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[Treatment] help with starting settings and titration for UARS
#11
RE: help with starting settings and titration for UARS
(06-10-2019, 11:31 AM)Sleeprider Wrote: Based on your posted results with pressure of EPAP min 4.0, PS 4.0 and Pmax 20, your pressures stay low and you have insignificant AHI. Your pressure only ranges up to a max IPAP of 10.  According to the data, and charts you have very little flow limitation, which is the first thing we would look at with UARS.

I think we need to have a closer look at some of the data, especially where we don't see the pressure support being used.  If you can zoom into the flow rate graphs at 02:49 to 02:41, that is an area of flow limitation and pressure changes.  Your sleep looks disrupted after 03:00 and you may have been awake.  If you have the time, I'd like to get another shot of a time when you think you were definitely asleep.   You have the best possible machine for UARS and we can  work with its capabilities to get you as comfortable as possible.  One of the things I'm thinking about in increasing Ti Min to 0.80 to ensure you get more time at IPAP during those periods where the mask pressure and flow looks a bit ragged.

Hi I zoomed from 2:41 to 2:49 is that what you wanted to see?


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#12
RE: help with starting settings and titration for UARS
A couple of double breaths at the beginning and 100% normal and no flow limitation throughout. If this is typical, you just need to adapt to the machine's pressure, and eventually you will become more comfortable I don't see anything in your results that suggest a change in therapy. Very stable pressures, normal breathing, no events and very little flow limitation.
Sleeprider
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#13
RE: help with starting settings and titration for UARS
(06-10-2019, 11:48 AM)bonjour Wrote: Yes the ranges are wide but Your Pressures are stable, For all practical purposes you were at a fixed pressure of 4.1, so it wasn't pressure.  If you are that sensitive to pressure, don't fly, don't drive over mountains, and when a weather front is coming in drive to avoid it noting the above.  

Better
Provide several random 2 min segments and print those charts One around 1:30 your only significant event a flow limitation and the cause of a small pressure increase.  We will see if there is something in the wave form, but I see nothing here.


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#14
RE: help with starting settings and titration for UARS
       
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#15
RE: help with starting settings and titration for UARS
GM, how did it go last night? I looked at the one chart you posted (http://www.apneaboard.com/forums/attachm...?aid=12722) and I'm not really sure if any of that would typically be considered flow limited breaths, but if it were me I would be tempted to bump up PS just to see if it made any difference in how I felt. However not knowing more info I also think you might need to acclimate some still and strike a balance between testing different settings and giving your body a chance to adjust to the therapy.

Personally I'm trying to force myself to only change settings once a week unless it goes really badly so I can have better perspective, but it's hard when you want instant results. Other people I've seen on here said ~5 days on each setting to give it a fair shake. Hope you are still making progress!
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#16
RE: help with starting settings and titration for UARS
Tried using straight cpap, I tend to sleep a bit longer but do not feel refreshed.  Can we adjust this to get the CA's down?


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#17
RE: help with starting settings and titration for UARS
Can someone please chime in. Or do I need to go back to bilevel?
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#18
RE: help with starting settings and titration for UARS
I'm a newbie myself, struggling with similar issues, but it seems like people are telling you to keep the settings you had earlier, and give it some time.
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#19
RE: help with starting settings and titration for UARS
Goldmaster, I think we only need to reduce the EPR setting. At a setting of 9.2 With EPR 3 (9.2/6.2) you had no obstructive events, a couple hypopnea and moderate CA. I think we can reduce your pressure to 7.0 with EPR 1 and you should notice a difference. It is the reduction of EPR that should resolve the CA events. You may have to increase pressure slightly to keep obstructive out of the mix, but this should work in theory.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#20
RE: help with starting settings and titration for UARS
Thank you Sleeprider.  

Do you see any Flow limit issues or anything that needs to be fine tuned?  My CA's still need to go down a bit.


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