MrIvanDrago - CPAP|Bi-PAP Therapy Journey

[MrIvanDrago]

I have a question about humidity with these ResMed machines. I originally used 'Auto' for the tube and humidity levels, then in the winter switched to a high tube temp and a humidity at 6. Last week I went back to 'Auto' since it is summer now here in the NE US and was having a lot of moisture on my face which caused the mask to shift sometimes.

My question is, have folks had issues with humidity too high or 'Auto' not enough. I was getting a dry sore throat on 'Auto' these past few days, but liked the way it felt during the night. If I keep the humidity at 6, but turn the tube temp down, would I see rainout? Curious to others thoughts.

[PeaceLoveAndPizza]

Here is a link to the ResMed paper on CPAP humidity.

https://document.resmed.com/documents/pr...sa_eng.pdf

[G. Szabo]

I was getting a dry sore throat on 'Auto' these past few days ...

I had the same problem with the AUTO setting. I have been using the setting on the left successfully. It is about the condensation point in my climate.

[MrIvanDrago]

Hello All,

So I have settled in the last 35 days using the same settings on my Aircurve 10. 16.0/12.0 and all the default settings in S-mode. After 6 months of trying different pressures, trigger settings to 'High' and TiMax set to 2.5, I decided to go back to the original settings recommended to me by TheLankyLefty when I met with him last September.

Question: Is there ever any reason we would change Trigger settings from the default of 'Med' to 'High' besides for a large about of CA events? Curious to what folks on this board think. Thanks in advance for any help with this. I have attached a few screenshots of my OSCAR results recently.

   

   

[Sleeprider]

The medium trigger setting is right for most people, but high and very-high trigger helps with CA events when those are an issue. If you can detect a comfort difference between the settings that may also affect your decision. Higher trigger settings often mitigate the loss of respiratory drive from pressure support or increased ventilation, and as an individual adapts to PS, that higher trigger may not be needed. On the other hand, I almost can't think of a circumstance that is improved with lower sensitivity settings. You seem to have a pretty good grasp on what works in your therapy, and I see no reason to question that.

[bigguybri]

Thanks SleepRider for your advice as usual. I was wondering if over time a trigger setting of high or very high could cause people to depend more on the machine to trigger a breath rather than their own respiratory drive.

[SarcasticDave94]

If the VAuto, AutoSet, ASV, ST, were in the ventilator class with the accompanying settings and capabilities, maybe dependence can be an issue. These CPAP based machines do not drive your respiration, they do require spontaneous input, excluding the time settings on ST.

And I didn't mention ST-A which is between CPAP and ventilator classes. It has the footprint of CPAP but some capabilities of a ventilator class, but more limited in maximum pressure.

[Sleeprider]

Bigguybri, I don't think dependency is a problem. Even very-high trigger setting requires spontaneous effort to trigger IPAP, and that is not going to affect dependency. All of us depend on the stent positive air pressure provides, and most of us are more comfortable with pressure support than without. Pressure support does not cause the breath at the levels used in spontaneous bilevel, but can make respiration easier by mitigating flow limitation and providing lower expiratory pressure. Any of us with severe OSA would be very reluctant to give up PAP, so however you define dependency, I suppose we are to some extent, but I've never heard of someone that stopped breathing because they didn't have PAP.

[MrIvanDrago]

I am starting to dial in my therapy and wanted to ask the group a simple question which may turn out to be a larger discussion. I am now looking at lowering my User Defined Flow Limit #2 (70% Flow Restriction, Event Duration 7.00s) in OSCAR and asking what would be the best way to achieve this? 

Would it be lowering pressure, upping the pressure, lowering pressure support, or lowering pressure support if anything at all? Many of my nights consist of frequent arousals and may have found the culprit, but I could be wrong. I noticed looking back on historical data, that lower pressures had less UF#2 identified, but this could be a coincidence, I'm not sure.

Attached is last nights data from OSCAR:

16.0/12.0 PS4.0 (Been using these settings for 65 days now consistently)

   

[Deborah K.]

We could better help you if you set up your Oscar chart differently.  We need to see the following items, and these only, in the order listed:

Event Flags
Flow Rate
Pressure
Leak Rate
Flow Limits

We need to see to the very bottom of the Flow Limits, but no further.