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[Pressure] TheWallofSleep's Therapy Thread
#61
RE: Help Calibrating APAP Pressure
I did call them, however, I understand it is not their fault. I meet with my doctor in a few weeks, then I will see if I can get a script. If insurance will not cover it, I will probably take my business back to Supplier #2.
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#62
RE: Help Calibrating APAP Pressure
Long story short, I couldn't talk my provider into covering an ASV, but I was able to get most of a brand new VAuto covered. That's right, 0.0 hours on the clock. I have a clean SD Card, and am ready to go. I am assuming as long as I keep the machine under a seperate profile on OSCAR, there will not be any problems.
Eventually I will receive the data from the study which will have their recommended settings, but I have a feeling I will be self-titrating regardless. My Former APAP settings was 10-15cmH20. I am copying the climate settings over as is, and already disabled ramp. I do not know if the VAuto was preprogrammed by the DME in accordance to my doc or if this is the default settings, but right now I have:
Mode VAuto
Max IPAP: 9.0
Min EPAP: 5.0
PS 4.0
Ti Max 2.0s
Ti Min 0.3s
Trigger Med
Cycle Med
 
Should I run with these for a few to see the data, or should I tweak based on what I was working with on my APAP. I have a feeling the MaxIPAP/MinEPAP range will be too low right out of the gate.
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#63
RE: Help Calibrating APAP Pressure
Yeah it seems like they're maybe doing the Avoid CA Game by making this lower pressures than what you were using. I guess best to try it as is 1 night, post OSCAR, and tell us what you liked and didn't. Keep a sharp eye on CA. On the VAuto Trigger can be edited to High. Just a maybe, run it as is to get a base number. Then make an edit. If it is totally nasty as it's set now, then do something of an edit, either trigger high or pressure edit.

I hope it goes well but BPAP and CA don't play very well together. Be ready to complain very loudly if it's a bad mix for you.
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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#64
RE: Help Calibrating APAP Pressure
Here is my first night with VAuto. The numbers look good, but I feel pretty terrible. I did not sleep for the first 2hr24 minute section, so I have excluded that from the count. The data here is only for 4hr52m, so I feel I need to maybe get a few more hours down to have a useful baseline. Tolerating the machine is not too bad either, which is something I have heard people complain about.

When posting screenshots for the AirCurve 10 VAuto, is there a different set of charts or chart order that is more useful than the default ones the CPAP users share? If so, just let me know. I am consistently appreciative of all the advice.


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#65
RE: Help Calibrating APAP Pressure
The same OSCAR that one would show for AutoSet will be fine, just like what you've showed.

The VAuto is just a true Auto BPAP and not a very high level machine like the ASV. Due to the ASV being issued for Central or complex Apnea, different charts may be needed there.
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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#66
RE: Help Calibrating APAP Pressure
Finally, we get to start having some fun. I decided to raise the EPAP/IPAP by 1cm to see what what happen and the centrals lit up. I am assuming that was a change in the wrong direction. I may go back down by 1cm tonight to see what happens.
I do not know how much of this is inconsistent centrals, or just too high of a pressure.


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#67
RE: Help Calibrating APAP Pressure
Well that went the wrong way, yes I'd revert back to 9/5 pressures. Since your prior chart shows CA at 1.03 vs this one of CA 8.23. That increase of 1 supposedly added 7.2 to your overall AHI. But remember one night's not a trend, but as that went badly, I'd dial it back. As your CA seem to be hyperactive compared to the others, you might want to give it a few days and try again. Remember your ResMed has fractional steps between the whole cmH2O steps. Between 9 and 10 are these fractional .2 steps, 9.0, 9.2, 9.4, 9.6, 9.8 and then 10.0. Maybe do smaller steps next time.
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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#68
RE: Help Calibrating APAP Pressure
I definitely should take more advantage of the ability to make adjustments in smaller increments. As I saw you say in a different thread about treatment with the VAuto, it is a game of teeter-totter. Since I have both OSA and somewhat prevalent CSA, I will gradually and independently work on increasing max IPAP to combat OA/HA, and then gradually lower PS to see about diminishing CA. I want to find a middle ground where I can feel the best. If anything, it will help me rule out certain changes in certain directions. From what I saw earlier, I don't think my max IPAP can ever go over 10cmH20, but ~9.2 may be beneficial.
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#69
RE: Help Calibrating APAP Pressure
Please provide a 10 minute view that has your centrals, let's see if it is CO2 induced or ideopathic.
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#70
RE: Help Calibrating APAP Pressure
And I should add that if it is CO2 driven it is likely that PS is the main driver, yes pressure is involved, though usually a minor player. You do want a few CA events to drive your apneic threshold down and make you less susceptible to low CO2 induced centrals.
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