New user struggling with treatment

[Deborah K.]

Leave it at 3 for a while.

[staceyburke]

Of course do whatever you think is best for you but I would still suggest

EPR full time
EPR 3
Min 9

[Expat31]

I realize there's no clear answer for tackling treatment so I appreciate both of your advice. 

I forgot to reenable EPR last night, on top of starting out with an increase to my minimum pressure (mistakes were made). Eventually I moved the minimum back to 8 but didnt notice EPR was off and ended up with lots of aerophagia and waking feeling out of breath. I attached my data but it's pretty messy.

I'm glad I gave it a try but I feel like I may need some EPR at 8-12. I'll plan to stick with 8-12 at EPR 3 for a few nights to get a baseline and report back. Maybe I should next try titrating EPR down to 2 and then 1 and see how things go?

Hi, thanks for the latest screen shot and your clear observations. 

Sorry my call on EPR at zero did not work out. I really felt it was worth a shot. 

It would either validate or eliminate this move, which I thought was important. 

I thought it may be useful to review the last two nights to see what can be learnt :-

     Date          Time        Settings     Fls 95%  Fls 99.5%  EPR   
                     in apnea       
 20th April     4.58           8/12           0.00         0.21          3
 22nd April    5.26           8/12           0.07         0.26          0

Zero EPR certainly did not move the needle on central apneas. They were still as stubborn as before.
 
The flow limitations only increased marginally, which was a surprise. 

On the other hand there can be variations night on night even using the same settings, so difficult to draw any real conclusions on such a small sample. 

I am a firm believer in "leaving no stone unturned" so applying this maxim, please work through all alternative possibilities until you find what you are comfortable with. 

Only you can decide what is best.

Let's hope the alternative settings proposed will be more successful.

It is a process of trial and error. 

Normally the only settings option with your machine to reduce centrals is reducing EPR when there is C02 washout, which has just been proven is certainly not the case this time. 

Sometimes increasing minimum pressure can work,  but mostly when they are "false positives", 

So what is left? 

This is beyond my knowledge confort zone, but I understand that ths AirCurve 10 CS PaceWave -Adaptive servo-ventilator ASV device is designed to treat central apnea issues. 

I am sure other members who are well informed in this area and can help out. 

Kind regards

[Expat31]

Sorry, I forgot one thing. 

Narrowing the gap between minimum and maximum pressure can reduce C02 washout and mitigate central apneas.