Seeking advice on SH screenshot

[vsheline]

Hi Frank,

Regarding
"Any thoughts on further adjustments would be seriously appreciated. I am probably going to try lowering the MIN pressure a little to see if I can get the CA's down a little."

Your number of CA is fine, not a problem.

You don't want to decrease the Min Pressure, not as long as your pressure needs are so high. Presently your main problem is the obstructive stuff.

If anything, the Min Pressure could be raised a little, but not until after you have found a way to decrease the tightness of your mask, so it's not painful.

However, Obstructive Sleep Apnea is usually highly positional, and flat on our back is usually the worst position, requiring the highest pressure to treat. If you can take precautions which would prevent your ability to roll onto your back, your pressure needs might be greatly reduced.

Take care,
--- Vaughn

[PoolQ]

"TiControl’s Ti Max and Ti Min parameters play a significant role in maximizing synchronization by
effectively intervening to limit or prolong the inspiratory time when required. This ensures
synchronization even in the presence of significant mouth and/or mask leak."

The way I read this and use it, is that Ti Min will not drop the inhale pressure until after this amount of time no matter what the patient is doing ie "prolong the inspiratory time when required" it tries to keep you inhaling. I know for a fact that Ti Max will cut off the inhale after the time set as this is exactly what it was doing to my very slow inhales-quite disturbing if not "needed"

[FrankNichols]

Hi, Frank. Amazing job on getting rid of the REM "cluster bomb" OAs! Mine are better, but not gone. I guess I'll have to stop saying "but they're not as bad as Frank's."

You're not using any EPR at all? Wow, that's amazing. It feels comfortable? Did you try using EPR and get bad results?

Thanks, I tried EPR and didn't feel it made me more comfortable. In fact, the only time the pressure bothers me is when I try to use the P10 instead, and then it is only a couple minutes before I am used to it. I guess I am one of the "lucky" ones that the pressure doesn't bother, in fact sometimes I wake up and I am not sure it is on unless I inflate my cheeks or raise the mask a little to get a leak.

[FrankNichols]

Vsheline,

Thank you so much for your insightful comments on my screenshots. You have given me a lot to think about.

Frank

[justMongo]

As Vsheline has pointed out, zero crossing in the flow waveform is way the machine counts BPMs.
That fine structure in the flow waveform is crossing zero, and the machine is scoring a breath.
Looks like there are from 3 to 5 zero crossings between where Frank makes a big exhale.
And, the big exhales are space at about 4 seconds (or 15 BPM).

I'd show those graphs to my doc... They are unusual.

[vsheline]

Hi Frank,

The zoomed-in periods show you are gurgling at a rate a little higher than 1 Hz. I suppose this may be too slow to be counted as snoring.

This is obstructive stuff.

I think a different sleep position or neck/head position could avoid it.

[vsheline]

"TiControl’s Ti Max and Ti Min parameters play a significant role in maximizing synchronization by
effectively intervening to limit or prolong the inspiratory time when required. This ensures
synchronization even in the presence of significant mouth and/or mask leak."

The way I read this and use it, is that Ti Min will not drop the inhale pressure until after this amount of time no matter what the patient is doing ie "prolong the inspiratory time when required" it tries to keep you inhaling. I know for a fact that Ti Max will cut off the inhale after the time set as this is exactly what it was doing to my very slow inhales-quite disturbing if not "needed"

That makes sense.

[kwhenrykerr]

The larger the mask the more pressure on the straps. Can you use a smaller mask size or type?