NEED EXPLANATIONS RE: Ti MAX/MIN, TRIGGER, CYCLE please?

[slowriter]

For the last 5 nights and the majority of my nights, my 95% reading states I am at 2.0 Inspiratory Time.

Because your TiMax is set at default of 2.0, which means you're hitting that threshold.

Change it to 3.0 and then see what it says?

[Plmnb]

 Good Morning All.


Well, as usual my results are up and down.  Even though I adjusted my Ti Max to the suggested setting of 3.0s, my overall results are mixed.

It turns out I really did need to do this.  I had many instances of surpassing the prior factory default setting of 2.0s.  I am curious, do many people need to change this setting higher than the factory default?  If so, why doesn't the doctor and/or DME address this setting?

Now, what about the Ti Min?  Based on the charts from last night I should leave the Ti min at 0.7s, correct?

Also, does last night's chart indicate it would be beneficial to go ahead and adjust the Trigger and Cycle settings, or is it too soon to determine this?  Should I post a zoom of anything?

Btw, although there is a graph for FLOW RATE in the tab with the colored stacks (what OSCAR calls the OVERVIEW tab, it is blank.  Is it supposed to be?  I just noticed this).

Thank you for your continued help,
Plmnb

EDIT:  Also, the graph with the Insp. Time is set to 2.50.  I exceed that in some places.  Should I set it to show a higher number?  If so, what should I change the range to?

[attachment=19672]

[OpalRose]

I don't know.  I'm not one to make a lot of changes unless something doesn't feel right.

How did your breathing feel after you made that T1 Max change? You can usually tell if your inspiration and exhalation feel normal or labored.

I have been trialing this machine for a month now, and I knew right away my inspiration felt cut off, like I just couldn't get a full breath. If you felt ok with the T1 Min and max settings that SleepRider suggested, then set it back. There should be a "reason" to make changes.

With that said, I don't believe those particular settings have any bearing on AHI numbers.
Someone can shed some light on this if I'm wrong.

[Sleeprider]

I'll point out my suggested Ti Max of 2.2 is equal to your 95%. That's what I use, and I don't think it serves any purpose to use 3 seconds at your respiratory rate. That said, your AHI is a bit higher, but normal, as is your flow limitation. Let's hope it's a trend.

[Plmnb]

Thanks all.

I think I'll split the difference and try 2.5 Ti Max tonight.  I'll leave the other settings alone for a bit.

It did dawn on me this morning when reviewing my video again that one reason why my machine usually shows so many separate sessions....without knowing it I take the mask off, and almost always turn the machine off, without knowing it WHEN I DO MY SIT UP SLEEP.

The shrink really didn't address this parasominia issue and neither has my sleep doctor.  I have a call in to the sleep doctor to talk about it.  This really could cause an issue with compliance requirements.

Greatful for the help as always,
Plmnb

[Plmnb]

 Hi all.

Honestly, I think my Bipap is toying with me.  I say black, Bipap says white, I say down, Bipap says up, I say yes, it says no.

I don't care about the numbers in as much as they are just numbers, I just don't feel as rested as I want to be and I get sleepy too early in the day.  Don't the numbers help to act as a guide to FEELING better?

I would like to know if the following number readouts/results for the Ti Max are inconsequential?  I also have a number of questions.      (Just trying to understand, not being obsessive, I promise). 

Because I kept hitting the wall of the factory setting of Ti Max 2.0s, It was suggested I adjust the Ti Max to 2.2s.  On my own I decided to adjust to 3.0s, just in case.  I reported my results and it was pointed out that I really didn't need to adjust to 3.0s based on my respiratory rate.  I do not know how the respiratory rate impacts the Ti Max measurements, another calculation I know nothing about, but I went ahead and sort of split the difference last night and adjusted the Ti Max down to 2.5s just in case I hit the wall at 2.2s.

I had a lot of leaks again last night at the end of my first session and the entire second session so I discounted any info from those portions of readouts. So, now I am basing last nights results on The first part of the first session and the entire third session.

I did indeed come close to and a few times did, hit the 2.5s wall, at least in the third session. Hovering over the colored stacks in the overview tab, the readouts for last night show my median 95% reading as 2.26 and my peak at 2.50s.  (The previous night was median 95% at 2.22s and peak at 2.52s).

1) Do I need to stay at the Ti Max of 2.50 for at least another night to determine where best to set this setting?

2) Since I did get a peak measurement of 2.50s last night should I go up one to 2.60s?

3) Should I set the Ti Max at 2.20s as suggested in the first place and pay no never mind to the readings I got?

4) How do the respiratory readings determine the most useful Ti Max setting? (The respiratory readout is something Sleeprider mentioned).

5) I'm still unclear as to how or if the expiratory readings figure into all this?

6) How do Flow Limits figure into all this Ti stuff if at all?  (Because I had some, one tiny blip in the first session and pretty constant in the third session). 

7) Am I making a mountain over a mole hill?

Here is my last night's OSCAR chart, so sorry about the Large Leaks...I can't get a handle on these at the moment.  One day fine, one day terrible, back and forth, rrrghh.

[attachment=19692]



Thank you in advance for your help,
Plmnb

[geauxdbl]

My first thought is that in the first part of the night, your chart looks amazing... until the leaks start. No flow limit, insp. time is stable, no events. As soon as the first leak starts, Insp. time becomes unstable and starts pegging the limit of 2.5.

Beyond that... ya got me!

[Plmnb]

I know geauxdbl, right 

This is part of the mystery of my situation.  Just when I get one thing taken care of something else goes cookoo.  I just can't seem to get it to consistently come together. 

I have a feeling everything hinges on the sitting up craziness.  I have a called the sleep doctor yesterday and they haven't called me back.  I just called the psych dr. and left a message.

I guess I should wait and see what they say.  In the meantime maybe none of my questions can be answered.

Plmnb

[Sleeprider]

There is no "wall" with setting tiMax at 2.5. It is just allowing your machine to cycle back to EPAP after a length of inspiration to provide a secure time for expiration. Your I:E ratio is 1 to 1.36, and once your inspiratory rate hits 2.5, you are looking at a respiration rate of 10.7 bpm. When IPAP cycles back, it encourages, but does not force expiration in an appropriate time for you. In the last chart, you only hit the Ti Max in the maximum statistic. I think if you were routinely hitting it in the 95% statistic you might have an argument to increase it. If you look at zoomed views of your peak inspiration time, I doubt you will be able to see it in the flow rate or correlate it to other metrics of therapy. I don't think having TiMax longer hurts or helps, but Resmed only includes guidance for up to 2.0 at breath rates from 10 to 15 bpm. At higher respiration rates it drops.

Bottom line, Ti Max is not a significant factor in your comfort or therapy.

[Plmnb]

  Sleeprider.  Thanks for setting me straight on this.

Plmnb