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Raise or Lower Pressure for Flow Limitations?
#31
RE: Raise or Lower Pressure for Flow Limitations?
           

two nights in using ResMed AirCurve VAuto 

little different breathing from old ResMed AirSense 10 Auto.  

Dealing with mask slippage and face farts.  Waking me up
Caused by greater difference in inhale/exhale pressure???

Maybe lower minimum pressure back to 9.0 (same setting used during past year without affecting AHI)??

Started with pressure support at 4.0 (was 3.0 EPR using AirSense machine)

Anyhow, could use some guidance as whether the settings I am using are a good start and what adjustments can be made to improve my sleep (flow limitations i believe are the main culprit)

Current Settings:
 VAuto
Max IPAP at 25.0
Min EPAP at 10.0
PS at 4.0

Not quite sure what these settings (comfort?) mean yet, but i will learn:
Ti Max at 2.0s
Ti Min at 0.3s
Trigger at Med.
Cycle at Med.


One step further down the road to eventually a good restful sleep

Thanks,

Dave
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#32
RE: Raise or Lower Pressure for Flow Limitations?
I note for the record that you accidentally went up 3 points in pressure switching machines. If you're looking for what Bonjour recommended, set the min EPAP at 7, pressure support at 3, and IPAP max at 20. That should help address the face farts.

EPAP of 7 + pressure support of 3 = IPAP pressure of 10.

You're currently at EPAP of 10 and IPAP of 14.
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#33
RE: Raise or Lower Pressure for Flow Limitations?
(12-14-2019, 07:43 PM)geauxdbl Wrote: I note for the record that you accidentally went up 3 points in pressure switching machines.  If you're looking for what Bonjour recommended, set the min EPAP at 7, pressure support at 3, and IPAP max at 20.  That should help address the face farts.

EPAP of 7 + pressure support of 3 = IPAP pressure of 10.

You're currently at EPAP of 10 and IPAP of 14.

oops... thanks for pointing that out.  explains why mask leaking much more than usual

slept with new/different settings last night
Max IPAP at 25.0
Min EPAP at 8.0
PS= 4.0

woke up and still feeling pretty refreshed. will post charts after a few days using these settings for review.

hopeful,

Dave
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#34
RE: Raise or Lower Pressure for Flow Limitations?
Look forward to seeing the new charts. Based on the first set of charts I think you should reduce EPAP min to 7.0 and I'd be fine with 6.0 just to see where it moves. With higher pressure you still see significant pressure increases as a result of flow limitation, so I'd like to see PS increased to 4.6

The objective here is to improve flow limitation and see where EPAP settles without resulting in OA. Hopefully lower overall pressure makes you comfortable. It sounds like you moved that direction with this latest change.
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#35
RE: Raise or Lower Pressure for Flow Limitations?
(12-16-2019, 09:26 AM)Sleeprider Wrote: Look forward to seeing the new charts.  Based on the first set of charts I think you should reduce EPAP min to 7.0 and I'd be fine with 6.0 just to see where it moves.  With higher pressure you still see significant pressure increases as a result of flow limitation, so I'd like to see PS increased to 4.6

The objective here is to improve flow limitation and see where EPAP settles without resulting in OA.  Hopefully lower overall pressure makes you comfortable.  It sounds like you moved that direction with this latest change.

Had a better day on sunday (AHI was actually 0.0!), today not feeling so great/refreshed
same settings both days so...

going to try above settings (EPAP Min at 7.0) tonight as see what happens

last night:     
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#36
RE: Raise or Lower Pressure for Flow Limitations?
I was going to suggest an PS of 5, I see SR suggested 4.6, either would be fine.
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#37
RE: Raise or Lower Pressure for Flow Limitations?
last night charts/data:

   


feel OK today. tired but not sickly tired.
feel better than day before and shows on charts/data when comparing (see above post for previous night charts/data)

for tonight:
thinking/planning on lowering EPAP minimum to 6.0 from 7.0 (lets see what happens...)
and increase PS from 4.6 to 5.0

thoughts?
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#38
RE: Raise or Lower Pressure for Flow Limitations?
My thought is your down to fine tuning. Don't go by how you feel night to night give the settings a week between each change, otherwise you get into knob twiddling.
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#39
RE: Raise or Lower Pressure for Flow Limitations?
Why would you lower Min EPAP when you're still having OAs?
Nothing I post is medical advice and should not be taken as such, always consult a medical professional for guidance.
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#40
RE: Raise or Lower Pressure for Flow Limitations?
(12-18-2019, 02:22 AM)JoeyWallaby Wrote: Why would you lower Min EPAP when you're still having OAs?

From what i am learning using VAuto machine (new to me), with pressure support at 5.0, add that to min EPAP of 6.0, that gives me a minimum pressure of 11.0? That was more than enough pressure when using my old AirSense 10 machine to control O.A. (mostly used 9.0 fixed pressure during AirSense 10 machine use)
Am I correct in this thinking?

anyhow, at EPAP min of 6.0 last night, AHI still below 1.0 with only 4 O.A. flagged. only one night so far, but was a typically night for me.

(Also a suggestion by Sleep Rider to try and see where it moves)
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