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Sooo...last night I decided to do a little tinkering with my PS. I've been running it on 3 pretty much forever. My flow limit numbers have never been high but my flow chart has always looked kind of "grassy" to me. I think I read somewhere that indicates flow limited breathing but I've always just let it ride since my numbers were low. Night before last I bumped the PS up to 4, everything went fine and I think it looked a tiny bit better.
Last night I decided to go for the gusto and pushed it up to 5. That appears to have been not a good idea. I'm not sure how much of this I was awake because I really don't feel like I slept much at all. I know I was awake a lot of the night. Got up a little before 1 to use the bathroom and somewhere between 2:30 and 3:00 I put the PS back on 4. I assume OSCAR is showing the PS setting as 4 because that's the last setting it was on.
Needless to say, I'll be leaving the PS on either 3 or 4 from now on.
Your flow limit is fine. The 95%-tile is showing 0.0. You are probably experiencing CAs because of CO2 washout. I would drop the PS to 2 for the whole night. Do not start dial-winging during the night.
- Red
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.
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.
(05-31-2023, 08:33 PM)Sleeprider Wrote: Remember PS on the Vauto can be adjusted in increments of 0.2, so no need to go to 5, 6, 7. You can try 4.6, 4.8 etc.
That is a very good point. This apparently wasn't the time for a "go big or go home" approach.
I observed that making a single large change in PS increases CA's significantly and these CA's then seem to persist for some days or weeks.
On the flip side, dialing back the PS until the CA's go away and then making very small incremental increase of 0.2 a day as Sleeprider mentioned seems to make it possible to achieve a higher PS level over time.
The CO2 washout issue, must trigger some quite significant response that persisist for a while in some way, hence why large changes are problematic. Its a bit annoying not being able to make quick changes, but slow and steady seems to be the method that needs to be applied.
I observed that too.
But in your opinion, what would make more sense?
To try to fix respiratory effort and RERA that mostly happen in REM sleep. Would you try to get the highest PS possible by incrementing slowly the PS every week to avoid CA and hope that the body will use to and CA will reduce over the time or simply increase both EPAP/IPAP.
In my case, I know that over 5,4 of PS, I get much more CA. I got recommandation to use high PS like 6 but I'm not sure that it is worse it over keeping a raisonnable PS (4-5) and simply increase both EPAP/IPAP ?
Machine: Phillips Respironics Trilogy Evo Mask Type: Full face mask Mask Make & Model: F & P Vitera Humidifier: separate F&P humidifier CPAP Pressure: Epap 4-10 PS 4-20; "auto" rate CPAP Software: Not using software
Other Comments: Using 45 degree angle upper body wedge (36"x36") and 4.5"soft cervical collar; 500 assured tidal vol
With a machine that provides a back up rate, PS can be raised pretty much as high as needed (and no CA's will result). Hopefully neither you or OP will need to take this step though.
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Why does backup rate affect CA's? Can the same be achieved if forcing a shorter breath with a reduced Timax?
I noticed during one test I had Timax set to low at 2.0 seconds and inspriation rate was getting cut short and forcing a switchover, I noticed CA's were absent despite higher PS.
