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RE: Still dialing in pressure and understanding data (help)
I merged your two threads. Both have to do with your therapy, and the history is important. If you want a new title like Tpoc Therapy Thread, let me know. Please keep therapy questions together.
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Sorry forgot to add these. Feel like my numbers keep getting worse. Last night wasn't very good couldn't barely stay asleep and when I started to, I woke up feeling like I wasn't exhaling properly or something. I had my mouth taped for each of these nights too. Any feedback would be greatly appreciated.
For context, I bumped up the max to 11 from 10.8 and turned down the EPR to 1. Should I just turn it completely off and bump my max pressure down to 10.8 where it was?
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
I just wanted to note that I have NOT been able to get past the 5 hour mark without waking completely up. My AHI keeps going up and I have no idea what to adjust next. Any advice would greatly be appreciated.
Saw the doctor on Friday last week for a follow up. He suggested using CPAP mode instead of using the min/max and setting it low, then coming up. Worse comes to worse, he wrote me a script for a titration so I can dial it in at a facility. I'm probably going to bump it up but I feel much better with it at 8 in CPAP mode. My events look better too.
When we started you 95% flow limit was way up at 0.68. With EPR at 2 that was significantly reduced to 0.09 to 0.13 and with EPR at setting 3 your chart on May 8 and April 11 shows 0.01 which is excellent. The most recent chart with fixed pressure using EPR 2 shows flow limits back t 0.05. I think you did fine on Autoset mode, but you should judge based on comfort. You clearly respond to the use of EPR 3 with much lower flow limitation, slightly better minute vent volume, but similar AHI. May 8 had some positional obstruction, but that should clear up by avoiding taller pillows or chin-tucking, but with the minimum pressure set at 8.0, it also resulted in a lower EPAP pressure which increased the obstructive events. We can therefore conclude that with EPR 3, you need a minimum pressure of 9.0 to compensate, however the maximum pressure of 11.0 does not need to change.
A titration test is unlikely to find a CPAP setting that is more useful, but it might be interesting if it includes moving to bilevel if needed. You are not very well treated by CPAP, a single pressure for inhale and exhale. With EPR you are getting bilevel pressure, and it has obvious benefits for comfort, flow limits and shorter inspiration time (easier breathing). So your data is showing a clear benefit of pressure support.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
couldn't barely stay asleep and when I started to, I woke up feeling like I wasn't exhaling properly or something. I had my mouth taped for each of these nights too. Any feedback would be greatly appreciated.