RE: New to CPAP - Need advice!
"No promises, but since you have no OA currently I would start at Vauto mode, EPAP min 9.0, IPAP Max 16.0, P.S 3.0. We really need to see how you react to pressure support before going much further."
Sleeprider - So the Expiratory min value does not need to match the current min value on the AUTOSET? nor the Inspiratory max does not need to match the max value on the AUTOSET?
Is the pressure on the VAUTO higher in volume(or something) so I don't need the same values? Sorry for all the newb questions...
12-07-2018, 07:07 PM
(This post was last modified: 12-07-2018, 07:14 PM by Sleeprider.)
RE: New to CPAP - Need advice!
No. I suggested a range that starts well below your current pressure, but provides 3-cm of pressure support. The maximum pressure allows EPAP pressure to rise in auto mode to your current pressure, but will deliver 16/13 IPAP/EPAP. The objective is to identify a minimum EPAP that prevents OA, and use PS for hypopnea and flow limits, but avoid higher pressure that might encourage centrals. We also have the option to use inspiration timing and sensitivity for trigger and cycle; but for now, we will leave those at defaults. It's a conservative start for evaluation purposes.
RE: New to CPAP - Need advice!
Ok. thanks for the clarification. So I'll leave the trigger and cycle on medium.
What about the Ti min and max?
RE: New to CPAP - Need advice!
0.3/1.8.
RE: New to CPAP - Need advice!
I received the VAUTO yesterday and was able to use it last night. It had only 9 run hours so it was almost new!
I think I had an OK sleep last night. From what I remember when I had used EPR, I think PS is much softer if that makes sense...?? If its even the same kind of thing...??
Anyway, one thing I did notice on the VAUTO is that my inhalation breaths were cut off right about the middle when I was breathing in. Meaning, I would breathe in and while breathing in, I noticed the machine would halt air flow. A least that's the way it felt to me.
How do I add more air at the end of the inhalation breath? I also recorded a couple of OAs which I haven't had in a while. It did record a few Hypopneas and one Centrals as well. Other than that I think it was OK.
Thoughts? Suggestions?
Thursday - last night with AUTOSET (This is only one of 2 nights I've seen lower than AHI 1 since starting treatment in August 2018.)
[attachment=9328]
Friday 1st night on the VAUTO
[attachment=9329]
Event list from 12-07
[attachment=9330]
12-08-2018, 01:36 PM
(This post was last modified: 12-08-2018, 01:41 PM by Sleeprider.)
RE: New to CPAP - Need advice!
This is a great start on the Vauto! Central events were not a problem, and I think we nailed the EPAP min based on good OA results, but I can see a n increase to 9.6 in your future. We are going to be increasing pressure support to treat hypopnea, but let's just add 0.4 cm to P.S. 3.4. For the feeling of IPAP being cut short, let's increase Ti Max to 2.0 We may go to 2.2 eventually if you need it. Note how 90% and max time of inspiration equals the setting? That is not a coincidence.
Now, let's talk about why this is so much better in spite of higher AHI (mostly "H"). Your inspiration/expiration times are finally in balance for the first time, and tidal volume and flow limitation are improved. Your respiration rate has also dropped back to a much better 14.4 from 19 BPM. The increase in PS and Ti should further reduce FL and H. I am very encouraged not to see CA emerge with bilevel.
12-09-2018, 09:57 AM
(This post was last modified: 12-09-2018, 09:58 AM by avaholic.)
RE: New to CPAP - Need advice!
Last night was even better and I actually FEEL more rested today. Maybe I got more deep sleep??
I changed the following per Sleeprider:
Min EPAP 9.2
PS 3.4
Ti Max 2.0s - I think I'll try to bump this to 2.2 tonight since I still felt like my inhalation breath was cut short.
From another VAUTO thread, I also changed trigger and cycle per Kosoku:
Trigger Very High
Cycle Very Low
He mentioned that those settings helped with CAs and H.
Why are the .edf entries not listed under the sessions? Most days it lists them but sometimes it only shows the session times and not .edfs like last night.
Saturday
[attachment=9337]
12-08 Events
[attachment=9336]
12-09-2018, 10:22 AM
(This post was last modified: 12-09-2018, 10:27 AM by Sleeprider.)
RE: New to CPAP - Need advice!
You are very close. Looks lime PS 4.0 will be no problem and EPAP min to 9.6. I don't think you need the trigger and cycle sensitivity settings, but if it feels okay to you, there does not seem to be any problem. The flow limits and hypopnea should respond to pressure support, and CA has not been a problem. Respiration timing looks good, better than CPAP. I don't have an answer to the .edf question.
12-10-2018, 09:31 AM
(This post was last modified: 12-10-2018, 09:33 AM by avaholic.)
RE: New to CPAP - Need advice!
Well, I was expecting my AHI to decrease even more but it went up instead. Wonder why?
As recommended, I changed PS to 4.0 and EPAP Min to 9.6
CA went from 1 on Sat to 6 on Sun.
HA went from 9 on Sat to 10 on Sun.
OA went from 5 on Sat to 3 on Sun.
Notice the .edfs are listed again... very odd.
Sunday
[attachment=9345]
12/9 events
[attachment=9346]
RE: New to CPAP - Need advice!
Results are not linear with pressure and this is nothing to worry about. We probably went through setting changes too quickly and didn't get a representative range of results at each setting. I don't see a problem here, so just hold off on any further changes for a while. The increase in PS increased tidal volume and minute vent, and that may have led to a small increase of CA. It's still well below 1/hour, so not much of a problem. How are you feeling aside from the numbers?
