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[BiPAP]

ajack/Sleeprider: Thanks for your insight. I noted in my log that I had a very rested sleep (even though I only slept 6.5 hours) at the p.s. of 5.0 which is indicated in one of the charts. I noted a very small CA of .3 which was absent at a p.s. of 5.8 and 6.0. I take it that you're not concerned by a CA of .3? As opposed to 0? If this is the case I may set the p.s. to 5.

[ajack]

You can have PS:6 min epap 6 if you want to, it won't hurt you. PS:6 won't over ventilate your lungs, I just can't see a need for it.
In the titration manual, Page 34, after all the OA are sorted, they suggest raising the default PS:4, till the H are controlled and o2 is above 90%. For CA you lower the IPAP/PS, page 37, evaluate tidal volume if needed.

we are making an assumption that if the OA and H are controlled, your volume is ok with a normal breath per minute. That will keep your o2 above 90%. You can get a 24hr o2 recorder off ebay for $50 cms50f if you really want to, but there is nothing to indicate that you need to.

If anything, a lower PS can reduce CA, The first thing with cpap is to turn down the epr/flex/PS, if there are a lot of CA. You are going to get nightly variations and you look at the stats over a week

[trish6hundred]

Hi BiPAP,
WELCOME! to the forum.!
Good luck as you continue CPAP therapy and also with your new machine.

[BiPAP]

Thanks ajack. I made a few adjustment based on our discussions. Mainly ps back to 5, epap min to 6 and Ti min to 1. Last night was comfortable. It dropped my AHI to .8 with a CA of .1. Pressures averaged 12.5/7.4 with a Vt of 560. I'm going to post the SH charts once I have a few days results at these settings.

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Trish6hundred

[BiPAP]

ajack/Sleeprider - 

I have 4 more days with the new EPAPmin setting of 6. I kept PS at 5. The only changes were minor tweaks to the Ti max/min and Trigger/Cycle settings. The final night (Nov 9) I raised the humidity to 6 and experienced some minor droplets in the slim line tube. I'm not sure if that had anything to do with the higher AHI but thought I would mention it. I raised the humidity level as I was experiencing dry mouth every other night. I have recently ordered the climateline tube and I plan to read up on it before installing to ensure I optimize it's benefits. Hopefully that will help with the dry mouth.

Thanks for all your helps!

https://imgur.com/a/rsION

[ajack]

That's looking good, I wouldn't change the PS, I would lift the min epap to 7 for the few events left. Try a chin strap to keep it closed, it may reduce the mouth breathing inside the FFM. Mouthbreathing or open mouth in a ffm, doesn't affect therapy, but you still have a tongue that feels like a dried up bit of leather.

[BiPAP]

Thanks ajack. I just assumed since it's VAuto the machine would adjust to my needs, but it sounds like the closer we fine tune the better/quicker it adjusts and prevents the OAs? I've installed the climateline tube. Hopefully that will help with the dry mouth? I've never used a chin strap but if this new tube doesn't help I'll look into it.

[ajack]

your doctor and everyone here would be happy with your numbers, but I think tweaking the epap a bit to keep around the median or 2 under 95% seems to help a lot and stop a lot of events before they start. Even though my ASV is very adaptive, I'm running min epap 1cm under my 95% now and I like that. (sounds like a DS apap )
A bit of nose care goes a long way, you can also use a salt wash/buy fess, if you need to and make sure your nose is clear.

[zzzZorro]

In the titration manual

Curious where this manual is located? Thanks

[ajack]

I gave the link in post 7. Manual may be a bit overstated on my part, more of a bullet point guide than a real manual/book, but it hits the main things and give you stuff to research.