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Hi,
I was diagnosed in hospital with UARS caused by RERAs in sleep. I got around 14 RDI. After trying CPAP for sometime it is not helping, i am trying to reduce RERAs but they are still here and a lot of them. Flow rate chart is all over the place every night. That results in bad sleep.
My current settings are Min: 10 Max: 11 EPR full time: 3. Nasal Pillow resmed airsense 10
I dont know where to go from here. Should i be increasing pressure till they are gone? or should i consider BIPAP machine or any alternative method of dealing with flow liminations and RERAS?
What's your height and weight? Looks like you have plenty of arousals, not necessarily respiratory effort related though. If you're just underventilated in general you can have partial awakenings just to top yourself off here and there. My tidal volume and minute vent went up about 10-15% after my nose surgery and I found less of those spontaneous arousals scattered around in my charts after that.
Look, I'm an engineer, not a doctor! Please don't take my opinion as a substitute for medical advice.
Since there is no flow limitation or obstructive events, I don't think arousals are "respiratory effort related arousal", but might come from another source. We're going to have to zoom into the arousals to see if they are preceeded by any respiratory flow limitation or if they are instead spontaneous or external to therapy.
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So i am about 6′ 0″ height and 70kg weight. i attached screenshots of closer look at flow rate. What does not respiratory effort related arousal mean? Arousals comming from anatomy due to samller jaw or something? or awekings not caused by breathing at all and casued by other sources like reflux?
Hmmm, tidal volume and minute vent are a little low for that size. So it's possible you are waking up to get some deeper breaths every once in a while because you're building up respiratory drive during your sleep overall, not from a particular respiratory effort trigger. Bilevel might help if this is the case, or finding some other way to open your airway up to more flow to get the amount of total respiration you need.
Look, I'm an engineer, not a doctor! Please don't take my opinion as a substitute for medical advice.
Here are some additional flow rate screens: https://imgur.com/a/rg6V9It. I will attempt to increase the pressure incrementally each week, aiming for around 12/13. If this approach proves ineffective, I will consider exploring BiPAP therapy.
It may be related to upper airway resistance. If you breathe through a straw for a few minutes, you'll want to shake yourself awake a little to get that nice deep breath of air. Pressure support (or EPR) can be a way to boost respiration despite this kind of resistance, because it increases inhalation pressure and then lowers the exhale pressure to allow more flow through a narrow or partly occluded airway.
Look, I'm an engineer, not a doctor! Please don't take my opinion as a substitute for medical advice.
