RE: MrIvanDrago - CPAP|Bi-PAP Therapy Journey
(02-16-2024, 03:04 PM)Sleeprider Wrote: I assume this is related to the other thread concerning respiration rate. People tend to keep a fairly constant minute vent, so when we use PS to increase tidal volume, it typically causes a lower respiration rate. Whether it will affect your centrals is trial and error.
The PS of 4.0 seems to be the sweet spot for me up to now. I'm curious to the jump to a higher pressure set and if it would clean up RERA's when present? This other person said it did, but I haven't heard you or others on this board ever mention this. I obviously trust the folks on this board because I have got the best results using the suggestions here.
RE: MrIvanDrago - CPAP|Bi-PAP Therapy Journey
RERA arises from flow limitation. Without respiratory effort to overcome insufficient volume due to flow limitation, there is no RERA. There are a ton of possible arousal mechanisms that have nothing to do with respiratory effort, so I'll reserve judgement. With regard to PS, what has happened to the three horsemen, tidal volume, respiration rate and tidal volume, in the past as you raised PS? That might be the best way to model or predict your response. Finally, you don't have to increase PS in 1-cm increments.
RE: MrIvanDrago - CPAP|Bi-PAP Therapy Journey
(02-16-2024, 03:31 PM)Sleeprider Wrote: RERA arises from flow limitation. Without respiratory effort to overcome insufficient volume due to flow limitation, there is no RERA. There are a ton of possible arousal mechanisms that have nothing to do with respiratory effort, so I'll reserve judgement. With regard to PS, what has happened to the three horsemen, tidal volume, respiration rate and tidal volume, in the past as you raised PS? That might be the best way to model or predict your response. Finally, you don't have to increase PS in 1-cm increments.
Ok that makes sense. I have only tried > 4.0 pressure support one time since converting to the Aircurve on Sept 30th, my first day with it. This was by accident, but it was in ST mode and the pressure support was 5.0.
[attachment=59705]
RE: MrIvanDrago - CPAP|Bi-PAP Therapy Journey
Well in that chart your tidal volume median was 580 mL and your respiration rate dropped to 17.6 resulting in a minute vent close to your normal of 10.25 -10.75. I think your tidal volume normally is around 540. You can push on one aspect of respiration or another, but it all tends to even out on a spontaneous PAP device.
RE: MrIvanDrago - CPAP|Bi-PAP Therapy Journey
Ok so I am going to try those settings again tonight. Will update and see how things feel in the morning. Thanks for the input and help!
RE: MrIvanDrago - CPAP|Bi-PAP Therapy Journey
Here's last night's OSCAR data. The first half of the night I tried 17.0/12.0 PS5.0, then the second half I adjusted to 17.0/12.0 PS 4.0. Not sure if I should stick to a PS of 4.0 or 5.0. Any insights would be great. Not feeling a whole lot different today, but maybe a bit better.
[attachment=59734]
RE: MrIvanDrago - CPAP|Bi-PAP Therapy Journey
I think you wanted to compare tidal volume and respiration rate. The resp rate was more consistent with PS 5.0, but not remarkably different. No events at PS 5, but with PS 4 there are more spikes of FL, a single H and 3-CA. A random zoom of flow in both scenarios might be useful. Either one looks acceptable. I think it's difficult and disruptive to try split-nights, and our therapy effectiveness and comfort is really more of an aggregate of longer-term evaluation using a journal.
RE: MrIvanDrago - CPAP|Bi-PAP Therapy Journey
Makes sense I should stick to with the PS 5.0 for a few days and see what happens. I did not intentionally wake up and switch settings, it just felt like the thing to do when I woke up...?.
Anyways, I will try the PS 5.0 again tonight and see if I can get an entire night's data at these settings. Thank you for the input and analysis.
RE: MrIvanDrago - CPAP|Bi-PAP Therapy Journey
I updated my settings last night and seemed to do ok. I think I'll leave it at these pressures & PS for a bit to get a good sense if things are changing for the better unless anyone suggests otherwise. Thanks.
AirCurve 10 VAuto
PAP Mode: VPAPauto
PS 4.4 over 11.6-17.0 (cmH2O)
[attachment=59798]
RE: MrIvanDrago - CPAP|Bi-PAP Therapy Journey
I updated my settings last night and seemed to do ok. I think I'll leave it at these pressures & PS for a bit to get a good sense if things are changing for the better unless anyone suggests otherwise. Thanks.
AirCurve 10 VAuto
PAP Mode: VPAPauto
PS 4.4 over 11.6-17.0 (cmH2O)
[attachment=59798]
