(05-10-2016, 02:06 PM)plaidwandering Wrote: The pain and nausea are too severe for me to 'just do it' for a while to see if my esophagus learns to block out the air.
I asked if lowering the pressure range would help me get used to it for a while, and was told not only no, but that it would make the treatment worthless. They fail to grasp that not being able to do it is also worthless for treatment.
Yep. Been there, done that. It took the PA in my first sleep doc's office 3 "semi-emergency" meetings with me looking like something the cat dragged in before she was willing to admit that maybe, just maybe they'd over titrated me at the titration sleep study.
In terms of dealing with the idiots at the DME or sleep doc's office who just don't get it, I would suggest bugging them on a daily basis if need be. Every time you wake up feeling like you swallowed a basketball, call the doc's office. And I do mean every time.
OR get the clinical menu and reset the pressure setting yourself. Seriously: If they're not willing to help you, you might just need to get brave enough to help your self.
Quote:Is it really completely worthless if you aren't clearing your AHI down below 5? Is there any harm in a lower range for a trial period? It's not like I could be worse off than on my own right?
While long term you're likely not to feel much better if you are using a pressure that is too low to bring your AHI down to below 5, there's the very important issue which you raise: It's certainly NOT better to forgo therapy completely simply because the powers that be tell you there's no point in lowering the pressure.
Here's the thing: Aerophagia is often very pressure sensitive. As in dropping the pressure by 1 or 2cm may be enough to reduce the aerophagia down to where it is NOT an issue. And it is possible to be over titrated: Toward the end of the night on a titration study, the tech may jump the pressure up by 2cm in response to a couple of events rather than the more usual 1cm. (That's what happened to me.) And an APAP can also be used so that the pressure is at or just above what your stomach can tolerate for as little time as possible.
Here's my advice since you have a DreamStation Auto: Check your data and find out what the 90% pressure setting actually is. Also check the detailed daily data in SleepyHead to find out what
is driving the pressure increases. If it's flow limitations instead of OAs and Hs, you may be much better off with capping the max pressure right below your 90% for a week or two to see if (a) it takes the edge off the aerophagia and (b) how much the AHI actually goes up.
There's just a chance that your AHI might stay below 5 even if you reduce the max pressure setting to something that your stomach can handle.
And if the AHI winds up increasing to something above 5, you still have the option of slowly increasing the max pressure (and the min pressure if need be) once your stomach starts to acclimate to PAP therapy.