which grows into hypopnea and RERA. The concern is that we don't trigger more CA events. We may be able to reduce EPAP min to lower overall pressure, but the priority right now is to increase PS.
Sleeprider
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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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