Suspected UARS - Question Re Next Steps

[Crimson Nape]

Mainly reduce or eliminate the hypopneas.

[slowriter]

Thanks for the reply. What might bumping min Ipap accomplish?

If you're on vauto, you're only bumping PS; right?

[theclient1437]

Yes, I'm on VAuto. I've been bumping PS gradually up to 3.8 where it is now. Are you suggesting I bump PS up? Or, are you suggesting I bump MinEPAP up?

In either case, what would the potential positive outcome be (just trying to understand)?

[slowriter]

It's just vauto doesn't have a min IPAP setting; that's controlled with PS (min EPAP + PS = min IPAP).

As crimson says, PS controls hypopneas, RERAs, etc., and so is really useful for UARS in particular.

You want it high enough that it minimizes or eliminates those RERAs, but not too high that it introduces significant centrals.

I'd keep PS stable for awhile and see how you do.

[theclient1437]

Sorry, I had a typo in my previous post.  What I meant was: what would increasing *EPR*, as you suggested, accomplish? 

Thanks, and sorry for the error.  Also, I really appreciate all the input.

[theclient1437]

The latest is that I've switched from nasal pillows to the Resmed F20 full face mask. Attached is the OSCAR report from my first night with the F20.

Despite the AHI and leak rate, both of which are higher than I'd like, I do feel relatively rested today.

So, two questions:
1.) any suggestions on how to reduce leakage with the F20? I trimmed my beard this AM in hopes that having a tightly-trimmed beard will reduce leakage, but I'm open to other suggestions as well.
2.) Any suggested tweaks to pressure? I note that the average pressures last night are higher than with the P10 nasal pillows. Is this perhaps due to the higher leak rate?

Thanks for all the help.

[Gideon]

Titration on a VAuto

1. Titrate min EPAP to manage Obstructive Apnea (Done)
2. Titrate PS to manage Hypopnea, Flow Limits/UARS, RERAs, Snores

[slowriter]

I note that the average pressures last night are higher than with the P10 nasal pillows.  Is this perhaps due to the higher leak rate?

I'd think so; yes.