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Which chart is better
#1
Which chart is better
A is my settings. 
B is the doctors settings (before I changed them). 
C is also the doctors settings, but on a different day.

(A) provided me with a thicker bushier looking flow rate, but less consistent and spiky-er. The pressure was able to remain level and consistent at times.

(B) gave me a thinner, but more stable flow rate. The pressure jumped around a lot and never became stable.

And before you declare (A) the winner, © is the doctors same settings, but on a different day. That was the worst evening of my life while on a machine.



But, pretending you didn't know about ©, which one would you have naturally chosen to be the better settings? 

The doctors settings were chosen because my tidal volume (or something) was (apparently) more than enough. Even IF the doctors settings were better for me on a good day, what good is it if its worse on another day?


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#2
RE: Which chart is better
not sure which is A and which is C but I vote for B, assuming that's the one in the middle. tv of 920 is too high. even 560 may be too much. 400 in B might be low depending on your height. I'd try min epap of 7, then 8 for that and to get rid of the early events occurring between 6 and about 8 cmw.
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#3
RE: Which chart is better
Overall, B or C is better than A. Any CPAP style machine is expected to reduce AHI numbers, which both B and C did better compared to A. Apnea, especially central apnea, is not consistent. No 2 sleep sessions will be identical, even with identical settings. And it looks like Ramp is On which typically isn't good for treating central apnea.

PS I took it that charts were in order of A B C.
Dave

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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.
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#4
RE: Which chart is better
(09-22-2019, 03:04 PM)sheepless Wrote: not sure which is A and which is C but I vote for B, assuming that's the one in the middle.  tv of 920 is too high.  even 560 may be too much.  400 in B might be low depending on your height.  I'd try min epap of 7, then 8 for that and to get rid of the early events occurring between 6 and about 8 cmw.

I titled the pictures but it doesn't show I guess. They lined up in C B A order. 

What are the consequences of too much tidal volume?
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#5
RE: Which chart is better
I don't know the answer to consequences of a high tv except to say in my very very limited experience maybe lightheaded and shaky.
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#6
RE: Which chart is better
It appears your doctor lower EPAP min to 6.0 IPAP max 10 with PS  4 to 9.
You changed it back to EPAP min 10.0, EPAP max 15, PS 6 to 11 and have about 30 minutes of ramp.

What I see are two very different results from the doctor's settings.  September 16 is a rough night with numerous apnea and a very active machine, while September 19 looks to be one of your best nights, but short at 3:46-hours. on the 19th your EPAP stayed near the minimum of 6, and IPAP was mainly 11-15 (PS 5-9).  The tidal volume and respiration rate look pretty good here, but as you note is not particularly high.

With EPAP min of 10.0 you seem to treat all obstructive events except during ramp.  With only this to look at, I'd say an EPAP range of 8.0 to 11.0 should be good.   You have very long stretches where your PS is at the maximum of 11.0, and this is a pretty unusual pattern, and is almost like fixed bilevel of 21/10. It seems to effectively control events, however your tidal volume is very high at 920 mL, but your respiration rate averages less than 8 BPM.  Frankly, I liked seeing a more normal respiration and tidal volume from your doctor's settings, but you're the one that lives with this.  You tolerated your settings for a longer therapy session than either of the ones using the lower pressure.
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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