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09-25-2022, 09:27 AM (This post was last modified: 09-25-2022, 09:28 AM by APAP4ME.)
RE: New to APAP & Need Advice
(09-24-2022, 11:09 AM)Dormeo Wrote: I'm sorry I missed the post just before this last one. I'm glad the conversation with the pulmonologist went well. I imagine he's figuring that with less pressure and less EPR you might see a reduction in CAs without too big a risk of a lot of OAs. It's an experiment worth trying if and when you feel like it. If you want to stick with your current settings for now, though, I think that's fine too.
Did the doctor speculate about why you mostly see the CAs later in the night?
I didn't specifically ask if he had any idea as to why the CA's were happening later in the night. I should have but tend to forget to ask the right questions in the less than 5 minute time that he spoke with me. I may send him a message about it.
In one of your prior posts, you suggested eliminating the EPR altogether and see if that helps with the CA's. What's the theory behind this?
Your chart CAs and your question, "In one of your prior posts, you suggested eliminating the EPR altogether and see if that helps with the CA's. What's the theory behind this?", are both related to CO2 washout.
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.
Thanks. Just searched the Wiki for C02 washout and found very little. What changes to my settings do you suggest? I could reduce the EPR to make it more difficult to exhale and therefore retain more C02 which will drive me to breathe. Maybe take a small step and reduce the EPR to 1 so I end up with pressure support of 1? My doctor also said that I could try min=max=5cm and leave EPR where it is so I get the same pressure support of 1? I really don't know which approach to take?
Your chart looks as if you were hyperventilating. EPR doesn't enter as a consideration during those events. Leaving your machine set to Auto and setting the min to equal your max will provide you with a static pressure (like CPAP mode) and also still report your flow limitations, which the CPAP mode does not.
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.
You can't hurt yourself by reducing or eliminating EPR. You could just see how comfortable or uncomfortable you felt. CAs are highly variable (consistently inconsistent, as some people put it), so you might want to take plenty of time to see what happens with each experiment.
Thanks for the replies. I haven't made any settings changes yet and last night was even worse. See the attached OSCAR data. I'm going to try some sort of change tonight.
Three nights ago, I reduced the EPR from 3 to 1 while leaving Max=Min=6 unchanged. I have attached OSCAR screenshots from these nights and still see a lot of CA events. These CA clusters seem to be happening as I'm waking up. Should I give it more time at these settings or shut off EPR entirely? Any ideas as to why I'm seeing these clusters of CA's? If it wasn't for the CA's, my AHI would be very good.
Actually, things seem to be getting somewhat better. CAs will often sort themselves out. But why don't you experiment with turning EPR off and see what happens? There's no harm, and there might be a benefit. Whenever you get stabilized, you can try re-introducing EPR gradually.
