Raise or Lower Pressure for Flow Limitations?

[CPAPUserDave]

Quick Update

2019 Recap: 

was on CPAP (9.0 fixed)

switched to APAP in June (various settings), but still not feeling refreshed
      ran with EPR at 3.0 to "attack" flow limitations but still not feeling refreshed

purchased Bi-Level machine to achieve more pressure support for flow limitations
      after one month and adjusting settings, feeling much better/refreshed
      getting to the point I just need to let the settings be and get some refreshing sleep that I have been lacking for awhile

current settings on ResMed AirCurve 10 VAuto:
     P.S. 6.0 over 5.2-25.o cmH20

I did notice one issue that developed. seemed like I 'paused' breathing for couple seconds between inhale/exhale. kind of like I held my breath before exhale. noticed when laying in bed and falling into sleep, which aroused me enough to not fall asleep. so in the middle of last night, I changed the cycle setting from medium to very high to see what that would feel like. And of course, I fell asleep before I could analyze it. So did that change help me or did I just finally fall asleep on my own? Have limited understanding what cycle/trigger do but I think this may have helped?

Dave

[ragtopcircus]

Basically, trigger is the sensitivity to the beginning of inhalation, and cycle is the sensitivity to the end of inhalation.

When the beginning of inhalation is sensed, the pressure will start to slowly rise toward EPAP+PS. When the end of inhalation (NOT the beginning of exhalation) is sensed, the pressure will quickly drop back to EPAP.

For me, there is some interaction between PS and Cycle. Lowering PS may require lowering Cycle sensitivity so IPAP is maintained a bit longer and vice-versa. If PS is high (for you) and Cycle is low (for you) it can feel like IPAP is maintained a bit after your lungs are full and you are ready to exhale.

[CPAPUserDave]

sure sounds like this could (or was) happening. guess tonight i'll see what happens

[Sleeprider]

I have generally suggested increasing trigger to high and decreasing cycle to low for flow limitation. The idea is to be more sensitive to starting pressure support and less sensitive to decreasing it. Not everyone needs that.

[cbailey1616]

Quick Update

2019 Recap: 

was on CPAP (9.0 fixed)

switched to APAP in June (various settings), but still not feeling refreshed
      ran with EPR at 3.0 to "attack" flow limitations but still not feeling refreshed

purchased Bi-Level machine to achieve more pressure support for flow limitations
      after one month and adjusting settings, feeling much better/refreshed
      getting to the point I just need to let the settings be and get some refreshing sleep that I have been lacking for awhile

current settings on ResMed AirCurve 10 VAuto:
     P.S. 6.0 over 5.2-25.o cmH20

I did notice one issue that developed. seemed like I 'paused' breathing for couple seconds between inhale/exhale. kind of like I held my breath before exhale. noticed when laying in bed and falling into sleep, which aroused me enough to not fall asleep. so in the middle of last night, I changed the cycle setting from medium to very high to see what that would feel like. And of course, I fell asleep before I could analyze it. So did that change help me or did I just finally fall asleep on my own? Have limited understanding what cycle/trigger do but I think this may have helped?

Dave

Your story sounds exactly like mine; sinus pressure, headaches, brain fog, fatique. Cpap didnt really work out because I cant get my flow limits down. I get my Aircurve in tomorrow so Im hoping this helps out!

[sleepyp]

For 4 nights straight my flow limits have significantly reduced by lowering pressure to fixed 7 epr3, down from min 9-20 epr3.
Still very low As and Hs, less CAs, lower flow limits. Happy days!
Can’t explain it, but it seems consistent and not what I’d expect based on the general knowledge on this forum.