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Advice on this CA event, it fully wakes me up
#11
RE: Advice on this CA event, it fully wakes me up
(07-20-2023, 07:58 PM)Sleeprider Wrote: RERA is a function of flow limitation. It is caused by increasing resistance to flow as inspiration progresses, and shows up as flattening of the inspiration peak. This causes a "respiratory effort related arousal".  Our first and best tool to treat this is pressure support or EPR.  Both result in an increasing pressure as inspiration progresses which offsets respiratory effort and results in a smoother, easier airflow.   Your solution is simple. Increase minimum pressure to 7.0 and turn on EPR Full Time at Setting 3.  This will start your pressure at 7.0/4.0 (inhale/exhale) and allow you to increase to 9.0/6.0.  This pressure support will solve the problem.

Thanks Sleeprider,
Will those settings help with something like this (see the red box on my chart) even if there isn't a flow limit? I had this last night, it woke me up, I was so frustrated after that, I turned off the machine and went back to sleep for a while.

   
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#12
RE: Advice on this CA event, it fully wakes me up
The red highlighted segment shows a very low flow rate, but is not close enough to interpret the flow wave beyond volume and apparent flow restriction (flat tops). EPR or pressure support can help with this, but a sudden increase in flow limitation like this is most likely positional, meaning it is caused by your chin-tucking or head turning to the side in a way your airway becomes obstructed. It's very common and discussed in the positional apnea section of the Optimizing Therapy wiki linked in my signature.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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