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A soft cervical collar has changed my AHI scores from 6-ish to 1-ish (attached) with the virtual elimination of large leaks. (OSCAR data attached)
What should be my next step?
I'm thinking I should reduce my pressures and see what happens. I think it would also be interesting to put the pressure very low to understand what results I get wearing a soft cervical collar without the machine providing any therapy.
Any insights?
Thank goodness for this forum and all the archived information !
Spudhorse, you're using a Resmed Aircurve 10 ST at 18/14. The ST has a timed backup rate that maintains a set minimum respiration rate and is usually prescribed for individuals that have pulmonary conditions and occasionally need a backup breath. It would be interesting to hear how you ended up with this instead of the Vauto. You can certainly reverse-titrate the pressure to try lower pressures. Your EPAP of 14 is what sets the airway stability and IPAP is 4-cm higher (pressure support) to improve ventilation, reduce flow limits and other things. So trying lower pressures such as 17/13, 16/12, 15/11, 14/10 are certainly something you can try to see if you can find a more comfortable pressure setting. If my suspicion is correct, you would be a lot happier with the Vauto next time around. The ST is a pretty crude machine and has no EasyBreathe algorithm and it's a mystery to me that it still exists.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
12-01-2023, 04:31 PM (This post was last modified: 12-01-2023, 04:46 PM by spudhorse.)
RE: The Miracle of the Soft Cervical Collar
It would be interesting to hear how you ended up with this instead of the Vauto.
"Here's your machine. Good luck."
The physician's assistant I see said "this wasn't the machine we originally wanted." I didn't follow up since I couldn't think of a question to ask. As I learn more, I know more questions to ask. I was also dealing with AFib at the time which was much more important than a machine that blows air.
Sucks for you. This machine is not nearly as comfortable and has not automatic pressure algorithm. Like I said, next time insist on the Vauto. Anyway, give the lower pressrues a try. The biggestht problem with the ST is the square-wave pressure transitions. The Vauto and VPAP-S both offer the EasyBreathe pressure transition between IPAP and EPAP that is a lot more comfortable. I guess the point is, you don't have a medical need for the ST and should have be provided something with spontaneous trigger. Do you have a breath-rate (breaths per minute) set?
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Take it down to 11. On the ST we set the respiration rate at normal minus 3 BPM. Your normal spontaneous respiration rate is 14, so your machine is likely triggering unnecessarily when you take slower breaths. You could also change to VPAP S because you have no condition that requires a backup rate. We want to encourage spontaneous respiration and only rely on machine triggered breaths when needed. You should notice a positive comfort difference in doing this.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
12-02-2023, 02:23 PM (This post was last modified: 12-02-2023, 02:44 PM by spudhorse.)
RE: The Miracle of the Soft Cervical Collar
Thank you. You said the ST is normally prescribed for people who need a " timed backup rate that maintains a set minimum respiration rate and is usually prescribed for individuals that have pulmonary conditions and occasionally need a backup breath."
Do you happen to have a link to that type of information?
I want to build a case for the Vauto which is hard to do when everything associated with CPAP seems to be clouded by "we're medical professionals and you're not. Trust us."
I did find the attached from Philipps. Do you think this tells the story well enough?
This is fun . . . Here's what ChatGPT tells me:
User
What type of bipap machine is most associated with people who need a timed backup rate that maintains a set minimum respiration rate and have pulmonary conditions and occasionally need a backup breath.
ChatGPT
The type of BiPAP (Bilevel Positive Airway Pressure) machine most associated with people who need a timed backup rate to maintain a set minimum respiration rate and have pulmonary conditions is typically referred to as a BiPAP ST (Spontaneous/Timed) or BiPAP S/T (Spontaneous/Timed) machine.
These machines are designed to deliver two levels of pressure: a higher pressure during inhalation (IPAP - Inspiratory Positive Airway Pressure) and a lower pressure during exhalation (EPAP - Expiratory Positive Airway Pressure). The "S/T" designation indicates that the machine supports spontaneous breathing (where the patient initiates each breath) but also has a timed backup rate. This timed backup rate ensures that a set number of breaths per minute are delivered by the machine, providing additional support for individuals with respiratory conditions who may have difficulty maintaining an adequate breathing rate on their own.
People with conditions such as chronic obstructive pulmonary disease (COPD) or other respiratory disorders may benefit from the additional support and ventilation provided by a BiPAP S/T machine. However, the specific choice of device and settings should be determined by a healthcare professional based on the individual's medical needs and condition.
User
What results will such a machine give for someone who does not have a respiratory disorder
ChatGPT
If a person without a respiratory disorder were to use a BiPAP S/T machine, it would likely not provide any significant benefit and may even be unnecessary. BiPAP S/T machines are designed to provide ventilatory support for individuals with specific respiratory conditions, such as chronic obstructive pulmonary disease (COPD), neuromuscular disorders, or other conditions that may affect their ability to breathe effectively.
In a person without a respiratory disorder, the use of a BiPAP S/T machine could potentially interfere with normal breathing patterns and may not be prescribed or recommended by healthcare professionals. These machines are typically tailored to the specific needs of individuals with diagnosed respiratory issues, and using them without a medical indication may lead to discomfort or other complications.
It's important for individuals to consult with healthcare professionals, such as pulmonologists or sleep medicine specialists, to determine the appropriate treatment or intervention based on their health status and symptoms. The use of positive airway pressure therapy, including BiPAP machines, should always be guided by a healthcare provider to ensure proper diagnosis and treatment.
