[Treatment] Change to BIPAP vauto in hope for better therapy

[Dave Water]

Thank you Sleeprider.

I will look into P10 to see if it will help my leak.

Also, I want to say that this forum is amazing and is filled with such useful information.
I wish that my Sleep tech or my sleep doc would have these information when I first started using the CPAP machine.
Then I think I would not have to agonize on what my tonight sleep will be like or what my OSCAR will look like next morning for the last 18 months.

Even though I will still need sometime to fully adjust/understand the machine and finding a good mask. But I think I am one step closer
to have a good sleep. I think I understand a little more now on how to read OSCAR charts/stats to help me for an optimal setting with Vauto.
And the most important thing is that if I am really stuck, I know that there is the apneaboard forum I can go to for advice.
It really helps to take away my worry when i don't know what is the next step.

Thanks APNEABOARD forum.

[Dave Water]

Hi All, I would appreciate any help on understanding about my weird breathing patterns that happens a lot but not flag on OSCAR.
I have expanded the chart a bit to show more details on those events. Those events do not seem to be classified as any type of apnea but it does not seems right to me. Is there any setting on my resmed aircurve 10 vauto that needs to be changed in order to improve or eliminate these type of breathing pattern ?


Thanks in advance.

Resmed Aircurve 10 Bipap vAuto
FP Brevida mask
Trigger - very high
Timax - 3


       

[Gideon]

There is nothing there to flag by the rules.

It would take a major revision by ??? To change the duration of events from 10 seconds to something less. Even then the same argument would ensue, just for an even lower value.

You are having a arousal which is causing you to take huge breaths which will drive down your CO2 levels which will lessen your drive to breathe resulting in central hypopneas which are not flagged. Your Trigger at very high is picking up those blips as breaths thus failing to meet the 10 seconds event requirement

I suspect I responded to you in another thread to set your PS= 3 from 8 but I) have to search and find it to confirm.

How often do these events occur?

[Dave Water]

Thanks Gideon for your info.

I went back a few days and did a count on those weird breathing pattern. I noticed that I have at least 20+ of those events
throughout the night. I wonder if these type of breathing pattern would prevent a good sleep.

I tried to set my epap to 6.6 instead of 6 and it seems it did not help or maybe i need to give it more time ?
  
Yes, I have started this new thread because I thought that this is a new issue.
My PS is always at 3 and I change to a new mask FP Brevida which helps my mask leak issue.
The SCC helps also even if I sleep on my back. 

Thanks again.

[Gideon]

Your therapy, whatever the issue is should be in one thread, if that was for your mother, than a different thread is good.

[Dave Water]

Apology for unknowingly open a new thread. Not sure how to remediate the situation.
Should I delete this thread and re-post my question on my old thread ?
Am I able to delete or remove this thread ? 

Please advice.

[Crimson Nape]

I'll merge the two threads together.
,
,
,
,
Done! All is well in the world.
- Red

[Dave Water]

Thank You Crimson.

[Dave Water]

Hi Gideon, I just read through the links you listed in your signature and understand that it would be beneficial for the treatment if all the history is in one thread and not to start a new thread base on issue. Apology again for opening a new thread.

incidentally, while reading through your links, I noticed the following statement which seems to relate to my breathing pattern, 

"This pattern can be exacerbated by pressure support or EPR which tends to increase ventilation to where the apneic threshold is reached. Reducing EPR or pressure support may help to make this feedback loop less likely to occur or eliminate it altogether. "

I would like to know if I decrease my PS from 3 to 2 on vauto,  would that help to improve my breathing pattern?
If I do that, would that also increase my epap pressure and make the treatment less comfortable ?
  

[Sleeprider]

Dave, I can only offer an opinion on this "non-event" screenshot. We can see you show a normal sleep pattern respiration, up to 23:03:30 where there is a small disturbance, I suspect might be movement or a swallow. This is followed by decreasing respiratory volume that does not look obstructive and an arousal at 23:04:15.  This hyperventilation satisfies the respiratory requirements and the flow rate again diminishes then resumes at a normal volume an rate.  There are no controls on your Vauto I can think of that would prevent this. It is likely an arousal, but completely normal.  With an AHI of 0.3, and very good respiratory statistics, what we can see of your therapy looks good.  Don't start turning the setting knobs. You seem to be in a pretty good place and any changes are unlikely to improve this.