[CPAP] Experimented with CPAP Pressures, Minimal Improvement (Possible UARS)

[Alark]

Your therapy was better with the CPAP with EPR. Can you go back to that?  The Lumis VPAP 150 ST does not have EasyBreathe available to make the IPAP/EPAP transitions more comfortable.  It also has a backup rate that can trigger IPAP on a timed basis.  Instead of EasyBreathe, we only have time of inspiration and rise-time controls.  To help with this particular device, we really need to know all of the settings.   Note this device is unlike the Vauto or VPAP S devices that lack backup rate but have Easybreathe and other controls.

my main machine is autoset 10

the lumis 150 is borrowed


the problem is i dont feel rested even when below 2 ahi


some examples from October attached.

[Sleeprider]

Your path to optimized settings may be bilevel, but it's not he Lumis 150 ST.  This is a device with a different intent. If you can get your hands on an Aircurve 10 Vauto or even the VPAP S, it will produce pressure very similar to what you experienced with the Airsense 10 with EPR, but with more pressure support and controlls for trigger, cycle and time of inspiration.  Take a look at the mask pressure chart for the VPAP ST and you will see it is a square-wave pressure change.  IPAP goes on and off very rapidly, which is why I need to know your current settings for things like rise-time. Look that this flow rate and mask pressure graph. Your flow rate is extremely flow limited because your ST pressure support comes on and stays constant until the cycle to EPAP.  Your flow rate (respiration) is a mirror of that.  This machine frankly sucks, and this problem is not unique to you.  ST is intended for use with patients with COPD and other pulmonary issues. That aside, your obstructive issues are clustered and it looks like a combination of upper airway resistance and positional apnea.

[Jay51]

Sleeprider is right.  The only reason I posted was because you suddenly changed machines from the Resmed S10 Autoset to the Lumis 150 ST; and I didn't know why this change occurred.

[Alark]

The lumis 150 ST
Has these modes:
Cpap
S
ST
T
IVAPS?
PAC?

I am using the S mode
with these settings
ipap 12
epap 8


ti max 2.0
ti min 0.3
rise time = min
trigger = med
cycler = med

[G. Szabo]

As suggested above, it would be advisable to rent an Aircureve 10 Vauto like mine or an Aircureve 11 Vauto for a trial period. With these units, you can further reduce your flow limit and feel better. I apologize for being vague and simply recommending a bi-level device. I should have been more specific. 
Until then, you should return to your Airsense 10.

[Sleeprider]

You will need to change Ti Max to 2.4, rise time to medium or max and trigger to high. If we see continued UA events, then use ST mode with a breath rate of 16.

The 150 ST is a very sophisticated and expensive ventilator class PAP. It is certainly not your best choice.

[Alark]

Back to AutoSet at 10.

Currently using CPAP with a pressure of 11 and EPR set to 3, along with 100mg of 5-HTP and a nasal strip.

While there hasn’t been significant improvement in how I feel, the AHI numbers are at least showing better results—though I’m wondering if it’s just a fluke.
Should I consider increasing the pressure to 12 or 13?

It also seems like OSCAR might be reporting some false negatives.
I do have a high arched palate.

[Sleeprider]

Higher pressure is not going to hurt anything. Trialing higher pressure and keeping notes on how you feel may help to optimize the best pressure for you. With a Vauto, my starting pressure is 9.6 plus 4.4 PS, so 14/9.6 starting pressure. I don't fine increased pressure to be a problem, and it's what works best for me, however it's not for everyone. The only way to know is to try it and evaluate your options.

Sorry about the VPAP 150 ST fiasco, but your CPAP looks a lot better in both the overall therapy and zoomed views. If you ever get a chance to try an Aircurve 10/11 Vauto or S, it will be a better experience.