durxll - Therapy Thread

[SarcasticDave94]

We need an OSCAR chart to help. There's different suggestions that will be given for the events that show.

If there's Positional Apnea patterns, settings may not matter, because the airway is physically and externally blocked.

Keep posts here in this thread please.

Thanks.

[durxll]

We need an OSCAR chart to help. There's different suggestions that will be given for the events that show.

If there's Positional Apnea patterns, settings may not matter, because the airway is physically and externally blocked.

Keep posts here in this thread please.

Thanks.

I'm going to post some more in a day or two when I get more nights in because I changed my pressures to 6 epap 10 ipap for PS, but do you understand what I mean about the conflict between trying to get rid of flow limits caused by exhalation pressure and OAS when your OA pressure is higher than the needed exhalation pressure for flow limits? 

Basically I need a six epap to get rid of most of my OAs but I also seem to need an epap of four to get really low flow limits so I will just end up having to choose which one I want to be better or do a combination that leaves neither of them great?

All of this is if the collar doesn't work or a special pillow I suppose, which could lower my OAS and allow me to use a four epap?

[SarcasticDave94]

I would not think a low EPAP gives better flow limits control than a reasonable low EPAP with pressure support working to give some pressure differential. I'm probably not following, because what you're saying seems contradictory.

[durxll]

I would not think a low EPAP gives better flow limits control than a reasonable low EPAP with pressure support working to give some pressure differential. I'm probably not following, because what you're saying seems contradictory.

Well I may not understand exactly how it works I was under the impression that you could get flow limits raised if you have an issue with being able to exhale properly into too high of an epap but maybe I mistaken I guess. 

My goal right now is to do what you said and try to get this to a 6/12. I have it at 6/10, but when I had a difference of five between the two it was giving me central's. Only a couple every other night or so except for one of the nights it gave me quite a few. So I just went from a 4/9 to a 6/10. I will keep it at this pressure for at least a couple days eventually I will get it to 6/12 and see if my flow limits are dropped. If I end up needing a 12 on the ipap and it gives me centrals because of the six difference I will then try to get to 8/12.

Thanks for the help

[SarcasticDave94]

You can set PS to 3 or so and see how it goes. If I'm not mistaken PS is a static single number. What this does would then is to force EPAP and IPAP to have a separation of that PS of 3. The min EPAP is the low pressure bookend, Max IPAP is the high pressure bookend.

[durxll]

I know there are more options on a BiPAP like trigger etc but if those are on default are these settings going to provide the same therapy or is the BiPAP doing other things? I have an air curve 10 v Auto and an airsense 10 Auto set. The air sense 10 reports reras to Oscar and the air curve 10 BiPAP does not. Why it doesn't is beyond me but it doesn't. So if the therapy is the same I would use the auto set. I may end up needing a bit higher pressures but as long as the difference in pressure is a Max of three they are the same?

[SarcasticDave94]

There's not much context here to answer the question. Why are you now on the VAuto but were originally on the AutoSet? If you say some therapy x is better on VAuto, or comfort is better, etc.

In theory, the 2 machines would be similar with those settings for therapy. However in practice of therapy they can be very different.

[durxll]

There's not much context here to answer the question. Why are you now on the VAuto but were originally on the AutoSet? If you say some therapy x is better on VAuto, or comfort is better, etc.

In theory, the 2 machines would be similar with those settings for therapy. However in practice of therapy they can be very different.

I went to a v Auto to try to lower my flow limits which I was told could be helped by being able to make the difference in pressures higher than three but as I've gone up in pressure it looks like I may not need it higher than three. My flow limits have seemed to have dropped just by making my pressure higher in general on inhalation and not necessarily by having a higher than three pressure difference but I need more testing to make sure that this is true that's why I said I might be staying on the BiPAP. If I don't end up needing more than a three then I would like to be able to look at my reras. I am now on 8 epap 11 ipap 3 PS and was thinking about moving to 9/11 or 9/12. Sorry for a lack of punctuation I am using speech to text

[durxll]

There's not much context here to answer the question. Why are you now on the VAuto but were originally on the AutoSet? If you say some therapy x is better on VAuto, or comfort is better, etc.

In theory, the 2 machines would be similar with those settings for therapy. However in practice of therapy they can be very different.

Oh I also wanted to be able to have my exhalation pressure lower than my inhalation since when I went back on my CPAP on a straight-up 13 in 13 out CPAP setup I had chest tightness and short of breath and went to the ER. Research showed me that this can happen sometimes until your muscles and lungs get used to it and I figured it was more than likely that the breathing out against a high pressure was the culprit than the breathing in so I wanted the exhalation to be  quite a bit lower or at least more than three while I was getting used to a low exhalation pressure and slowly dialing it upward I'm now at an eight and possibly going to a nine soon maybe even tonight.

[SarcasticDave94]

I would think the VAuto would be the more capable then, when dealing with flow limits. Your pressure will already be set differently than the CPAP at straight 13, as you said EPAP was 8, which should be the EPAP Min 8, and then PS 3 which is static, that gets you to IPAP Min 11. At the top end, whatever your IPAP Max is set to is there to help with Auto adjusting space.

Be sure to keep posts together reading therapy, as the context is mostly missing. You'll want the OSCAR charts to help tell the story as well, which you've likely used in another thread to help get things tuned better.

If you want, I can get a moderator to merge this to you main therapy thread, since this is likely just a continuation of it.