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[Pressure] TheWallofSleep's Therapy Thread
RE: Help Calibrating APAP Pressure
I'm going back to answer one that I've previously forgotten. Mode. Specifically ASV Mode. There's 3, CPAP, ASV, ASV Auto.

Here's the basic differences.

CPAP is straight or static, no EPR as in you put in pressure 15, you're getting 15 period.

ASV, you have pressure support as a range, minimum PS 0-5 and it must always be 5 minimum between min and max PS. Straight EPAP. IPAP is Auto configured from PS and EPAP.

ASV Auto, EPAP is now a range along with PS, and IPAP again is auto configured from these.

I recently tried CPAP mode. NO way. New doc's decided I really don't need ASV. Wrong. New doc's are fired. Otherwise I've always used ASV Auto until ASV is not treating, too long and too off topic. ASV isn't right for my COPD.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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RE: Help Calibrating APAP Pressure
I wish they made one machine available to patients that could do it all, but they would probably make it near impossible to get your hands on. It would be the holy grail of CPAP machines though. 

I am confused on the connection between PS and breathing patterns. It seems that higher PS correlates to less FL, at least that is what I gather from reading other threads, although for mixed/CSA cases it comes at the cost of increased central events. However, at the same time I hear that ASV is not FL friendly. I do not suffer from very abnormal FL to my knowledge, but I do see these odd pauses in breathing throughout the night not registered as events of any kind. Am I correct to assume that this is a byproduct of lower PS?
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RE: Help Calibrating APAP Pressure
Personally I'm not sure what that would be that causes that. As for ASV not being particularly friendly to flow limits, my FL was oddly mostly at or near zero when my pulmonary issues was playing well with ASV. And a zero on my events area wasn't uncommon either. It wasn't my goal but zeros just happened. And FWIW untreated my CA were 124 with 24 OA in 2017's diagnostic so there were events the ASV has to contend with.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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RE: Help Calibrating APAP Pressure
I do not know what causes it either. I have been digging through other people's posts and cannot find an exact solution to my problem. Again, someone correct me if I am oversimplifing this, but it seems PS helps regulate breathing, so I will try a PS=5 and see how bad it is fighting the centrals. There seems to be an identifiable inverse relationship here, and ASV might be the balance of the two. I need to exhaust the capability of VAuto first.
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RE: Help Calibrating APAP Pressure
My sleep doctors office told me that if I bought a CPAP online I would need to find a local vendor to take it to to have it programmed.

I am looking at one of the ResMed autoset machines. Can't I program that machine myself? Isn't that the whole point? I had a titration study on a ResMed no less. Shouldn't they give me the settings they used and I can start with those on a ResMed machine I purchase? I found an instructional video on programming the ResMed CPAP and it looks super easy to program. I learned how the tubing and face mask work at the titration study and how the CPAP should feel. It went really well actually. Plus they gave me all the ResMed tubing and face masks they used for the study so I am set with that stuff.

I am also looking at getting a machine from a local vendor with my insurance but it's really not that great of an option from what I've seen so far.

I was just a little surprised at the doctors office reply. I told them specifically which machine I was interested in purchasing.

thank you for your help!
Valerie
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RE: Help Calibrating APAP Pressure
I was using the ResMed Autoset for over a year. I only had to switch because of a fairly rare variant of sleep apnea. In order to change the settings on that machine, and seemingly any ResMed machine, you hold down the knob and the home button simultaneously for a few seconds until the menu shows an option called "clinical settings". Once you are at that point, you can change anything that can be changed on that machine all by yourself. There is no need to take it anywhere to be programmed. They are probably telling you that because they don't want you to program it, but it can indeed be programmed from home. Just be sure to upload your OSCAR data so people here can give educated advice on what to program. Best of luck to you.
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RE: Help Calibrating APAP Pressure
Valerie, yes you can do setup for yourself. Look at the top black banner for CPAP Setup Manual then find ResMed AirSense 10 AutoSet. Request the manual and it goes over everything. The AutoSet is the best CPAP style machine for most users. Get OSCAR, the free app to monitor your CPAP data. It's safe to use. You'll have a lot more data than Dr. Dolittle knows what to do with.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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RE: Help Calibrating APAP Pressure
What is your trigger set to? High or Very High have helped users with central.

Increasing Pressure Support (and EPR) benefits the treatment of Hypopneas, Flow Limits, RERAs, and UARS. It Increases the volume you breathe and as such increases both Oxygen intake and CO2 removal or flushing. The CO2 Flushing, in susceptible individuals, NOT everyone, can increase the number of CA events when CO2 levels dip below your apneic threshold.
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RE: Help Calibrating APAP Pressure
Gideon, I have my trigger set to very high. I am getting good numbers, but if I didn't look, I wouldn't believe it. I see a fair amount of flat lines in my flow rate that are not marked as an event of any kind. I have some screenshots of these in post #100. Do you think these are events that are not fully treated by the machine and are just not long enough to be marked?
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RE: Help Calibrating APAP Pressure
just looked, your breathing seems shallow. your tidal volume is 280, it should be 500-600.
is there a reason for this?
your weight for a better estimate.

other than shallow breathing a few arousals i don't see issues in those charts.
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