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The first part of the third night with my Vauto was pretty quiet, and I actually managed to sleep well for a while. I slept with an oximeter this night.
I also looked briefly at the insp. time. I think I am running into the limits of 2.0 seconds at least during the second half of the night. This means I need to increase the Insp Time?
Occasionally the breathing seems to go crazy.... What is causing this?
Go ahead in try EPAP min 6.0 and increase TiMax to 2.4. If CA continues, we will try trigger very-high, but leave that one until you try the lower EPAP and TiMax.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Night #4 with VAuto:
The higher TiMax provided a more relaxed sleep. I no longer feel like I have to fight the device. Death anxiety in response to the ICD shock two days ago is probably also reduced because of this. I am very happy about this!
Other than that, still pretty many arousals, especially after the toilet break.
Min EPAP is now 6.0, Med EPAP is a little bit higher, 6.16. Does this mean the EPAP can be lowered even further?
I am of course happy to post more screenshots if needed
I see nothing but improvement and you're free to try a lower EPAP min. You seem to have caught on to this quite well. Keep in mind that the only kind of arousal we can mitigate is respiratory related. Many other causes forms of arousal and sleep stage disruptions exist and lie outside of control of PAP settings.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Thank you very much for your help Sleeprider. In the situation I am in now, all help is very welcome. To be clear, tonight I will try Min EPAP 5. Should any obstructions occur I will go up in 0.2 increments until they disappear, ok?
PS is fine or is there anything to improve here?
Trigger setting on high does not need to be increased?
Your methods are correct. I don't see a lot to be accomplished by higher PS, but we can review this once you settle in on a comfortable EPAP. Your flow limits are resolved for the most part, and the only thing we might do is randomly check some zooms of your respiration wave. I don't want to cherry-pick the unusual stuff, I'm after your most consistent "typical" sleep breathing.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Thank you for this confirmation. I will continue to optimize the Min EPAP in the coming days. I think it would be wise to post a link to sleephq afterwards, so that the flow pattern can be visualized over the entire night.
Pressure reduced to PS 4 over 5-15. No major fluctuations in pressure this night, but I slept restlessly. I think I am extra alert after the shock from the ICD a few days ago.
After my pee break around 5:30am, I noticed labored breathing. On the Insp Time graph it is easy to see that I was running into the already elevated limit of 2.40. Given my cardiac situation, is it a problem for me to raise the TiMax a little more to, say, 2.80?
No problem. It might be useful to see the respiration rate compared to insp time. Normally a long inspiration time will correlate with low respiration rate and minute vent remains the same. In fact, there is a graph setting for that. Go to View and select reset graphss and check the Advanced option. That will switch to a view of respiratory function. We normally like to see the Standard view, but questions of respiratory timing are better with Advanced.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.