New to CPAP - Need advice!

[avaholic]

I'm feeling pretty good. I did have a small headache this morning and didn't have one the day before but overall I do feel like I slept well.

[avaholic]

Howdy!

So I've used the AUTOSET during the week to keep on top of compliance needs and I am using the VAUTO on the weekends. After using the VAUTO, it's extremely difficult going back to that higher constant pressure on the AUTOSET. 

Last night, I think I slept really well save for the 1.5-2 hr period of me falling asleep. Once I actually fell asleep though, it appears that I had no events whatsoever!

Any way of eliminating the events while falling asleep?

Thanks!

Friday
[attachment=9398]

12-14 events
[attachment=9399]

[Sleeprider]

Events while falling to sleep are not "events" and may be disregarded. The period of sleep after 12:30 looks great! Floe limits are nearly gone. Your respiration is greatly improved for I:E ratio, volumes and rate. I don't know why you would go back to the Autoset. It might be appropriate to explain to your doctor why this is so much better and get a change in prescription.

[avaholic]

Do you think that's even possible with only 4 months of usage? (Only 3 on the AUTOSET...)

Should I tell her that I purchased it because I wasn't satisfied with my results on the AUTOSET?

Specifically, on the VAUTO my flow limitations are nearly gone and my respiration is greatly improved for I:E ratio, volumes and rate.

[Sleeprider]

The most common reason for bilevel approval is discomfort or intolerance of CPAP. You actually have quantitative evidence of efficacy improvement. There really is no reason for your doctor to deny this. You have done the work, self-financed and can attest to improved quality of sleep and comfort, as well as improved efficacy. At least your next prescription will be bilevel.

[avaholic]

Sunday was the best night so far on the VAUTO so I am not going back to the AUTOSET. I sent my sleep doc a message over the weekend. Hopefully she'll respond positively very soon.

I'm excited I'm doing so well on this new machine. I feel even better than I have since August! 

I woke up around 4 am because I had to go to the bathroom. After that I added a bunch events to my results so I'm just not even including that 1.5 hr period in the graph.

Any more thoughts or suggestions?

Sunday
[attachment=9435]

12-16 events
[attachment=9436]

[Sleeprider]

Suggestions are hard to come by considering you are doing better than me. Keep us posted on your doctor's response, if any. You are getting better results at lower pressures and better comfort, so looks like a win to me.

[avaholic]

Good morning ABF! Hope everyone has a very Merry Christmas and a Happy New Year!

I have been sleeping fairly well with just a few odd days here or there. I still feel like I'm fighting the inspiration cut-off on my unit. Last night before bed, I attempted a few settings to see if I could force the machine not to shut off my inspiration mid-breath. I wasn't very successful so I guess I still don't fully grasp the Ti min/max and Trigger/Cycle functionalities.

The current settings are:
Mode VAUTO
Max IPAP 16
Min EPAP 9.6
PS 4.0
Ti Max 2.5s
Ti Min .05s
Trigger Very High
Cycle Very Low

I tried:
Ti Max 2.0s, 2.2, 2.6, 2.8 - (I went back to 2.5 around 12:30 am...)
Ti Min .05s, .06, .07, .08 - (I went back to .06 around 12:30 am...)
Trigger Very High - No changes made
Cycle Very Low, Low, Med, High (I went back to Very Low around 12:30 am...)

Just a bit frustrated that I can't get the machine to do what I want. LOL

From my best night so far, Thurs 12-20:
[attachment=9512]

Saturday 12-22
[attachment=9513]

Sunday 12-23
[attachment=9514]

Sunday 10 min snip
[attachment=9515]

Sunday events
[attachment=9516]

[avaholic]

I realized I didn't ask a question in my last post...

The Trigger/Cycle and Ti controls are a bit confusing to me. 

I thought that Ti Max was the setting that I needed to change but even going to 2.8 didn't change the feeling that my inspiration was cut off mid-breath.

My median respiration rate according to SH is between 12-15. From the clinician's guide, the chart shows that I should use Ti Min 1.0 and Ti Max 2.0. I'm not sure how best to set them but I definitely don't want to cause any more breathing issues while sleeping by changing the settings incorrectly.

Which of those settings or combination of settings is/are the one(s) I need to change to extend my inspiration breath? 

Relevant excerpts from the Clinician's Guide:

[attachment=9538]
[attachment=9539]
[attachment=9540]

Thanks!

[Walla Walla]

You want to adjust cycle to a lower setting to extend the inspiration breath.