[Pressure] Reaching maximum IPAP - Time to change settings?

[sheepless]

I'm not really clear what your question is but... flow limitations are making your pressure top off. the first thing to do to help with aerophagia is to reduce max pressure. it may be that the machine is doing its job and keeping you from having oa, but it doesn't look like you need that high ipap to address these. raising min epap will help w oa though, if necessary, and might help the machine address event precursors like flow limitations more quickly. you have room between your set 7 and median of nearly 9 to go a bit higher without materially changing it's affect on aerophagia. ps is a better means with vauto to address snores and flow limitations.

[SarcasticDave94]

Me says something similar to sheepless...BALANCE the therapy vs. aerophagia demands...find a middle ground and run with it. Find by trial and error the balance of lowest events and lowest aerophagia while not hindering the other. I do not know which if any setting to edit as individual or as a whole setting group, but sheepless' comments sound headed rightly.

[Frajola81]

thanks @sheepless and @Dave!

So what you guys are saying is that I should not pay too much attention to the pressure topping off when I decrease maxIPAP? Like I said, even at 16, it was topping off at times and that's when the aerophagia started.

I don't think the EPAP =7 or even 9 should be a problem. But that's a guess.....   like Dave said, some trial and error is needed.

What I am not understanding is how PS affect all of that. My nurse practitioner recommended the biPAP when I was having issues such as aerophagia with the Autoset CPAP so I thought this problem would not appear in the biPAP. Am I wrong in thinking like that? I thought increasing PS would make the aerophagia less likely...

[SarcasticDave94]

Yep, to address aerophagia go blind on the topping off of max pressure data...don't see it so you can address aerophagia via dropping that same Max press. Call it selective sight.

Added via edit...PS and affecting symptom or whatever is not automatic, you or another has to edit that PS for some reason, in this case you'd like to attempt to combat aerophagia via editing PS. You can try anything your heart desires and your mind wants to on this therapy machine. Not trying to be too sarcastic, there is an ownership thing happening. It is your therapy and you are in control. I don't care which doc scripted it or who provided it, this is YOUR therapy and is considered your machine. Ownership, you own this. Take and maintain control and fight those who want to take control from you if that ever occurs.

We here help guide your therapy settings with hopefully some semblance of sound reason, and hopefully data to explain that reasoning. Despite that, you're at free will to edit any or every setting as you desire or in any way reason it out as why you should do x y or z. I am not saying to do or not. Just saying PS can be changed for whatever reason you choose. Trial and error remember? Try it, and it might be an error to do it. Trust me you'll know very soon if it was in error or if it works well. Picture an analog AM radio tuning knob. You're getting station xyz but it's a little fuzzy. What to do? Tune it, turn the radio physically or maybe aim the antenna. You should try tuning the radio and see via trial and error if you need to dial up or down the dial to get desired results. You choose IF, WHEN, and WHAT DIRECTION. AND I am not saying you should not edit the PS, nor am I saying you should. I'm neutral. Do or do not is up to you the owner.

[sheepless]

flow limitations are driving your pressure up, apparently causing aerophagia but not visibly improving anything. my suggestion is to let it bump up against a lower max ipap to try to reduce aerophagia. increase epap min to 95% or just under to quicken machine response to obstructives and obstructive precursors like flow limitations. increase ps min incrementally to help reduce flow limitations and snores which might in turn stop the machine from increasing ipap against them. see what happens. reevaluate. adjust again as indicated if necessary. as Dave says, trial and error.

[Frajola81]

@Dave, yes I will own my therapy and during any follow up with my provider, if asked, I will have data and notes handy to justify any action. Not that I need anyways, like you said. I appreciate your feedback though as I am new to this therapy.

@sheeplesss, your explanations on what is driving what were very helpful. I now understand what's going on. I will definitely decrease the maxiPAP back to 15, and increase the EPAP and evaluate. Later on, I may incrementally increase PS to see if it takes care of the snores and FLs. 

Thank you both for the explanations.

[SarcasticDave94]

Welcome, just remember bro. we all were new to this PAP therapy one day. You can best this thing by way of calm and rational problem solving and a cuppa joe each morning like this one.

This message funded and approved by Apnea Board where Sleep Apnea patients help one another.