10-18-2024, 08:21 AM
RE: Switched to full face mask last night. Flow limitation increased
Obstructed Airway101, all of your charts show the use of CPAP pressure in the range of 10 to 14 cm with the use of VCOM. In general, you seem to settle in at 12 cm pressure. The two charts you posted so far show very different results with the first displaying RERA and high flow limitation, and the second showing sporadic OA and OA clusters. Sometimes we can learn more about how you respond by changing up some variables. I'm not a fan of VCOM so be aware of that bias. The pattern of obstructive events suggests you may have some occasional positional obstruction. The OA events and even the high flow limits in the first graph arise with little to no warning. The occasional clustering of OA events in the second is typical of chin-tucking, and then full clearing of the apnea. Take a look at the positional apnea wiki article and consider whether this may be applicable to you. https://www.apneaboard.com/wiki/index.ph...onal_Apnea
The theory behind VCOM is that it uses expiratory flow to increase pressure during exhale. With the fixed CPAP pressure you are using this should not be needed, and you are correct that it basically counters the effect of EPR, which you're not using. I think omitting VCOM with your pressure at 11-13 should prove comfortable since you tolerate CPAP pressure without EPR. I don't see a need to change your pressure range. At some point I'd like to see you try EPR, without pressure correction, and see what a lower expiratory pressure does for you.
The theory behind VCOM is that it uses expiratory flow to increase pressure during exhale. With the fixed CPAP pressure you are using this should not be needed, and you are correct that it basically counters the effect of EPR, which you're not using. I think omitting VCOM with your pressure at 11-13 should prove comfortable since you tolerate CPAP pressure without EPR. I don't see a need to change your pressure range. At some point I'd like to see you try EPR, without pressure correction, and see what a lower expiratory pressure does for you.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com
____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier
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.
Apnea Board Moderator
www.ApneaBoard.com
____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier
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.
