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[Pressure] Help needed with new VPAP and new to forum

Thanks for the reply. Below are two screen shots. First is overall with the 4 graphs and second is zoomed in at an event cluster.

Is this what you were asking me to do? If not, let me know. What can you tell.
[img][Image: xATP1Mbl.png][/img]

[img][Image: oDKmLDYl.png][/img]
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Pat, this is some kind of periodic breathing I'm not familiar with, and it would be remiss of me to give you any other advise other than to bring this to the attention of your doctor. The very short interval between the CA and regular breathing is unlikely to leave you hypoxic (lack of oxygen), but it is a concern. Not to be too personal, but are there any other medications that you use, history of cardiac or brain injury?

This is not a normal expectation for CPAP use and I think you'd be best advised to get some professional advise.
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No meds Rx or otherwise. No history of cardiac issues or brain injuries. I live in the remote highlands of Panama. There are no Doctors here that even know as much as you or I know about this stuff. Had to get my VPAP flown in via Miami and paid a hefty freight charge.

One puzzling thing is that I was definitely awake from about 5:30a until about 6:30a. I was paying attention to my breathing. During this time period there were many, many CA's recorded.

How could I be having CA's if I was awake and my breathing was steady and even?

Looks like to me that almost all of the CA's events coincide with an Insp time that hits (exceeds) the 2.0 seconds limit (set by the TiMax setting of 2.0 seconds).

My max and also my 95% Insp time is 2.0 seconds. I believe that means that 95% of the time I am trying to inhale longer than the TiMax time limit of 2.0 seconds will allow and the VPAP is not waiting any longer and switching to exhaling.

If I zoom in at a gap on the Events graph where there are no CA's, and look at the Insp time graph for this same time period, my Insp time does not hit the 2 second limit; whereas, zooming in on the events graph where there is a cluster of CA's, the Insp graph shows that many of the breaths hits/exceeds the time limit of 2 seconds.

My breaths while awake between 5:30a and 6:30a also were very slow and hit/exceeded the 2 second limit on most every breath. A CA was recorded at almost every breath also.

Coincidence? Just wonder why this is so????

Might try changing the TiMax to 3 seconds and see what the results look like overnight. If the CA's drop a lot then I am on to something, if not, keep looking.


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(03-14-2015, 04:39 PM)jpatfarrell Wrote: One puzzling thing is that I was definitely awake from about 5:30a until about 6:30a. I was paying attention to my breathing. During this time period there were many, many CA's recorded.

How could I be having CA's if I was awake and my breathing was steady and even?

It's not unusual for people to actually be asleep while believing they are fully conscious. You shouldn't conclude that you were awake just because you thought you were conscious. An EEG will often show otherwise. Given your location I don't imagine you have access to EEG equipment.

Most of us believe we are awake when we dream. You might have been dreaming that you were lying awake breathing when in fact you were in REM sleep.

A brain disturbed by insomnia and apnea over years isn't always in the best position to see things clearly.

Ed Seedhouse

Your brain is not the boss.

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Nope, I was definitely awake. Dogs started barking at 5:30, they were let out and I laid there watching the projection clock on the ceiling, listening to the dogs bark outside and monitoring the breathing.
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I have the S9 version of the machine that you have and I had the S8 version of the same machine earlier. It is too bad that you have not been using Rescan. It has a notation in the statistics page under respiratory rate that gives the percent Spontaneous Cycled Breaths. You may need to adjust the sensitivity of the change from IPAP to EPAP. The setting to do that is one of a set of two. "Trigger" and "Cycle" arre the pair. Cycle is the one that adjusts the sensitivity of the change from IPAP to EPAP. It is normally set at Med and you may need to set it to high or Very High.

I would go ahead with your plan to set Ti max up to 3.0. I do not believe it will hurt anything. I think that I might seriously consider raising Ti min to 0.7 at the same time.

I have not quite figured how but I really feel like the CAs are at least in part being caused by the machine at its current settings. It is also too bad that there are not more of us on the board that use this machine and are familiar with these detailed settings. More viewpoints can be helpful. justMongo has the same machine history that I do and he is sharp. Hopefully he will chime in.

Best Regards,


Admin Note:
PaytonA passed away in September 2017
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~ Rest in Peace ~
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Payton, thanks for chiming in. I don't use a resmed machine, and am admittedly lost on some of these finer points. Perhaps you know...Pat is using a machine capable of treating conditions that go beyond the moderate OA he was diagnosed with. Is there a simpler setting he can employ on this machine that will not trigger breaths and just supply simple IPAP/EPAP pressure? I get the sense the machine is trying to override his natural breathing pattern when all he needs is a simple CPAP.

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Hi PaytonA,
Thanks for the info. I do have ResScan on my computer and just uploaded the data.

It shows 76% for % Spontaneous Cycled Breaths.

Is it the percent of breaths that are spontaneously terminated by the patient (termination of IPAP and changing to EPAP)?

If correct this tells me that 24% of my breaths were terminated by the VPAP....correct?

What affect does this have? I am guessing it is not good to be that low.

If this is not good, what do I change. TiMax, TiMin, Trigger and/or Cycle. Or something else?

I have increased the TiMax to 3.0.

Do you still recommend changing the TiMin to 0.7 and also changing the Cycle to HIGH or VERY HIGH?

Should I leave the Trigger at Medium?

Your help is greatly appreciated.

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thanks again for replying....I'll take all the input I can get on this new machine.

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Well, I wish I could be more help, but this particular machine has settings I have not learned. I think if you could shut off the timing, you would end up with an appropriate positive air pressure therapy. It seems your needs would be met best by a simple APAP or Bilevel. This unit actually tries to take over when you don't initiate a breath within the time it is set to override the breathing cycle.
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