Looking for suggestions

[chzuck]

I am still trying to understand the jagged pressure graph and what I changed to give me that result.  Do I understand correctly that now the machine is only providing higher pressure when thee is an event?  If that is so, what suggested change resulted in that?  I am so used to seeing two flat lines, one at 19 and the other at 15, except for ramp up.

[staceyburke]

Ok, I will try to explain the pressure lines.  Cpap stands for Continuous positive airway pressure.  When they first started using this type of device, all the machine did was to blow air at a preset speed.  A pressure graph would have been ONE strait line at the number the machine was set for.  That worked for some but as the pressure was increased, it became difficult to keep the mask sealed and many people had trouble keeping their mouth closed – making the therapy useless because either one stops it for being  “continuous positive pressure”.  Every time the mask leaked or the air came through the mask the pressure was gone.
 
Later on they developed a higher pressure to stop the apnea and a lower pressure to exhale.  The advance was called EPR – Exhale Pressure relief.   The setting EPR was 1, 2 or 3.  So let’s say you had a high pressure to stop apnea at 12 and an EPR 3, your exhale pressure was 9.  Those became the normal CPAPS of the day.  Very little else could be changed in settings.  Those Cpap are now called auto CPAPs because they do not have stay at the highest pressure, they range between the low (inhale) pressure to the Max pressure when they encounter Apnea.  If they don’t find apnea the pressure stays low until it needs to rise to fix the apnea.  Those are  the peaks in the pressure graph.
 
Then came the BiPap which was a more expensive machine that you use PS – Pressure support.  Pressure support was just like EPR except it increase was not 1, 2 or 3, PS could go up as high as the machine can go and the increments were not by one but .2.   IF you had PS of 5 and a low of 10, your inhale would be 15 your exhale would be 10 (obviously more than just 3 EPR) Now the Bipap like you have can be adjusted with all types of settings, as we did with your trigger setting.
 
Think of it as a car when I was a kid.  If it was hot you rolled down the windows and drove faster to let air come in the car.  Then came air conditioning that you did not need to open the windows you just turned on the air conditioning but you only had fan speed of low med and high.  Now in my car you set the temperature to 74 degrees and it will turn on the air, regulate the fan speed and even turn on the heater if the temperature in the car drops.
 
You can make your pressure graph a straight line by making the max and min the SAME number and that will give you a straight line but it may be too low to stop the apnea or you can turn it way up and stop the apnea but make the pressure so high it is uncomfortable to use or too much pressure that your mask can not seal.  In either case your cpap is not going to do you much good but you would have a straight line on your pressure graph.

[chzuck]

Thank you for a great explanation.  I understand it much better.  I had forgot to change the trigger last night so I did not send you last night's data.
I looked at several collars and hope to decide and order one by tonight.  Would you have a favorite?

[staceyburke]

No I do not need one but the main measurement is the height of the collar. It has to be high enough to stop chin tucking but not so high that it pushes your neck.back. The correct height is the distance from your chin to your Sternum.

[chzuck]

No I do not need one but the main measurement is the height of the collar. It has to be high enough to stop chin tucking but not so high that it pushes your neck.back. The correct height is the distance from your chin to your Sternum.

OK, thanks for all of your help and information.

[Deborah K.]

When I had positional apnea I tried numerous collars. I liked the Caldera Releaf Collar the best by far. It worked as well as any others but was much more comfortable. Amazon carries it.

[chzuck]

When I had positional apnea I tried numerous collars.  I liked the Caldera Releaf Collar the best by far.  It worked as well as any others but was much more comfortable.  Amazon carries it.

Thank you.

[chronic]

I obtained futuro cervical collar from amazon. It has an adjustment area under your chin that can make it not so tall, if that is what is needed. Probably about $20. Not bad but getting a bit warm for this weather. You have a very interesting thread going here.

[chzuck]

I obtained futuro cervical collar from amazon.  It has an adjustment area under your chin that can make it not so tall, if that is what is needed.  Probably about $20.  Not bad but getting a bit warm for this weather.  You have a very interesting thread going here.

Well, my experience is you don't learn much from your doctor or equipment provider!
So glad to find this information.  The thing that concerns me about a collar, being too warm and not being able to fall asleep, but I need to see if it helps.

[chzuck]

Looks better. Let’s go down 2 on the min and up one on the ps.

Ps 5 over 8-19

Your centrals may be helped by using the trigger setting.

Set trigger to high.

You asked about the pressure chart looking jagged. You had your pressure so high it was at the max 19 almost full time. That make it much more likely to have to much pressure and leaks. It also can make it harder to get deep sleep. Most people do better at the lowest pressure you can use without O events.

Last night's results.