[Treatment] Still fatigued, history, are these CAs real?

[GuyScharf]

Yes, seems like I'm about at minimum pressure. I'll go back to 9.2 tonight. EERS is a week out yet. As for adding EPR, that will require a VAuto machine. I've just found a good deal on a VAuto with only 18 hours of runtime and will be getting that soon.

[GuyScharf]

Is there any conflict between EERS and heart issues? I had a triple CABG about 12 years ago, but no problems at this time.

I ask because I tried both 6" and 12" EERS for a short while earlier today. While the 6" was comfortable, the 12" left me feeling panicky. It was really just a few minute test of 12" so maybe after I sleep a few nights with 6" I'll be able to tolerate more.

[Gideon]

No conflict that I am aware of.
Let's see what 6-inches looks like, Compare it to without then try the 12".

Why panicky, what is making you think that? I've heard that from non-EERS users with low pressures.

[Sleeprider]

All we are doing is increasing the space between the vent and mask. Each section ads about 58 mL of rebreathing space. If you have a tidal volume of 500 mL it Is less than 11.5% of volume. each section adds that amount. It increases CO2 but if you feel uncomfortable, then don’t increase.

[SarcasticDave94]

I can't think of any heart contraindications with the EERS.

[GuyScharf]

First night on EERS 6" results:

I see little change in the overall flow rate pattern.  Breathing is perhaps a little harder, but could be my imagination.  Minute Vent increased from average of about 6.3 to 7.13.  I have not seen a number that high before.  Other numbers within normal range that I see.

                   

It will be a week or more before I get my VAuto.

[GuyScharf]

I tried 12" EERS last night, with a pressure range of 9.6-10.2.  I increased pressure over yesterday because I felt I couldn't get enough air when I tried the 12" for a brief time a day ago.  I had no problem with 12" at the higher pressure.  I'm not seeing much difference in the breathing pattern in the flow graph.

Minute vent increased to 7.50.  Tidal volume is increased; respiratory rate remains about the same as before trying EERS.  SpO2 median remains at 93.

Fitbit continues to report mostly light sleep and short on deep sleep.

I had expected to see a slight improvement in the breathing pattern but so far not seeing much.  Suggestions?

                  

[Gideon]

I see significant changes. Prior to EERS you had full nodes similar to what you see in the last 2 bars of the current chart, throughout, a slight improvement with 6 inches, with 12 it is just the last 2 bars, though there is some minor waxing and waning in the other bars. The bottom two I would call disruptive.

Try this for a few days to allow some adjustment Set your FR chart again after 3 days for comparison, then try 18. Higher pressure is ok if you feel the need as you did with 12 inches.

[GuyScharf]

3 days with 12" EERS is not a strong statistical base, but the average for those three days is hopeful: reductions in AHI, CA, and H indices.  AHI average was 1.01 compared to a 30-day non-EERS average of 1.5 or more.  Energy level has been stable (not great, not awful), except one day when I had to get up without sufficient sleep.

Looking at the flow chart, might a flow limit trigger oscillatory breathing?  Maybe my breath control mechanism (CO2 concentration) doesn't stabilize very quickly after being thrown off by a flow limit and slightly decreased volume?   (Not sure if I can make a strong case for the flow graph indicating that.)

I'll try 18" EERS starting tonight.

I have been using a pressure range of 9.6 - 10.2 with EERS=3. I expect the VAuto to arrive this weekend or Monday.  I am thinking of trying just minimal changes from my AutoSet, perhaps with mode=VAuto, EPAPmin=6.6, PS=4, IPAPmax=12.  (I'll set the various comfort parameters as they are now and of course Essentials=Plus.)

What settings do you recommend?

[Gideon]

Match your AutoSet and PS=4
Night 2 try Trigger Sensitivity on high or very high, it does help many with centrals and this way you can see the difference.