RERA .6 or so, Respiration 35-50?

[CROWMAN]

Identified cause of high respiration rates. Somehow I had selected antibacterial filter-on. When I switched it to off max respiration dropped from 50 to 27.

Bonjour - please look at the above graphs and give me some more advice.  Pat

[Gideon]

What is your AHI?  Please include a full night view along with the Event Stat chart

[CROWMAN]

Here they are. Please let me know if I need to post something else. Pat

---

Is this the events stat chart you asked for?  Pat

[CROWMAN]

Bump for Bonjour. 

[Gideon]

How do you feel? The numbers are all good. Changes should reflect eliminating symptoms, not chasing numbers.

On numbers I would increase PS a bit, to 4, to eliminate the last remnants of the RERAs, An increase in pressure may do the same. But as I said above, Changes should reflect eliminating symptoms, not chasing numbers.

[CROWMAN]

The last few days I have felt better than usual later in the days. Oddly, the last two nights were not so good with many events in the last 1-1 1/2 hours of sleep. I don't remember dreaming then so I don't know what caused it.

You suggested raising pressure support to 4. Please explain. Pressures now are 14/18 with EPR at 3.

Also, note that I updated my profile to s10 Auto from s9. I forgot to do that before the original post on this subject.

Thank you again for your help. I finally feel like we are getting somewhere better after so many years of no change in how I feel.

No doctor or NP has been able to determine why I go into a brain fog after I am up for 1/2 hour or so and stay that way until I go to bed at night.

Pat

[Gideon]

You suggested raising pressure support to 4. Please explain. Pressures now are 14/18 with EPR at 3.

Pressure Support (PS) is the difference between EPAP and IPAP, Exhale and Inhale pressure.  It is used in Titration protocols to optimize treatment of Flow Limitations, RERAs, Hypopneas. EPR, as you are using it, applies a PS of 3 cmw.  Since your machine is a ResMed CPAP this value cannot be increased.  In making recommendations I always consider ResMed CPAP machines as BiLevel machines limited to 3 cmw of pressure support.

[Sleeprider]

Fred, I think Crowman would certainly benefit from the higher pressure support of bilevel, which would also help with the hypopnea and persistent flow limitation. It's interesting that the Airsense 10 is not marking the flow limitations as expected, probably because there is almost no normal baseline inspiration. The causes of inspiratory flow limitation should be investigated by Crowman's doctor, however, I see some suggestion of positional issues with clusters of H and OA, and wonder if that might not be worth looking into.