S9 VPAP ST-A OSCAR Data Question

[gadgetmaniah]

Thanks for this; I appreciate it! However, I'm not using my machine on iVAPS mode actually. I'm using it on regular 'S' mode. Still, your advice about comfort settings is useful. I did try increasing my minimum rise time to 500 ms and it felt much more comfortable, but right now it seems that I have lower flow limitation if I have my rise time is low. So, I'm still experimenting with the settings to see what suits me best. 

Last night I had an alright sleep - not too bad but not too good. I can see that I had some unclassified apnea which look like obstructives, so I'm thinking that I should try raising the EPAP and IPAP by 1 cm. Other than I can see the typical short arousals in my sleep but I guess there isn't much you can do about them and they're probably not a concern as long as they're not respiratory related arousals. The good thing is that, other than the UAs and mini arousals, my flow rate seems good and I don't see the irregularities in the inhale portion like I would on the Resmed Autoset. So it seems like the pressure support is helping. I subjectively feel better too and I hope the improvement continues.

Some images below of last night's sleep. I guess for tonight I'll keep EPAP at 7 and IPAP at 12. I've set the rise time to 250 ms for now and Ti Min is at 0.6. Trigger is high and Cycle is medium. One problem though I anticipate with a higher IPAP is air leaking into my eyes, and I have been having a lot of problem with dry eyes and pain due to this recently.

A few more images.

[Sleeprider]

Your more recent graphs seem to show a more natural respiration wave, but it's not clear what you are changing in any given session. The longer rise time sounds like a promising solution. What are you doing with Ti Min?

[gadgetmaniah]

I've changed the Ti Min to 6. Today my sleep was similar. It was much better than the sleep I was experiencing with the Airsense 10 Autoset, but I think there might be still some improvements I can make. I tried raising the the EPAP to 7 and IPAP to 12 but I still experienced the same amount of UAs. It's possible that the UAs are Clear Airways so I could perhaps try increasing the Trigger to Very High.

My current settings are:

IPAP: 12
EPAP: 7
Ti Min: 0.6
Ti Max: 3.0
Trigger: High
Rise Time: 150 ms
Cycle: Medium

I feel like I have a better sleep when my rise time is shorter, so I might just leave it at 150 ms for now.

[Crimson Nape]

You can certainly try the trigger at Very High.  Other than eliminating my CAs, I could not feel any difference in my breathing. I hope it will work for you.

[gadgetmaniah]

Ok, thank you. I'll try it out and see if it improves my AHI.

[gadgetmaniah]

Ok, I did not have a very good sleep today. Woke up feeling quite tired and sleep deprived despite sleeping for about 8 hours. I can see some patches of flow limitation so I wonder if that is what is causing the fatigue. However, I am monitoring my oxygen levels using the Contecn CMS50D+ and they seem fine. 

Some images below.

Should I try increasing my PS?

[gadgetmaniah]

Ok, I did not have a very good sleep today. Woke up feeling quite tired and sleep deprived despite sleeping for about 8 hours. I can see some patches of flow limitation so I wonder if that is what is causing the fatigue. However, I am monitoring my oxygen levels using the Contecn CMS50D+ and they seem fine. 

Some images below.

Should I try increasing my PS?

[Gideon]

Please show the standard charts and a full night view, look at the organize link in my signature for guidance.

All of the zoomed views are significantly flow-limited. Are you using a cervical collar? if not try one on a hunch. I think the consistency of the flow limits may be implying a positional alignment issue.

[gadgetmaniah]

Thanks. Here you go. Unfortunately this machine doesn't show FL data I think.

   

Also, by the way, here is what my flow rate normally looks like on this machine. The inhale breaths look a bit spike shaped due to the short rise time I believe (150 ms) which may be making the flow rate look more flow limited than they actually are. I'm not sure though. 

   

I can certainly look into trying a cervical collar to see if that makes a difference.

[gadgetmaniah]

Some pictures from today. I changed the Trigger setting back to High from Very High. I feel better today though not sure if it's due to changing the trigger setting. Still struggling a bit with residual sleepiness however.