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Taking my VAUTO to recess
#11
RE: Taking my VAUTO to recess
(05-23-2022, 07:31 AM)Sleeprider Wrote: Nothing apparent from those charts. You might try comparing against respiration rate, tidal volume and minute vent.

Good question.

Here are two zoomed charts off the two big drops that include resp rate, tital and minute vent and I can't see an obvious issue.

   

   

I have seen this mystery happen several times over the last few weeks. I wonder if I am getting into an issue with my mask exhalation ports getting blocked? I am using the p30i and while I might have blocked the one on front at my nose in the pillow, the one at the connection on the top would be hard to block.
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#12
RE: Taking my VAUTO to recess
If we assume the desaturation is real, then we have to conclude it is unrelated to respiration or your therapy. I'm sure it's possible to have SpO2 desaturation without respiratory anomalies, but I'm not familiar with what the mechanism might be. This is a gradual decline and recovery, and I don't even see an indicator of arousal.
Sleeprider
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#13
RE: Taking my VAUTO to recess
It is strange. I figure if it was a spurious reading, it would jump (lose contact) and then take a moment to settle back in. As you said, the drops are gradual over a prolonged period without radical jumps.

I know my pulse is pretty low (41-44) so perhaps recovery takes this gradual process? Either way, it doesn't hang long below 90, so I'll just monitor.

Thanks for taking a look.
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#14
RE: Taking my VAUTO to recess
It has been quite a while since I started this thread. Through much experimentation I have achieved an avg AHI of about 1. (I know this is not the best measure of one's sleep, but it is nice to have it stable.).

It took a VAUTO machine, taping my mouth (shaved my mustache for the cause), a chinstrap with light pressure (not leaving indents in my skin), placing my tongue forward in my mouth to keep pressure from going into my mouth and a long, dense pillow that I can position just right to stop me from rolling over. The secret is lay on half the pillow and roll on my side. It pinches the side enough that the pillow forms a wall against my back. (I also sleep on a Medcline wedge to relieve GERD but that doesn't appear to affect my apnea for good or bad.) It is quite a crazy methodical arrangement of pillows!

By staying on my side 95% of the time my IPAP can stay under 12 (7+4.8 =11.80) which limits my aerophagia. When I was started on APAP (medicare rules I was told - even though they figured I would need BiPAP) I couldn't get pressure high enough without intense, painful aerophagia. My numbers were all over the map with mostly CAs and bouts of Cheyne-Stokes breathing every once in a while. The VAUTO let me set a large enough value of pressure support (PS) to tame the belly beast most of the time. If I get over on my back, pressure climbs to the max (12.8) to mostly control OAs but I will be sure to have some painful aerophagia. (I would love to sleep on my back and just crank up the pressure. Perhaps my hiatal hernia is working against me and allows air into my stomach, who knows.)

I still fall asleep on the couch sitting up some days, so all is not quite right. I am going to go to a Dr at Emory to see if I can get a solution for my PLMS/PLMD (never sure which of these to call it) that I think is the final impediment to blissful sleep.

My VAUTO settings (don't see the
=================
Mode
VPAP auto
Min EPAP 7.00 cmH2O
Max IPAP 12.80 cmH2O
PS 4.80 cmH2O
Ti MAX 3.0s
Ti Min 1.1s
Trigger Very High
Cycle High

Climate Control Auto
Essentials Plus
Humidifier Status On
Humidity Level 4
Mask Pillows (P30i)
Ramp Off
Smart Start Off
Temperature 78.8 Fahrenheit
Temperature Enable On

P.S.
Much thanks to all the regulars here that answer all the questions of all the newbies year after year after year. You helped me immeasurably in finally making my PAP therapy doable. You have saved me from who knows what health consequences down the line.
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