Struggling finding the right settings for flow limitations

[snakewrestler]

Last night I slept with Sleeprider's recomendations.
Breathing out was harder and not very comfortable. 
Also I had a lot more aerophagia.
My AHI was a bit lower, but I had this number with my previous settings also several times.
I see that the pressure is not hitting the ceiling of 12 so often anymore, so that's positive.
I had that too when increasing the "Ti Max". (but hen the apneas went up)
I have to say that due to some stress at the minute it was not a normal relaxed night.
Maybe I have to try it some more nights or set the EPAP min a slight bit lower.


16-1-2023 old settings

   

17-1-2023 adjusted settings

   

[Sleeprider]

There is very little difference between the two night in terms of pressure that would trigger aerophagia, however the lower PS did lower the CA events and did not increase FL. Based on your feedback, I'm going to suggest we lower and stabilize pressure by taking the variable pressure out of the equation. EPAP min 4.8, PS 3.6, Max IPAP 8.4.

[snakewrestler]

There is very little difference between the two night in terms of pressure that would trigger aerophagia, however the lower PS did lower the CA events and did not increase FL. Based on your feedback, I'm going to suggest we lower and stabilize pressure by taking the variable pressure out of the equation.  EPAP min 4.8, PS 3.6, Max IPAP 8.4.

Hi Sleeprider,

I didn't expected the aerophagia either.
I agree the difference in pressure is little.
So far i only used the vauto modus,  since it was configthis way. 
Do you mean I have to take another modus or can I just use this values in vauto ? 

Many thanks

[Sleeprider]

The settings I suggested are in Vauto mode but could be done in VPAP S mode with EPAP 4.8 and IPAP 8.4. I tend to stay in Vauto mode because we get data on flow limits that is not provided in S mode. The idea here is to take pressure variation out of the equation of what is working best.

[snakewrestler]

The settings I suggested are in Vauto mode but could be done in VPAP S mode with EPAP 4.8 and IPAP 8.4.  I tend to stay in Vauto mode because we get data on flow limits that is not provided in S mode.  The idea here is to take pressure variation out of the equation of what is working best.

Ah, I now understand.

Thanks ?

[snakewrestler]

Hi Sleeprider,

Unfortunately i forgot to put back in my SD card yesterday 
To my knowledge the device should cache the data and write to SD when available, but aparently
it didn't and left me with very little information about last night.

Anyway, no aerophagia anymore and breathing very easy.
Sometimes the feeling i had to suck the air out of it when breathing deeply.

AHI went up a little with some hypopneas. Do we maybe have to raise the IPAP max a little ?

   

[Crimson Nape]

The CPAP only stores summary data. The finer resolution data in the sleep data requires the presence of an SD card.

- Red

[snakewrestler]

The CPAP only stores summary data.  The finer resolution data in the sleep data requires the presence of an SD card.

- Red

Thanks for clarifying this Crimson .

[snakewrestler]

These are the numbers for last night.
I raised the IPAP a bit (10) and aparently the Resmed algorithm decides that the pressure must go up.
Yesterday i had headaches all day and today i woke up with headache.
Not sure if the headaches are related to the new settings, but flow limitations seems to go up 

   

[snakewrestler]

Hi All,

Since i don't got any replies anymore i decided to work out the settings Sleeprider proposed.
Now my settings are:

Modus: vauto
Max ipap: 12
Min epap: 4.8
PS: 3.4
Ti max: 1.6
Ti min: 0.5
Trigger: High
Cycle: Med

And this result in this

[attachment=47288]

My own doctor isn't available for some time, but yesterday i finally could discuss it all with her replacement.

She agreed with the current settings but adviced to leave it and first sleep for some weeks to find out how it goes.
Lately I experimented a lot and i think it's the best achievable for now. 

Thanks all for your assistance.