RE: Stubborn Centrals
Most of your events are happening during Ramp and that is setting you up for poor therapy. Things do calm down after a time. Adapting to the ASV takes time, and it's better to just deal with the fact you are getting used to very different approach to therapy. I don't think ramp is working for you, and you should turn it off, and learn the "blow-back" method of establishing the rate and volume when the machine is unruly. If you are experiencing aerophagia, then cutting PS max to 12 may help. Once you fall asleep the max PS of 15 is not being used anyway. The way I see it, you need to get past this initial transition to sleep, and you will be fine.
RE: Stubborn Centrals
Thanks Sleeprider, I will hang in there and expect it to improve. I do see that most of the events are happening while I am falling asleep. I am surprised at how much lower the epap needs to be with this therapy. Would increasing my min ps to 3 improve my tidal volume?
Thank you,
Kevin
RE: Stubborn Centrals
My opinion, I'd probably leave PS where it is for now. However, I'd consider putting the axe to the Ramp if you can tolerate it. If that's not possible, shorten it to as little as you can. My usage of the ASV revealed that Ramp and ASV didn't mix well. Best to your success on this.
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.
RE: Stubborn Centrals
Kev, a PS of 3.0 might be more comfortable and may help stop some hypopnea, but I don't expect any big changes in tidal volume. I don't see much harm in trying it on that basis.
RE: Stubborn Centrals
Thank you both. I did turn the ramp off and had much better results. RDI 1.7 with minimal osa. The hypopneas that remained were mainly from a period that I was awake and fighting with the machine. I tried to blow back, but after a couple of breathes, it went back to blowing just as hard as it was. I may have had some results turning the machine off and back on. I still had some pretty bad aerophagia. Is my main option to help with that turning down ps max? I was thinking that may help with the pressure swings keeping me awake as well. The highest my epap has gotten has been 8.
Thank you all,
Kevin
RE: Stubborn Centrals
Sounds OK on the plan as far as I see it. And correct on not maxing PS, as you just went over 18 for overall pressure. That puts your Max PS at about 9 I'm thinking.
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.
RE: Stubborn Centrals
That looks great, and I recommend you don't make changes for a few nights. A UA of 0.4 does not warrant increasing EPAP. Our objective is to have you feel as comfortable as possible, and you made great progress towards that goal. Keep that, and hold off on changes until you can establish a clear need or objective.
RE: Stubborn Centrals
I am having a problem with low oxygen saturation averaging 92 down to 80%. I was thinking that increasing pressure support and improving tv should help with that, but after reading through some posts, it looks like the epap pressure has more to do with oxygenation. It is confusing because the titration for the bilevel machines say to increase ipap for low o2 saturation.