WW4B Therapy thread

[WW4B]

Hello and glad to be part of this forum. Have been using CPAP therapy for awhile and looking for advice on my charts. I have included three charts with different settings in trying to fine tune my therapy. Large leaks seem to be a major issue. The charts with the latest two dates hav e the trigger and cycle set to very high. The earliest dated chart have the settings set to default with lower pressure settings. There are times that I feel that the breathing cycle when inhaling could/should be longer. I feel that I want/need to be taking deeper or longer breaths. Would my charts indicate that this is happening? Would I benefit by changing trigger and cycle settings back to the default settings or changing the Ti min/max settings? Have been reading and absorbing so much on the subject that i get myself confused on what is the right or the more correct approach to fine tune my therapy and feel refreshed when waking. Can someone please offer thier advice, guidance and wisdom. Thank you accepting me into the forum. 
   
   
   

[WW4B]

Hello again. I have attached 3 more charts for review in hoping that they may help in deciding what would be the best course of action in determining the correct or best solutions in setting my machine to the correct settings. 
thanks to all in advance...
   
   
   

[WW4B]

Hi everyone, it has been a few days since this post...does anyone have any advice or guidance to offer.

[WW4B]

Hello again, still looking for advice on my settings. I have changed pressure support to 5 and decreased minimum to 8 in hopes of decreasing large leaks. 
Feel like I am having issues with inhalation as I feel it should be a bit longer. Current settings...
IPAP / 20
Epap / 8
PS / 5
Trigger & Cycle / Med
Ti Max / 3
Ti Min / 0.3 Default
Have attached 2 additional charts to review. What course of action would better suit my needs in regards to what the charts are displaying. 
Should i consider trigger changes or Ti changes? Lower or higher PS? Min pressure changes ?
I realize I may be all over the place but based on my charts what would be a good starting point. 
Than You in advance
   
   

[WW4B]

Frustrated....I give up !

[Gideon]

Sorry for the delay, but I was busy getting some back surgery for pain.

IMHO you have no reason to change Trigger and Cycle.  Leave them at medium. Your IE ratio is near standard, and a lot of variability is common.  

Your large leaks are steady, implying the possible mouth breathing or a hose fitting or humidifier gasket is leaking or not firmly fit.

With your numbers the question becomes how do you feel?

On PS use the default of 4 for now.

[WW4B]

Gideon, thank you for the reply and hope your back surgery was a success and alleviated your pain. Just off of surgery myself with a hip replacement 8 weeks ago myself and still on the road to recovery but pain free now. Always felt that my inhalation needed to be a tad bit longer. In tinkering I have set trigger to high, lowered min pressure to 9.2 and increased ps to 4.8. Ti max is set to 3.7 and Ti min is at the default setting of 0.3. The only other addition i made was to change the standard head gear on my DreamWear nasal pillow mask to use the headgear with arms. I feel it is a somewhat better fit and the headgear sits lower on the back of the head closer down to the upper base of the neck. 
My first night with these changes resulted in a leak rate of a low 4/L min which is unheard of for me, no large leaks, 0 AHI, and no events. Last nights charts are attached. 
Would very, very much love you advice or opinion on last nights results. Did I just get lucky, who knows at this point but will continue to sleep with and monitor these settings for a few more days. Thank you very much in advance. 
     
   

[Gideon]

I don't see a difference between this chart and previous ones.
I'd put Trigger and cycle at Medium, the default values and not change them without a very specific reason and expectation, returning to default if the expectation is not met.
I'd also start with a PS of 4.

Comfort should be driving your changes, not numbers.

[WW4B]

Very appreciative of the advice and guidance given. Two additional recent graphs are attached. Question...with my 95% pressure settings numbers around 10 and 14 would it be more beneficial if I switched min epap settings to 6-7 / max 20 and lowering PS to 3 or 3.4 range.
All other settings are Trigger & Cycle = Med, Timax=3, Ti min = 0.3. Also how are my flow limitations ?  
Thanks.
   
   

[WW4B]

Last nights chart with differing pressure settings. Where or what would you recommend I stay with for the next 2-4 weeks. Would love to have sleepriders opinion on my settings.