[Treatment] John70's Therapy Thread

[Sleeprider]

That is everything we can ask for, with pressure moving in a very small range, nice even respiration and low event counts.  I'd judge this is representative of good sleep opportunity.  I think you have come a long way from where this started.  In fact it used to look like this:



I think this is much better:

[John70]

GM Sleeprider,

I know I am controlling my Central Apneas with the Very High Trigger setting. 
The screenshots below 5-24 has the trigger set on High and 5-25 set on very high.

My question what is the correlation between the trigger setting and increasing pressure?

The reason I ask is because I am waking up tired. 

I thought I would ask you and the AB this question before I try lowering my pressure support. 

My doctor recommends EPAP 11 and IPAP 15, no mention of PS. So I am using PS 4 EPAP 7 which essentially is EPAP 11.

I have great AHI's, with my current settings which one may conclude that I should be having my best sleep ever which is not the case. 

Let me know your thoughts,

Thank you so much,

John

          

Last night I did change my mask from P10 to Dreamwear cushion as I have a sore at the bottom of my nostril. I prefer the P10 as it is very quiet. I am controlling leaks with mouth tape. I also check my oxygen level with the mouth tape on which is always over 90.

[Sleeprider]

Your pressure support is the same as your doctor's recommended 15/11 pressure, but you are getting effective therapy 95% of the time at 12/8 pressure. By changing the trigger sensitivity, you simply reduce the flow at which your Vauto triggers IPAP and begins to increase pressure. The Vauto and S both use your spontaneous breathing effort to trigger to IPAP and cycle to EPAP. Sensitivity is actually just a way to reduce the amount of inspiratory flow (or expiratory flow) the machine requires to trigger/cycle. The reason it works to prevent CA is that at very high sensitivity, you barely have to make any respiratory effort to trigger the machine. This can queue you to continue breathing, while a slower or less sensitive trigger will leave you at EPAP longer.

There is a widespread expectation among PAP users that if AHI is low and the machine is optimized, that somehow your sleep should be better and more restful. That generally turns out to be the case, but many of our members mention this complaint. The therapy is designed to reduce or eliminate respiratory events, and there are many reasons besides airway obstruction and respiratory effort that arousals may occur. When you have taken the therapy as far as you can to make it comfortable, but still have sleep or fatigue issues, it's usually time to look outside the therapy for solutions, like reducing stress, lifestyle, medications and many other reasons that even people without apnea suffer.

[John70]

Sleeprider,

The other factors you mention could very well be an issue. Now that I am aware of them, I will pay attention to see what areas I can improve.

There are probably more issues now that I care to think about, however it good to have a realty check that it isn't all about sleep.


Thank you,

John