Optimizing UARS Therapy From ASV to Vauto

[Sleeprider]

There are still more leaks than not in here.  Pressure is not moving a bit, so I would say pressure is too high and leaks are too high.

[UARS.DDS]

I’ll bring my EPAP down a couple of notches. Thank you.0

[SarcasticDave94]

I don't know if I'd adjust pressures. You need to control leaks by way of better fit/sizing for you, mask adjusting, and then to control mouth and mask leaks. I think if you lowered pressure, it may artificially lower leaks but it's not been really addressed. And besides that it may hinder therapy even more.

[Sleeprider]

My suggestion on lower pressure is based on essentially no events and no pressure changes. I agree with resolving leaks, but those two things can go hand-in-hand, especially with the bilevel therapy.

[SarcasticDave94]

OK that edit then makes more sense in going together to resolve issues. I'd missed that earlier section as it being a 2 part action.

[UARS.DDS]

Past few nights with the ResMed AirCurve 10... mouth tape + double chin strap.

3 nights ago:

   

2 nights ago:

   

Last night:

   

I kept slowly bumping up my EPAP to prevent the machine from having to raise the pressure. From months of treating myself, I think ~18 cm H2O EPAP is where the machine is happy and doesn't have to raise pressures to combat events.

I'm thinking of slowly (.2 cm H2O at a time) bumping up PS every few days to see what happens to the FLs. Perhaps wear my cervical collar instead and see if that helps with the mouth leaks, although it's more comfortable sleeping with the double chin strap. What say you?

[Sleeprider]

Looks great, although your pressures are very high. Obstructive events when they occur, happen in clusters. I'm pretty certain you have found an effective therapy pressure and your best control of leaks was on 1/28.

Would you like me to change the title of this thread to something like Optimizing Therapy From ASV to Vauto?

[UARS.DDS]

Looks great, although your pressures are very high.  Obstructive events when they occur, happen in clusters.  I'm pretty certain you have found an effective therapy pressure and your best control of leaks was on 1/28.

Would you like me to change the title of this thread to something like Optimizing Therapy From ASV to Vauto?

I would appreciate editing the title thread - thank you very much Sleeprider.

Both sleep tests I have taken showed an AHI of 2, so very "mild," although I was highly symptomatic - I was diagnosed with generalized anxiety and OCD and put on meds for it; GERD every day for which I was on meds; tinnitus in my right ear which was driving me mad; high levels of fatigue; cloudiness/fogginess/forgetfulness; feeling highly on edge every day.

I believe my high RDI on both sleep tests (12-13) were the culprit, and were the reason for my eventual UARS diagnosis. I'm happy to report that, as of six months ago after starting VAuto, the symptoms have been reduced by 80% (NO anxiety/OCD and NO GERD (and no meds!!), NO tinnitus, BUT I still am fatigued about 30%). I think the key to feeling 100% will be to reduce FLs as much as possible and get my RDI down.

Barry Krakow MD's research into treating UARS supports the need for high pressure in treating these cases. Wish I didn't need it, but I'm grateful that I'm not intolerant of it and don't get aerophagia easily.

If anyone's interested to know, I'm having an MSE (Maxillary Skeletal Expander) placed soon to hopefully break my maxillary suture and have increased nasal cavity volume, and will have MMA surgery in about 6-8 months to bring both of my jaws forward and expand the airway. Fingers crossed!