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Where do I begin? [AirCurve 10 ST to Aircurve 10 ASV ]
#21
RE: Where do I begin? [Help with AirCurve 10 ST]
Here are the nights results with Gideon’s recommended setting of EPAP @ 13.0


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#22
RE: Where do I begin? [Help with AirCurve 10 ST]
Any info if you felt better with this? Better comfort, rest, so on?
Dave

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#23
RE: Where do I begin? [Help with AirCurve 10 ST]
This is so much better than your PS of 2 from earlier.
It is very important to note how you feel as Dave mentioed above.
See the cluster of events at about 0730 and the smaller one at about 0650? These normally indicate a positional apnea but because of the impovement I see from before I'd like to reduce EPAP by 1 again going to PS of 5 to see if we get additional improvement first.
Starting with the PS4 data and gping forward I'd like to see a couple of 5 minute views including at least one with UA in them
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#24
RE: Where do I begin? [Help with AirCurve 10 ST]
Mode: ST
IPAP: 17.0
EPAP: 13.0
Resp Rate: 10.0
Ti Max: 4.0
Ti Min: 0.3
Rise Time: Min
Trigger: Med
Cycle: Med
Mask: ResMed Mirage Quattro
Ramp Time: Off
Climate Ctrl: Auto
Temp Tube: 80 F
Humidity Level: 4

Did not post of how I felt because the night before was a terrible night. However, feelings from last night were better rested but, still woke with headache and brain fog. I will reduce the EPAP by 1 for a PS of 5 and see how that works. I am struggling with the machine going from IPAP to EPAP and vice versa until I can drift off. It feels as though timing is a bit off. The machine gives IPAP while just before I am ready to inhale and gives EPAP while I am still inhaling, rather annoying.


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#25
RE: Where do I begin? [Help with AirCurve 10 ST]
The purpose of the Trigger setting is to adjust the initiation of the switch from exhaling to inhaling.  
Cycle is the transition from Inhale to exhale.  
One change at a time, But I think you can do this while relaxed but awake.  
Your short segments are heavily flow-limited.  So I'll ask do you have any, other than apnea, pulmonary or breathing conditions?
Go to PS 5 by Increasing the max by 2 and the min by 1.

I think you want to try Cycle at low.


   
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#26
RE: Where do I begin? [Help with AirCurve 10 ST]
Not aware of anything other than apnea. Back in 1994 I was diagnosed with 10 apneas and hypopneas observed in sleep study. They were characterized as: 1 central apnea, 2 mixed apneas, and 7 hypopneas and that started me on CPAP at 8 cm of water with nasal mask. Before I left CPAP, on Oct 15, 2021, I was on an auto set with pressures at 12 and 18 cm of water with an averaged 14~15 cm of water thru the night with full face mask.
 
Go to PS 5 by Increasing the max by 2 and the min by 1.
Do you mean IPAP=17.0 EPAP=12.0 or did you mean IPAP=19 EPAP=11.0
I will try Cycle at low for tonight.
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#27
RE: Where do I begin? [Help with AirCurve 10 ST]
You are at
IPAP=17
EPAP=13
PS=4

go to
IPAP=19
EPAP=14
PS=5
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#28
RE: Where do I begin? [Help with AirCurve 10 ST]
(10-29-2021, 10:32 PM)Bird Brain Wrote: The first night I was bombarded with constant IPAP/EPAP pressures. Felt like pressure oscillations could not get a relaxed breath or sleep. I have been unsuccessful with his prescription. 

To be able to get some sleep, I changed the settings as follows.
Mode: ST
IPAP: 16.0
EPAP: 14.0
Resp Rate: 8.0
Ti Max: 4.0
Ti Min: 0.3
Rise Time: Min
Trigger: Med
Cycle: Med
Mask: ResMed Mirage Quattro
Ramp Time: Off
Climate Ctrl: Auto
Temp Tube: 80 F
Humidity Level: 4

If I try to raise the Resp Rate above 8.0 it feels like the machine wants me to exhale before I finish inhaling or it wants me to inhale before I am finished exhaling so it is left on 8.0
 

I have not finished reading everyone else's response , so forgive me if I am repeating some of what others have suggested (its actually a good thing if they have).
I am not sure why the machine even needs to know your "Respiratory rate" because it is clearly out of synch with your normal RR at 8, so if there is a way to shut this parameter down, it would be worth a try.
As for prescription EPAP pressure of 16 which you later changed to 14, in my opinion this is way too high. I am several years younger than you and have no other physiological issues other than CSA and I can't tolerate an EPAP pressure above the bare minimum of only 4 because of the conscious effort that I must put into exhalation at pressures higher than 4. High EPAP pressures are akin to sticking my head out the window of a speeding car at 200 MPH, trying to exhale...It is difficult and interferes with my sleep....So I am wondering if you are open to dropping your EPAP setting to a minimum and see how it impacts your sleep and then raise EPPAP (slowly, perhaps 1 CMH2O per night) if your AHI number is high.
Ipap of 16 for a bilevel machine is in my opinion also way too high, so dropping it down to 12 and seeing how you feel should help you with a better sleep. Of course if lowering IPAP makes you feel like you are gasping for more air at inhalation, then you can increase it by 1 at a time until you find your own sweet spot.
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#29
RE: Where do I begin? [Help with AirCurve 10 ST]
Thanks Gideon and S. Manz for input. I will try Gideon's recommendation tonight but I am interested in S. Manz suggestions also. I am so wanting to get a good night’s rest I think I am getting desperate.
 
S. Manz the Doc changed through the DME as the following
Mode: ST
IPAP: 18.0
EPAP: 4.0
Resp Rate: 10.0
Ti Max: 3.0
Ti Min: 0.3
Rise Time: Min
Trigger: Med
Cycle: Low
Mask: ResMed Mirage Quattro
Ramp Time: Off
Climate Ctrl: Auto
Temp Tube: 80 F
Humidity Level: 4
 
The change between IPAP and EPAP was terrible it felt like a hammer each time the pressures would change. I tried to stay with these settings till I would hopefully pass out but no luck. That is when I had a terrible night, worst night since on BIPAP.
 
I change the settings as follows and give it a try.
 
Mode: ST
IPAP: 19.0
EPAP: 14.0
Resp Rate: 10.0
Ti Max: 4.0
Ti Min: 0.3
Rise Time: Min
Trigger: Med
Cycle: Low
Mask: ResMed Mirage Quattro
Ramp Time: Off
Climate Ctrl: Auto
Temp Tube: 80 F
Humidity Level: 4
 
Sorry Resp. Rate has been @ 10.0 since Docs setting change 11/04/2021 and I have not changed it back.
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#30
RE: Where do I begin? [Help with AirCurve 10 ST]
Ok so I read a bit more about BIPAP machines and can now see why there is a "Respiratory Rate" setting. The machine internal algorithm uses this RR to calculate when to raise pressure (for IPAP or inhalation) and then drop pressure (for EPAP or exhalation) which is kind of strange because everyone's RR changes while they are asleep .
Normally people take between 12 to 15 breaths per minute which can drop as low as 6 or 8 for some (such as myself) during sleep so how a BIPAP machine compensates for this change in rate is still a mystery to me ( I use a ASV machine which automatically monitors my respiratory rate and adjusts), so I am still not sure how to deal with this setting on your machine.

As for EPAP pressure, I see that your doctor dropped it to the lowest setting at 4  but then you didn't like it because the IPAP setting was set too high and the rate of change in pressure with each breath, kept you up ( "felt like a hammer").
This is why I think that lowering the IPAP pressure as well as the EPAP is a good idea to try.
Let's say EPAP at 4 and IPAP at only 8 to start and see if your sleeping improves.
For now if there is a setting that simply stops the BILEVEL feature and sets up "AUTO" feature instead, it would be worth a try,
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