[Treatment] Valtor Therapy Thread - from Autoset to Vauto

[Valtor]

Thanks for thread rename.

The transaction with CPAPspecials was A+. Great price, super fast shipping, and they arranged things so that I could save hundreds of dollars on customs and taxes. Couldn't have gone better than that.

Regarding the sensitivity, I was just testing different combinations while wearing the mask under pressure and I felt that low for both gave me more natural breathing. I was surprised as well.

But maybe going for natural/comfortable is not what I actually need? By what mechanism does this have an impact on CAs?

[Sleeprider]

Trigger sensitivity affects how much spontaneous inspiration flow it takes for the device to "trigger" IPAP. The low setting makes your device hold onto EPAP longer and requires more flow for IPAP pressure support to start. By moving the trigger to medium or high, the trigger happens faster with less flow or spontaneous effort. In some cases, triggering pressure support stimulates a breath where a CA or hypopnea would otherwise occur. Your AHI is very very low and your last session is nothing I would criticize, but I normally leave trigger at medium, and move to high or very high if CA are present. Your event rate does not appear to require a high or very-high trigger, but I would move it back to medium and do a comparison.

[Valtor]

Duly noted. I changed both back to Med.

I also increased pressures since I'm switching to the AT F20 tonight.

EPAP Min 8
IPAP Max 16
PS 4
Ti Max 3.2
Ti Min 0.3
Trigger Med
Cycle Med

[Valtor]

The AT F20 was easy to use. Pretty glad of it.

Here is last night. The CAs are not real but the OAs looks like real events. And I am not sure what is happening in those zooms. I am waking a bit less often with the BiPAP maybe 6-8 times a night. I definitely feel better in the morning than with the APAP.

Should I change any settings?

[Valtor]

I'm going to try and get rid of any remaining OAs by increasing a little.

EPAP Min 9
IPAP Max 17
PS 4
Ti Max 3.2
Ti Min 0.3
Trigger Med
Cycle Med

[Valtor]

It seems that some OAs have now become Hypopneas.

I guess this means I should increase pressure again, probably ok until it starts introducing CAs?

Not sure what's up with this last flow limit zoom.

Settings I'm gonna try next:

EPAP Min 10.6
IPAP Max 19
PS 4.4
Ti Max 3.2
Ti Min 0.3
Trigger High
Cycle Med

[Sleeprider]

This all looks good to me. Event rate is almost too low to worry about, but you seem to be making reasonable changes.

[Valtor]

Yes, at this point I am mostly looking at the correlation between movements and events/flow limits.

I wish to pinpoint what is waking me up. It looks like I am really sensitive to any respiratory artifacts.

According to the data, I had 14 arousals last night, of which I remember at least 6. Still that is lower than before I started treatment.

With the BiPAP I can increase pressure higher to eliminate these without it being uncomfortable as it was with CPAP.

[Valtor]

I'm not sure how to interpret this one.

Does this mean that PS needs adjusting? Or maybe it requires a change in Trigger or Cycle?

Because I feel like my inspirations are not using all of the available PS if that makes sense.

I bet I should increase TiMax? It seems my slow inspirations are getting cut off. And maybe put Cycle to Low.

[Sleeprider]

Almost impossible to know. It looks like a single flow-limited breath without arousal. I think there is a limit to to the artifacts that need to be chased. Your TiMax is already at 3.2 seconds which is well-above your 99.5% max. So that is definitely not your answer. I would not change cycle to low, everything looks normal.