[Pressure] jonny7100 - Therapy Thread

[jonny7100]

Hi everyone,

Here is from last night.

I am not feeling great. Seems like I had a couple good nights but they went away....

Would be incredibly appreciative for some support and input.

[UnicornRider]

Barry Krakow has some very good insights. We will get into his area a little later.

Several things may improve your PAP Therapy sessions.

7 cmH2O is very low most adults do not feel comfortable at or below 7 cmH2O.

We are going to use the APAPauto mode to find where your sweet spot is.

Try setting the following parameters.

Mode: APAPauto
Press Min: 7.0 cmH2O
Press Max: 15.0 cmH2O
PS: 4.0 cmH2O


Your pressure will only rise as far as your needs dictate. I expect to adjust these settings as you progress.

Give these a try and post some OSCAR Reports.

[UnicornRider]

From an earlier post "I got in Bipap because after 200 days with CPAP, I felt worse and knew something was wrong. I could wear the mask all night long but kept getting woken up. My sleep doctor told me my data looks good. I found Barry Krakow online and he says that for many patients, cpap makes things worse. And my Watchpat data suggests maybe UARS, which I read online bipap can help with."

After we get you on APAPauto mode we can adjust pressures to mimic BiLevel if necessary, but will try auto ranging to get started. After we get you close then we will address UARS.

[jonny7100]

Hi there,

thanks for your response.

So for my first 100 or so days on therapy, I was using APAP 5-20cm. With nasal pillows, my average pressure was usually between 6.5cm-7.5cm . I also did an in lab cpap titration and the sleep doc prescribed me 7cm of pressure. 

I did ~7cm of pressure for around another 100 days with limited success. I have lots of OSCAR pages with 7cm of CPAP (not APAP). 

I am getting by far way more consistently good results symptom wise with BIPAP than CPAP. I don't feel great/rested per se but CPAP made me feel like death. I felt way worse with CPAP than without. 

I don't really think there is much benefit at this point of trying APAP mode again. I am 100% sure it will land around 7cm.

[UnicornRider]

Jonny7100, Thanks for the feed back, I wish I could see the OSCAR Reports for those other modes of operation, but that is not possible to review all of those. It is common for a provider to start a patient with "Auto mode 5-20 cmH2O". Auto mode will provide parameters to address CA events that I can not do in BiLevel mode. However I can make Auto mode perform as a CPAP or BiLevel and provide for addressing CA events.

I was thinking EPR vs, PS when I posted those previous values. So let me correct those settings and explain further what it will do for you.


      Try setting the following parameters.

Mode:         APAPauto
Press Min:   3.0 cmH2O
Press Max:  15.0 cmH2O
PS:             4.0 cmH2O



With these settings your Epap will be 3.0 cmH2O below Ipap. 
Ipap will start out at 7.0 cmH2O.

IF needed your machine will adjust Ipap to control events. it will not take pressure above where it determines you need it. But the information graphed and reported will be different than in BiLevel mode.

From those OSCAR Reports I can assist you, to fine tune your machine, but I need to see how it performs in APAPAuto mode.

From there we can adjust various parameters for effectiveness and comfort.

I suspect we may increase Pressure Support (PS) and adjust other parameters.

I hope this clarifies why I need to see Auto mode of operation.