MVoltaire's - Lövenstein prisma 25 ST (Therapy & Titration thread)

[MVoltaire]

Hi,

I recently also got a Löwenstein 25 ST machine and have just started my titration attempts.

I would be very happy about hearing experiences regarding machine settings and application of Auto ST for treating CAs!

[OpalRose]

Hello MVoltaire!  

Your post has been split off from another members thread.  

Going forward, please use this thread for all your therapy questions and charts you may post.  This will keep your history to one thread and makes it easier for others to advise.  

Thanks, I also sent you a PM.  

Also, update your profile with new machine information, mask, pressures, etc. here is a shortcut link to help.

https://www.apneaboard.com/forums/usercp...on=profile

[Macka]

Hi Mvoltaire, happy to help if I can.

I Just had a quick read through some of your previous posts.

You look to have a very occasional positional or anatomical restriction which occurs. This may be easily fixed with positional aids or a cervical collar and you should definitely be investigating this. A positional app for your phone like Torena or Somnopose can be very helpful during early investigation. Often positional issues are not easily resolved with pressure so you want to find out exactly what your up against before you go throwing a heap of pressure at it. Especially since you look to have little need for pap therapy the rest of the night.

Along with pulse oximeter and position app, you can set your machine to record breathing data by setting to cpap mode 6cm, no epr or softpap, no ramp. Just stable pressure to get a look at your needs. A home sleep study of sorts.

Will want Oscar customized a little and PrismaTS software is very handy. It is very easy to assist you, if along with charts posted here you are able to share the therapy.pdat file from your SD card. Using something like dropbox or google.

[MVoltaire]

HI,

And many thanks for replying!
I am currently still not sure whether it's positional or central sleep apnea in my case.
I remember many occasions drifting away half asleep and the SPO2 would alert me due to dropping oxygen levels, as I just stopped breathing again for a certain amount of time.
Last week, I ran another polysomnograph reading for my local doctor, let's wait and see what the data from this exam will tell us.

However, after playing around with the Auto ST mode I was able to reduce these desaturation events to zero and stay in the <92% range throughout the whole night.
As I am still in the setup phase, please give me a couple of days until I start posting some pressure settings.

Also, I have not yet made any  efforts towards data export and report generation. I'll need some additional time to figure everything out.

[MVoltaire]

   
Hello,

a brief update regarding configuration of my Prisma 25 S/T:

I am currently running with relatively mild pressure settings, but was still able to get rid of the isolated central events that used to appear in the past. The following parameter settings are used:

• EPAP max. 6.5 hPa
  
• EPAP min. 4 hPa
  
• autoPDIFF off
  
• BisoftPAP off
  
• autoF on
  
• Ti/t soll auto
  
• Trigger IN 1
  
• Ramp IN 2
  

Using my sleep oximeter to monitor overnight oxigenation, I was able to bring ODI down to 0 in most cases.
Currently, I am using CPAP only for the first half of the night, as this time interval seems to be the most critical period for occurrence of central events (also confirmed by polysomnography from my pulmonologist).

In addition, BIPAP application also seems to have a certain "carry-over effect" throughout the second half of the night, when I sleep without machine support, as the oxigenation levels remain stable (ODI at 1-2 max) throughout the early morning hours.