Why does my Pressure and Leaks go crazy

[robysue]

"And your PS is set to range from 1.8 to 18.3?? (That does not quite make sense to me, since it's an awfully wide PS range.)"

I agree, but I am not knowledgeable enough to know what changes would be appropriate. Any recomendations ar welcome.

tThat's above my pay scale.

Seriously, it's worth asking the sleep doc who is responsible for prescribing these settings why the max PS is so high and the min PS is so low.

But then again, these settings are working well for you most of the time. Do you often max out that IPAP = 25 with an extremely large gap between EPAP and IPAP?

[igdoc]

Sorry to drag up an old topic but I am doing some forum hopping and I know you are still having problems with the high levels of pressure support.

From the Sleepyhead graphs here I note that when the PS goes sky high, the EPAP also rises. During these same periods the overall flow rate has dropped and so the machine is doing what it is meant to do and trying to maintain a steady flow rate. I agree with Robysue and Palerider that the leaks are not the cause of the increased pressure support.

So the question is why is a PS of 18 still not giving you good flow when a PS of 10 should be more than enough? The answer is high resistance (partial obstruction). Assuming that you are not awake and fighting the machine which is certainly a possibility, this leaves : possible kinking of the tubing, your partially blocked nose or upper airway obstruction. As the flow did not respond to the increased EPAP it is unlikely to be upper airway.

This leaves your nose as the most likely suspect. I am sure that you know all about the potential remedies starting with nasal steroid sprays, regular saline washes (which do work for me) or surgery as a last resort!

Hope this helps.
Ian

[bwexler]

Yes Ian, I do believe my stuffy nose is the problem.
I will probably have to bite the bullet and resort to a nasal rinse or a full face mask. I have had chronic nasal congestion for years. It is sometimes worse than other times. Now seems to be a period of worse.