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Need help with pressure settings
#21
(12-23-2017, 06:13 AM)ajack Wrote: I would also see a lung specialist, to see if the high respiration rate and low tidal volume is an issue. If the machine is accurately reporting, I'd want it checked out. From the start it didn't look like apap was for you and you would do better on bpap. I would still zoom in and see if the machine is miscounting in sections

A lung specialist!  Now you have my attention...I will start by getting my machine checked out. High respiration rate and low tidal volume -  Is this something I should point out during my sleep study?
2010 sleep study 63 AHI
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#22
Before we push the panic button, you need to know your machine can double-count single respirations. Just zoom in on a 2-minute section of normal breathing, and we can probably tell from the flow rate chart. Your last results were pretty good but if we nit-pick the respiration statistics, your respiration rate is high, and your expiration time is longer than inspiration. This is practically the "fingerprint" of someone with a longer irregular expiration that "fools" the machine into double-counting a breath.

In other words, don't worry, post a close-up chart, and I think we can put your mind at rest. The pattern i mention can be improved by bilevel because it does much better at stabilizing respiration allowing a more relaxed exhale and supported inhale.
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#23
It's a flag that needs looking at, have you zoomed in and counted the actual breaths in sections and what the machine is recording to see if it's right? This is the first thing I'd do and post it up for other to see. sleeprider is very good at picking stuff out.

You could ask the doctor that is arranging the sleep study about it. If you haven't seen a lung specialist sleep doctor, I would anyway and get review every year or two. If the machine is right. You are outside the normal range of 12-16 or the acceptable up to 20, depending what source you read. Have you got any symptoms? I doubt you would be breathing slow during the day and fast all night.
The lab can see what your respiration rate, tidal volume and minute vent is, during titration and it should be in the report. As it is on sleepyhead. Only you will know that what the lab says will be right.
new http://www.apneaboard.com/wiki/index.php...re_success
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
From machine or charts for auto-cpap, set the min 1cm below median pressure, or 2cm below 90/95%. max at 20cm for now. Forum will help you fine tune settings
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#24
Last nite's data:

https://imgur.com/a/NWt54


Not sure where I zoom in on a 2 minute count - but here is a try:

https://imgur.com/a/7Bupg

Thanks
2010 sleep study 63 AHI
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#25
You have some impressive flow limitation. You can see every inspiratory breath has a downward sloping top which shows slowing flow as your inhale proceeds. A normal inspiratory flow pattern would have a rounded top. There is some raggedness in the flow wave that suggests restriction in your throat. As the wave form approaches 2:25:20 through 2:26:00 there are artifacts during the transition form exhale to inhale that would cause the double counting of breaths. In this section your actual respiration rate is 14 breaths per minute which is normal and probably typical for you, however if those false-peaks during exhale are persistent, then the machine could count as many as 28 BPM. Your treatment statistics also show a resp rate of 15 and 95% rate of 16 BPM. You are normal and healthy...and the suggestion of a pulmonary condition was unnecessarily alarming, and based of far too little information.

During this segment your pressure expressed in bilevel terms is IPAP 19.4 over EPAP 16.4 with Pressure Support 3.0 This is very close to the maximum pressure your CPAP can produce. You probably would benefit from more pressure support to resolve the flow limitation, and that would require a bilevel machine. The bilevel machines are capable of higher overall pressure to 25 cm and sometimes 30, but with the pressure support, it would be more comfortable.

You are getting good therapy, and everything we see here shows you have no pulmonary problems, but have airway restriction. If you discuss with your doctor, your treatment is effective and you are getting good results. Your results could be improved with more pressure support.

[Image: a2ZGVAZ.jpg]
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#26
Thumbsup 
Thanks!
2010 sleep study 63 AHI
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#27
I pretty much have decided to try a bpap to try and reduce the discomfort I have with the high pressures.  The question I have is do I really need a sleep study?  It might be cheaper if I just buy a bpap outright forgoing the sleep study.  I have a great ahi right now, and you all can help me adjust the bpap.  What will a sleep study buy me?
2010 sleep study 63 AHI
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#28
I would see BPAP as mainly a comfort feature for you, and an means of further reducing your event rate. By allowing for a higher EPAP, with more pressure support, comfort can be maintained while closing out the remaining OA events. You have some notable flow limitations even at CPAP pressures of 19/16, so that should also resolve. I would not expect any complications as you have no tendencies to central apnea. I absolutely think a Vauto or BiPAP auto is a good move, and if it saves money to self-finance, that is probably the way to go. A sleep study would add almost no advantage to self titration with BPAP auto.

FYI I do see a Resmed Aircurve 10 vAuto being sold by Sistemma on Amazon for $976. There are also used ones from $500 to $650, and several other sellers at 976 to $990 (Harvest Den, Medguru LLC). Sistemma appears to be a company related to Supplier #2 in Minneapolis.
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#29
Cool 
Thanks,Sleeprider.  I think I will run the numbers and see which way to go.
2010 sleep study 63 AHI
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#30
Smile 
Thanks for pointing me to Amazon.  I bought the one from Sistemma.  Stay tuned I am sure I will need help!
2010 sleep study 63 AHI
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