Help With Moms Sleepyhead Report

[Sleeprider]

Snore and flow limit do not seem to be available options, I have tried and they are not there, this is not an auto machine

Can you post the graph so that the top of the left column, with the AHI and machine type are posted? You indicated before this is a S9 VPAP COPD model. Did you download the clinician manual for this machine? We might want to zoom in on the respiratory flow line. The default Ti Max on the S9 is only 1.00 which may be withdrawing IPAP pressure too soon. It might be interesting to increase to 1.20.

[silversnore]

    here is the modified screenshot, hope it is correct.  I do have the clinical manual.  I will post newest screenshot when mom wakes up, thank you for taking the time to help with these

Mark

[silversnore]

[attachment=6280] last nights results, pressures adjusted to 7.6 and 11.6, no pressure support on this machine

[Sleeprider]

Did you increase the TiMax? I really think the machine is cutting off her inhales at the default 1-second, and I'm certain she needs more time. I suggested a conservative 1.2, but I could justify 1.5 seconds. Just look at how the inspiratory time graph is decapitated at 1.0. Compare that to your own.

I think we need to zoom into the UA event cluster and try to decide if we're dealing with obstructive or central events. The increase in pressure support (the difference between IPAP and EPAP) has decreased hypopnea. If the UA cluster is obstructive, I have to assume a positional issue. If it is central, then the increased PS may have contributed. She seemed to do better with lower EPAP pressure and less PS, so return EPAP to 7.0 and IPAP at 9.4.

[silversnore]

[attachment=6309] Does not seem to be centrals, mom sleeps on her back with three pillows, probably not the best position.   She has gerd and reluctant to change.  Thanks Sleeprider

[Sleeprider]

The three pillows explains the positional apnea. It forces her chin into her chest, and those events are likely obstructive and positional. Whether pressure can overcome the restriction is kind of academic. The best thing to do is to fit her with a soft c-collar and take away a couple pillows...or accept that she will have clusters of OA due to her preference for elevating her head. It's mom, she's the boss. This habit may not be easy to break.