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Low tidal Volume
#1
Low tidal Volume
I am trying to improve my tidal volume with my AirCurve 10 ST-A in the ST mode. The iVAPS mode is uncomfortable to me. The problem I have is sometimes even with an increase in PS I am not getting higher volumes on average through a night of sleep. I can see on SleepyHead/Oscar that my inspirations are very short, and the rise to full IPAP is very fast and actually overshoots the set pressure. Is anyone here good at optimizing the Ti, Rise Time, etc based on the mask pressure tracings?
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#2
RE: Low tidal Volume
Hi Matt. Perhaps you could post some OSCAR daily charts illustrating the problem? Your machine is fairly specialised, so seeing the graphs might help people address your question.
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#3
RE: Low tidal Volume
Typically with spontaneous respiration, tidal volume and respiration rate move inversely to equalize minute vent. Therefore, an increase in tidal volume will normally result in lower respiration rate and minute vent remains unchanged, and vice-versa. Any respiratory target needs to consider the normal interactions that occur and a clear understanding of whether the objective is really increased tidal volume needs to be considered and thought out. Clearly, we can use pressure support to increase tidal volume, but often at the price of a decreased respiration rate or even central apnea as the hemoglobin PaCO2 drops and reduces respiratory drive. There are ways to increase tidal volume and maintain PaCO2 using enhanced expiratory rebreathing space (EERS), and that has resulted in notable increases in the trinity of tidal volume, respiration rate and minute vent.

In any manipulation of your respiration rate, and volume, we must consider interactions of the respiratory drive and have a clear understanding of the objective, and why current respiration falls short of expectations. Individuals using AVAPS are normally dealing with pulmonary or neuromuscular restriction that influence the approach to improved ventilation, and I'd be reluctant to make a specific recommendation without more history or professional medical involvement.
Sleeprider
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#4
RE: Low tidal Volume
I do suffer from a restrictive lung disease. It’s hard to set the machine well. I have the DreamStation AVAPS as well but the dumb thing is that you can’t adjust trigger sensitivity so I get a bunch of breaths while sleeping that are machine triggered. For some reason I also get an AHI on the DreamStation even though on ResMed it’s always sero. The ResMed has more options but again the iVAPS is uncomfortable because it changes pressures so rapidly. The ST mode is comfortable but the Ti and such drastically changed from awake to sleep, and you can tell my inhalations are brief and the rise to IPAP very strong.
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#5
RE: Low tidal Volume
Post a current chart and I’ll try to help. The AVAPS hs a lot of options and I need to know your mode and current settings. If you are targeting tidal volume, what is the target?
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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#6
RE: Low tidal Volume
I will sleep with my PR System One AVAPS tonight since it works with Sleepyhead/OSCAR. My DreamStation AVAPS does not seem to show meaningful data on OSCAR with the current released version.
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#7
RE: Low tidal Volume
I think that is being corrected. Have you offered your SD card data to Bonjour to use in the next release?
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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