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[Pressure] Changing Max Pressure and starting a BiPAP trial
#61
RE: Changing Max Pressure and starting a BiPAP trial
Tenth night of BiPAP - seventh night side-sleeping+SCC

BiPAP Results: AHI = 1.1  (OA = 1.1, CA = 0.6) Min EPAP: 8, PS: 3.4, Max IPAP: 13

Ninth night was AHI = 2.1 (OA = 2.0, CA = 1.6) Min EPAP: 8, PS: 3.4, Max IPAP: 13

Aerophagia was a minor problem last night. I'm considering reducing PS to 3.0 for tonight.
I used the Coreflex Soft Cervical Collar last night and I noticed pain in the lower front teeth again.

I will try a few nights of side-sleeping without a Soft Cervical Collar and keep an eye out for OA clusters.

Noticed a brief period of flow limits above my typical zero level (see below).  Is that an indication of mask leak?

   


Attached Files Thumbnail(s)
       
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#62
RE: Changing Max Pressure and starting a BiPAP trial
I think the lower PS is appropriate to avoid aerophagia and should prove effective for you. The increase in flow limits appears to be from actual flattening of the inspiratory wave, and possible instability at the top of the wave, which may even be a snore. Would need a closer zoom to see it. We don't know if the FL is the result of slight positional impingement of the airway or airway restriction. Generally with people that have positional apnea, we can't dismiss the likelihood of positional flow limits. I think the best way to think about this is to see it as a positional apnea mitigated by the collar. Not a bad trade.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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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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#63
RE: Changing Max Pressure and starting a BiPAP trial
Thanks again Sleeprider!
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#64
RE: Changing Max Pressure and starting a BiPAP trial
Eleventh night of BiPAP - side-sleeping without collar

BiPAP Results: AHI = 0.6  (OA = 0.6, CA = 0.5) Min EPAP: 8, PS: 3.0, Max IPAP: 13

Tenth night was AHI = 1.1 (OA = 1.1, CA = 0.6) Min EPAP: 8, PS: 3.4, Max IPAP: 13 with collar

Aerophagia was almost nonexistent last night. I'm careful to position myself for side-sleeping all the time.

Overall Chart
   

Zoom in on a Flow Limitation
   
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#65
RE: Changing Max Pressure and starting a BiPAP trial
Twelfth night of BiPAP - side-sleeping without collar

BiPAP Results: AHI = 2.0  (OA = 2.0, CA = 0.6) Min EPAP: 8, PS: 3.0, Max IPAP: 13

Eleventh night was AHI = 0.6 (OA = 0.6, CA = 0.5) Min EPAP: 8, PS: 3.0, Max IPAP: 13

Daily Chart
   

I see a couple of OA clusters. Probably due to rolling onto my back in my sleep. I may try to attach an orientation sensor to my chest to correlate those events while wearing a collar.

Overview of BiPAP trial
   

This shows the remarkable improvement in my sleep quality over the duration of my trial, which ends on Friday. Prior to starting BiPAP on March 10 I started to use a soft cervical collar with my current CPAP because of the strong signal of positional apnea in the CPAP data. The BiPAP trial started at the prescribed PS 5, 5-15. Increasing EPAP brought down the OAs somewhat on March 11 and 12 while Sleeprider and Gideon kept pointing out the strong signal of positional apnea in the data. Finally the breakthrough on March 13 of side-sleeping. I wore a collar March 10-19 then for March 20-21 I did not wear a collar. Statistics over a longer period may show if there is some benefit for me with a collar. Thanks to Dormeo for other helpful advice during this trial. I'm very glad I found this site that provided clearer and more timely guidance than I could possibly get from my sleep doctor!
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#66
RE: Changing Max Pressure and starting a BiPAP trial
The graph showing your progress should be a persuasive argument to show your care team. I'm impressed! An important point is that your progress is not only with AHI, but with comfort and aerophgia as well.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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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#67
RE: Changing Max Pressure and starting a BiPAP trial
Excellent progress on all fronts -- really nice to see!
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