MrIvanDrago - CPAP|Bi-PAP Therapy Journey

[MrIvanDrago]

Ok, so I have experimented with various recommendations from this board and have three different nights to share as I try to lock in my settings for optimal therapy. I have been attempting PS of 2.0, 3.0, & 4.0 and asking if anyone sees the best option for me looking at my flow rate. Obviously AHI is low in each, but I am curious to those with expertise looking at the flow rate and seeing what I am not seeing, if anything. I will say the PS2.0 was the least comfortable for me as I felt I had a hard time getting air when I woke up.


If the answer is whatever i feel the most comfortable with, that is ok, but like I said, some folks on here have a good eye at spotting things I would never see. Thanks for any help, and continue to love this board.

AirCurve 10 VAuto
PAP Mode: VPAPauto
PS 2.0 over 7.0-13.0 (cmH2O)

[attachment=56544]

AirCurve 10 VAuto
PAP Mode: VPAPauto
PS 3.0 over 5.0-13.0 (cmH2O)

[attachment=56545]

AirCurve 10 VAuto
PAP Mode: VPAPauto
PS 4.0 over 5.0-13.0 (cmH2O)

[attachment=56546]

[SarcasticDave94]

I'm not certain if these charts represent one night only trials of settings or not. Regardless, I'd be inclined to think crossing off the first one with PS 2. The goal isn't zero events, even though there's 2 that gives that on PS 3 and PS 4. However, a few things why I'd eliminate PS 2 setup, you said you didn't think it was good, events overall were up, flow limits maxed at .3x. Probably indicates need for a touch more pressures, just focusing within PS 2 etc setup here.

Onto PS 3 and 4, FL and other events were down, leaks didn't increase so mask takes the increase ok, neither were indicated particularly by you as negative.

You could take the setup of either of 3 or 4 and be doing pretty well if you can duplicate similar results. Doesn't need identical zeros, just similarly low and decent to high comfort.

Also, I think your PS can be edited like other pressures in increments of. 2, so if PS 3 isn't enough but PS 4 too much, split the difference like PS 3.4, 3.6. I don't think you'll need higher than 4 PS though.

[PeaceLoveAndPizza]

Agree with Dave and your assessment that the PS2 looks a bit uncomfortable. Some of flow compression is from flow limitations. Not something we would recommend.

PS3 and PS4 are almost identical. I would use whichever one was most comfortable.

[MrIvanDrago]

Ok thanks for the input. I am going to go back to the PS4.0 and go from there. Each of the settings I tried for over a week and similar results. I'll report back. Thanks again for the help!

[gainerfull]

Can we see a zoomed in view of one of your REM periods? Your flow rate looks off but it could just be the way it's displayed in OSCAR.

I'd be interested to see the section from 23:15 to 00:15 on the PS4 screen shot - just trying to get a glimpse into what's going on there.

[MrIvanDrago]

Here you go 23:15 - 00:15:

[attachment=56557]

And here is a one minute snapshot from the same period:

[attachment=56558]

[MrIvanDrago]

This was from last night going back to the 13.0/5.0 PS4.0. Maybe these events were positional in nature? Not sure if I should make some sort of adjustment.

[attachment=56574]

[PeaceLoveAndPizza]

Looks positional to me as well. The best advice is flatter pillow and cervical collar. 

The only pressure adjustment would be to increase the top end to 15 so the machine has a bit more headroom to work with controlling apnoeas. It of course will not use it unless necessary.

[MrIvanDrago]

Last night used PS 4.0 over 6.0-15.0 (cmH2O). Felt a bit better overall. Wanted to share with the group if anyone sees anything or adjustments that may need to be fine tuned.

[attachment=56631]

[PeaceLoveAndPizza]

Looks good. Touch nothing for at least a week to give you time to settle into these settings.