[Treatment] RagingBull - Bi-Level Help

[Crimson Nape]

First, Your 3 threads all deal with your therapy.  For this reason, I have merged them into one thread.  This provides history of your treatment.  Please use this thread for all posts related to your therapy.  I have renamed your thread, "RagingBull - Bi-Level Help"  .  .  .  Pretty catchy, huh?

I see you are in the "S" mode.  This prevents the AC10 VAuto from reporting Flow Limits.  To achieve the same pressures using the VAuto mode and obtain your flow limits, you need to switch to VAuto and set the following:
Min Pressure 10.4
Max Pressure 17.0
PS 6.6

I feel your pressure support might be excessive.  Displaying the flow limit values can provide an answer.

[Sleeprider]

With Crimson Nape's merge, I see a thread I have previously participated in. When you want my input, that is the first way to get it...use a thread I have already replied to.

RaginBull, look at your settings and look for Trigger Sensitivity. If available, switch to High, and let's see if that's the magic you need.

[RagingBull]

LOVE the title - Raging Bull is my favorite movie of all time, with Robert De Niro and Joe Pesci - so having my own dedicated thread with that title is a huge honor

@Crimson Nape - In the past (a week ago ) I tried enabling VAuto mode and setting the same IPAP/EPAP and PS  in order to see flow limits, and the results were negligible. It barely showed any flow limitations, but i attached a screenshot to this comment in case it's helpful in anyway.

Note the last hour or so i was fully awake just mucking with different pressures, so that's why you see the pressure fluctuations at the end. I'll try using that mode again tonight and see if I get any different results.

I suspect that my nervous system is so sensitive to a subtle flow limitation that I wake up even before the machine can register one. But who knows, just an uneducated guess... what do you think?


@Sleeprider - I already have my trigger set to "Very High". Do you think it's worth changing it to just "High"? Im curious what you think about the heart rate graphs as well on my recent post in this thread. Is that data informative in any way?

[Crimson Nape]

To me, you are over pressurizing.  This is based on your very low flow limit.  If it were me, I would keep the settings of the min and max pressures I recommended but reduce the PS to 5.0.  If the flow limit remains low, drop the PS to 4.0. See how you feel.
- Red

[RagingBull]

I'm hesitant to drop the pressure support when i see things like this (attached) in my sleep data from last night. The pulse rate is a bit skewed, but that spike correspond with what looks like a RERA to me. No flow limit is reported, despite being in VAuto mode.

I'll try dropping the PS tonight, and keeping the IPAP/EPAP the same like you said. Maybe the over-pressurizing is causing events like the one in the screenshot?

[Sleeprider]

PS 7.0 is a lot. I have seen members get their PS jacked up thinking it was helping things, but they generally did better when they came back down.

[Crimson Nape]

If you go looking for problems, you will find them. It is the ones that find you that matter. I believe the Wellue/Viatom uses a 30-second window to calculate a pulse rate. If you have the occasional PAC (Premature Arterial Contraction), it can skew the pulse result. Don't sweat it.
- Red

[RagingBull]

Sorry, I meant "skewed" as in the pulse rate from wellvue is not quite synced with the data in OSCAR. So that pulse spike in my screenshot should correspond with the choppy waveform in the flow rate, but it's slightly behind it.

I dont think these are PACs. I'm having heart rate spikes that correspond with what look like arousals in OSCAR, happening throughout the entire night. 

Also, part of the reason I have the IPAP so high is that it doesn't feel like im getting enough air otherwise. But I'll try a lower PS tonight and see if anything changes.