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Therapy recommendations appreciated
#1
Therapy recommendations appreciated
Resmed 10vauto
Windows 11 operating system
Mode : S 
Ipap: 15
Epap: 8
Originally it was 14/9 I believe 
Ti max : 3.2
Trigger : medium 
Ramp : 10 mins 

Vitera full face mask 
Knightsbridge chin strap when I can tolerate it 

Recently switched from regular CPAP to bipap after a new in lab sleep study . I wasn’t tolerating CPAP well . 

I’ve been playing around with settings . On this forum is where I learnt about increasing ti max . I increased it to 3 then inched up to 3.2. Recently got over Covid but in the day time my oxygen levels fluctuate. 

Any suggestions on improving my therapy would be greatly appreciated. Charts are attached


https://ibb.co/wpgbdnd
https://ibb.co/MPcFR8T
https://ibb.co/0DV5BN1
https://ibb.co/6YCC5D7
https://ibb.co/HVNMNGt
https://ibb.co/BnDCqd8
https://ibb.co/4S36cXz
https://ibb.co/qmhkzvD


Attached Files Thumbnail(s)
       
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#2
RE: Therapy recommendations appreciated
My take is your current settings are not working for you. You need to find what your best pressure range is before taking the step to fixed pressure. Once you have found a consistent 95% you can decide then whether to go back to a fixed pressure (S mode) or even a reduced range Vauto mode. Personally, I used S mode for years (8-12 PS=4) but switched to Vauto mode using the same EPAPmin but with IPAPmax set to 1 above EPAPmin+PS (8-13 PS=4).

I suggest moving for now from a fixed pressure mode to APAP mode and allow the machine to find what works best.

Try the following:

mode VPAPauto
EPAPmin 8
IPAPmax 15
PS 4
No ramp

That gives you a bit of headroom if flow limitations require a pressure increase. As things settle in over a few nights you should start to see the 95% stabilise, which would be the possible future fixed pressures if you decide to go that route.
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#3
RE: Therapy recommendations appreciated
Hi Officialdee Smile

There was one good chart in there but it had OA events showing up (the others were minimal with sleep time but had CA events), I would raise EPAP min up to 9.6cm and turn ramp off, and raise your trigger to high, but do this for a few nights and see how you feel. I had Timax set to 3.6 and it helped a bit, but I moved back to cpap because it was more comfortable and I sleep more deeply.

Also I like bilevel-s mode as epap min pressure is locked and can't cause issues with over pressure and worsen the CA events.
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#4
RE: Therapy recommendations appreciated
This is my chart from last night


Attached Files Thumbnail(s)
   
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#5
RE: Therapy recommendations appreciated
You are also having Positional Apnea.  No setting can fix this.  PA shows up on your charts when you see Os and/or Hs clustered together.  This is because your chin is dropping toward your chest, causing a blockage in your airflow, much like a kink in a hose blocks water flow.  Some folks can solve this by sleeping on a lower pillow.  Most end up wearing a soft cervical collar, high enough to hold their chin up.  Most drugstores offer a few, and Amazon offers many choices.
Machine:  ResMed AirCurve 10 Vauto
Mask:  Bleep DreamPort Sleep Solution
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#6
RE: Therapy recommendations appreciated
(09-09-2024, 07:26 PM)Deborah K. Wrote: You are also having Positional Apnea.  No setting can fix this.  PA shows up on your charts when you see Os and/or Hs clustered together.  This is because your chin is dropping toward your chest, causing a blockage in your airflow, much like a kink in a hose blocks water flow.  Some folks can solve this by sleeping on a lower pillow.  Most end up wearing a soft cervical collar, high enough to hold their chin up.  Most drugstores offer a few, and Amazon offers many choices.

Yes I tried a few collars didn’t do too well on them I may go back on one . My Knightsbridge strap is okay it just makes me really hot .
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