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[Pressure] VINEDIGGER - Therapy Thread
#1
VINEDIGGER - Therapy Thread
I AM SORRY MY FIRST ACCOUNT GOT BANNED BECAUSE I USED LINKS. I WILL NOT USE ANY LINKS ANYMORE.

i am new to this forum and i hope to find help. i am struggling with flow limitations and my sleep is inconsistent, i feel sleepy and tired all day.

my life without cpap was horrible and i am better than before but i still wake up tired and sleepy. my energy through the day has improved "30%"

i tried different pressures with EPR AND without EPR. NO SUCCESS

the issue with pressure is aerophagia. i get it if the pressure is more than 7. the more pressure the more aerophagia. i tried wedge pillow it didn't help much.

what did i do wrong and what should be done. 

the first image is me using pressure 10 with and without epr of 3


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#2
RE: flow limitations. PLEASE help
Your pressure needs to be higher to manage the flow limitation, as we see in last part of night, with fixed 10 EPR3. Try auto mode, pressure 9, max 15 - EPR 3.
EPR 3 could help on aerophagia. Running no EPR makes it much worse.
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#3
RE: flow limitations. PLEASE help
I suggest going to a standard baseline where we can adjust things to better meet your needs. Try the following:

Mode APAP
Min pressure 8
Max pressure 15
EPR 3 full-time
No ramp

The EPR will help with the flow limitations that would be driving up pressure. As you started with fixed pressure we do not know what a good range is for you, hence the min=8 max=15 to titrate you and find what works. 

Give that a go for a few days and we can help fine-tune from there.
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#4
RE: flow limitations. PLEASE help
(06-10-2024, 08:24 AM)Stubert Wrote: Your pressure needs to be higher to manage the flow limitation. Try auto mode 10, max 15 EPR 3.

thank you. the problem with me not increasing the pressure so much is aerophagia. even with pressure 10 i get stomach pain and too much gas. the wave form of my breathing is still looking weird. i sometimes get 4 centrals all night. my questions is does bilevel help more in my situation ?
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#5
RE: flow limitations. PLEASE help
We do not have enough data that points towards needing a bilevel. The chart shows that adding some EPR helps with flow limitations in the second segment, so that is worth giving a chance to see how things are managed.

The aerophagia is difficult to diagnose without seeing more data. Adding EPR should help, as will starting at a slightly lower pressure. 

Back to my original suggestion of setting the range 8-15 EPR=3, which would be the next step in finding what works.
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#6
RE: flow limitations. PLEASE help
(06-10-2024, 08:28 AM)PeaceLoveAndPizza Wrote: I suggest going to a standard baseline where we can adjust things to better meet your needs. Try the following:

Mode APAP
Min pressure 8
Max pressure 15
EPR 3 full-time
No ramp

The EPR will help with the flow limitations that would be driving up pressure. As you started with fixed pressure we do not know what a good range is for you, hence the min=8 max=15 to titrate you and find what works. 

Give that a go for a few days and we can help fine-tune from there.


thank you for your answer. here is another night where i did 7 to 9 epr on 3.

so far i tried 

min 7 max 9 with epr 3 = still flow limitations
cpap mode at 10 with epr 3 = still flow limitations
i will try 8 to 15 epr 3 and see what i can do about aerophagia.


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#7
RE: flow limitations. PLEASE help
Try to stay with a setting for more than a single night, unless it goes totally off the rails. 

One thing I learned about my own aerophagia is that most came when I was fighting the machine. Breathing with the machine, not against it, made a big improvement. 

Relaxation is key to CPAP success. Try to remove all tension from your body when going to bed. It helps quite a bit in adapting to using the machine.
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#8
RE: flow limitations. PLEASE help
Your problem flow limits and EPR is the main treatment. With your problem wit swallowing air I would try these settings 

Cpap 7
EPR full time
EPR 3
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#9
RE: flow limitations. PLEASE help
Hello just an update, i did 10 to 15 pressure without epr and my flow limitations are huge. i uped humidity to 7 because i have nose congestion. when i add humidity my nose stays open all night. but still i have flow limitations with epr and without epr only difference is with epr i get fewer flow limitations. 

from what i have been reading. my situation needs a bilevel ?


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#10
RE: flow limitations. PLEASE help
my wave froms are just not normal.


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