initial aircurve pacewave setup

[Narcil]

thanks. guess i will start soft.

due to a delay, my mask could arrive before the heated tubing,
which leaves me with an unheated one.

which humidifier-setting would you recommend with an without heated tubing ?

try without the humidifier. i don't think many ppl use it here, my doc says less than 10% of his patients.. humidity is high here. it would make it a lot easier for you not having to bother with the reservoir.

[cexer]

i started with tcinoz's settings.

hmm it feels like my eyeballs are coming out,
and i was breathing to fast,
so my oxygen level has been going over the top.
the pressure also ramped up over time
till i felt like it being too much.

i haven't been able to fall asleep with his,
will see if the dynamics change, then.
it's my very first experience with such devices.
the mask seems to be nice, however.

any values else, i could try ?

[Narcil]

since it's your first PAP device, i would try to wear it during the day to get used to it. while watching tv or on the computer.

if you post some oscar chart maybe we can see something.

[Sleeprider]

cexer, any chance you can post a chart of your Pacewave results? Are you using the Pacewave due to therapy onset centrals with CPAP, or some other reason?

[cexer]

i suffer from obstructive and central events
as well as hypopnoic breathing.

the centrals are worst on subzero degrees outside,
which seems to be my spaciality.

hopefully i have fetched the right hardware.

in the oscar chart, i've thrown out empty graphs
and added my oximetry:



blue is oxygen, red is pulse.

the long time period between the dotted verticals
(and maybe the short one before) is where i tested the device.
afterwards i tried to sleep with my mandibular advancement retainer
but was sorta paralysed and couldn't sleep either.

[SarcasticDave94]

I would think that despite the zero AHI, you can get better therapy with a higher EPAP Min and a lot less Ramp, which is at 4 cmH2O for 45 minutes. I am surprised there's a pressure increase in any of those little sessions with that Ramp interference.

[cexer]

ramp was zero until like the last session.
i just wanted to sleep.

to me there was no recognizable difference
between ramp, no ram and changing pressure settings.

could the device be ignoring them all ?

[Sleeprider]

You will need to put together some longer session times for this to be effective. One thing you can do to help the situation is to allow yourself time to settle into a more relaxed breathing ahead of masking up. We can see as you start each session the tidal volume is very-high before dropping back as you relax. The simple truth is, this chart is pretty meaningless as none of it represents sleep and your longest sessions are barely 11 minutes.

[cexer]

the thing partly overstretched my lungs
(the pressure ramped up and i relaxed
to much in a moments notice),
i can still feel it, so i need some time to recover
before i continue my journey, i guess.

also it pulsed my sinus cavity
(which probably triggered a headache),
but this can't be avoided, i guess
so i need to see if my body can get used to it, right ?
the first time with the jaw retainer wasn't easy, too.

i was tired as hell
but will try to be even more relaxed.
ramp off or 20 mins or something ?
again the values of tcinoz instead default ?


right know i'm pounding the question,
if i rather should have bought the ivaps
for half the price more.

would it have decreased the pressure,
when my ox was going over the top,
thus making therapy more bearable ?

till now i also don't know if i would
still be hypopneic under pressure support.
if so, the ivaps could fix it, right ?

is there a chance, someone could talk me out of this
or could it be the bare truth ?

[Sleeprider]

Many of our members use the ASV and adapted to its therapy. Keep in mind this device responds to your spontaneous effort and will back off of pressure support if you show it you are in control by blowing back, or purposefully breathing and setting the pace. Also, it is important not to be hyperventilating when you start therapy. As I mentioned above, you seem to be breathing deeply as you mask up. This sets an unrealistic target for the device that it will try to maintain. I will give you some settings to try to mitigate this, but your biggest problem here is anxiety and I can't fix that.

Mode: ASVauto
EPAP min 4.0
EPAP max 6.0
PS min 3.0
PS max 8.0
Ramp: Auto