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Struggling
#11
RE: Struggling
With settings of 9/6 on VPAP ST you continue to have high rates of hypopnea and are not maintaining therapy in excess of 2-hours.  I'd like to hear from you why you find the therapy uncomfortable and prefer to sleep without the machine.  As far as what we can recommend for the hypopnea, let's have a look at the titration protocol for  your machine.   Your tidal volume (Vt) is very inconsistent, but averages 420 mL, and your minute vent is similarly inconsistent. I'm not aware of you using a recording oximeter, but it might be a good idea, especially considering how little therapy you tolerate. Seeing the oxygen desaturation during non-treatment might be a motivator..  Assuming we are concerned with treating the hypopnea, the protocol suggests an increase in pressure support (PS).  So based on very limited information, my suggestion is EPAP 6.0, IPAP 10.0.

We know you suffer aerophagia, and do not tolerate high pressure, however the pressure support should be brief. The lack of apnea (UA or OA) hints that if we need to make room for the higher pressure support, we might be able to lower EPAP to 5.0. This would yield 9/5 pressure compared to your present 9/6. The other question is why are you using a VPAP ST? On the right side of the titration guide is a list of conditions this therapy is intended to treat. Do you have COPD, or hypoventilation?

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Sleeprider
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#12
RE: Struggling
Thanks! Is this better?


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#13
RE: Struggling
With your pressure so low, I'm guessing you're air-starved. I'm no expert - although I took my mask off a lot when my pressure was too low - but I'd guess that is a factor.
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