This VPAP Adapt is beyond me, sorry to say.

[jcarerra]

removed by originator
another reply answered it

[Whitewabit]

Doc oked lower pressures for me .. going from 4-5-9 down to 4-3-5 .. this has to work now!

I see by your profile you're in the same asv mode with the same machine as me. Unless you're in the asv auto mode?

Can you tell me what the numbers you're being switched to are?
I'm thinking: EPAP=4, wait, now I don't know the rest.

Can you make it more clear, with headings, where you were and where your doctor is sending you? Otherwise I have to search through the two threads you and I have going on this air issue and our VPAPs.

And did you get your clinical manual through this forum yet? I swear, that's a lifesaver.

I'm so glad your doctor is working with you!

Well I found out the Adapt has to have a spread of 5 between Min and Max PS, so

my old settings were EPAP-5 Min PS 5 and Max Ps 9
new settings will be EPAP-4 Min PS 3 and Max PS 8

Doctor didn't want to go below 3 on the Min PS which made the Max PS to be 8 couldn't set it any lower. they had wanted the Max PS to be 6 but that is not possible with the minimum of 3.

will try it out for awhile this evening before going to bed, and if I have to I will take a pain pill to help me sleep with it if that is what it takes. but am afraid it might make my centrals worse. but I have to use .. it is the only way to find out!

[PhyllisBalboa]

my old settings were EPAP-5 Min PS 5 and Max Ps 9
new settings will be EPAP-4 Min PS 3 and Max PS 8

OK, my old settings were EPAP 8, Min PS 10, Max PS 15
new settings tonight are EPAP 6.4, Min PS 1, Max PS 6

Hope we sleep better tonight...

[PaytonA]

removed goofy double post.

Must the P10 making you goofy!

[PhyllisBalboa]

Well, that didn't go well.

Night before last I started gulping air blasts again before even falling asleep. I had to get up and pace a few times to move the air out, and was still full of air all during the next day. So before bed last time I lowered EPAP from 7.2 to 6.4, figuring I needed a bigger drop to take care of it. So my EPAP on my VPAP (kind of catchy) was 6.4, with PS at 1 to 6, max IPAP then should not go above 12 or so, instead of 13 or so.

That didn't work. Within 10 minutes my chest was hurting like mad, and I was filling up with air. I could feel large masses going down my throat, stomach was cramping up, and becoming nauseated. I was awake, on my side (I don't sleep on my back at all), with my mouth tightly shut and no mask leaks. So I've been thinking about some possible theories to account for this.

One, this seems to happen about every 4 days on therapy. So my idea is that after those days I'm pretty much filled with air throughout, and it takes several days to move and discharge. At the current settings I can't discharge air enough when I'm on the machine nightly. Maybe I need breaks. This is not promising, because I want to use my machine every night, so I must get the settings right.

Two, after being on VPAP for almost 4 months, my body has learned to swallow air for fear of over-inflating my lungs, which is probably more dangerous than air in the digestive track, so despite the lesser pressures these days, it keeps up this habit. This is not promising either, because I don't have a clue on how to do the untraining.

Three, the settings are still too high. I can drop the ps down from min 1 to min 0, and max 6 to max 5. I can drop the EPAP down in bigger chunks maybe closer to 5. I can switch from asv mode to asv auto mode, which allows me to set a range of EPAP.

Four, I can get a brilliant solution from one of these fine forum members.

I'm going for four, three if I have to.

[jcarerra]

Are you looking at your data to see what pressure the Adapt is trying to USE with the EPAP+min/maxPS? Does it frequently push it up near the max 12.4 on inhale?

If not, what seems to be the area it likes to be? << This varies with me depending on what body is trying to do...there will be periods during the night where machine capabilities are used near the top of the range, and long other periods where it hangs out happily in the lower numbers.

I will soon be off net for a few days, so may not get to reply.

I hope you are able to get this sorted out. I do not have any knowledge of how to prevent the air infusion to stomach.

[PhyllisBalboa]

Are you looking at your data to see what pressure the Adapt is trying to USE with the EPAP+min/maxPS? Does it frequently push it up near the max 12.4 on inhale?

Yes, the max IPAP of 13.2 seems to be where it's going most of the time, even when I'm still awake. My graph shows 2 hypopneas only, but still the pressure stays high. No obstructives for 4 months, rarely even get centrals, AHI's always below .3.

I wonder if I should take ps down from a net of 5. Is that a requirement in asv mode? Instead of 1-5, maybe I should have 1-3. Would that bring down max IPAP?

I think the only solution to air swallowing for me is to bring down those high pressures.

[jcarerra]

I believe the Adept has a minimum 5cm maxPS-minPS.

At least it is good news that you are having few apneas and hypos.
That does leave room to try lower pressures, but watch your data.

If you are right that you have 'learned' this air swallowing, trying to fins a way to unlearn it would be top agenda. How I don't know. IF it is a learned behavior instead of a 'caused' thing, then changing the pressures may not be the solution. But so long as the lower pressures do not cause apneas/hypos to increase, at least that is there to try.

[PhyllisBalboa]

I believe the Adept has a minimum 5cm maxPS-minPS.

At least it is good news that you are having few apneas and hypos.
That does leave room to try lower pressures, but watch your data.

If you are right that you have 'learned' this air swallowing, trying to fins a way to unlearn it would be top agenda. How I don't know. IF it is a learned behavior instead of a 'caused' thing, then changing the pressures may not be the solution. But so long as the lower pressures do not cause apneas/hypos to increase, at least that is there to try.

Yes, my thinking exactly.

[Whitewabit]

Do you think you are swallowing air at the same time you are just naturally swallowing? Or do you think it is just powering past your natural reflex stopping it? Don't know much about it but guess I will soon need to enlighten myself.

I'm am getting a little bloat also, noticed gas this morning and the day I used it for over 3 hours too .. usually I have very little. So wondering if this is the cause of it? But ate some spicy food for dinner last night too so will see what tonight brings.