[split] jschmoyer - Therapy Thread

[jschmoyer]

First time posting here, so bear with me please.
My wife and I just change pulmonary doctors and she insisted on new sleep studies even though both of us had them done 2 years ago.
My wife was called back for a second sleep study, this time using a XPAP machine (I assume since they adjusted it remotely while she slept)
She just recieved a call telling her the doctor recommended a BiPAP machine "since she did much better with it".

My wife currently sleeps with a ResMed 10 Airsense Autoset (8-20, avg. press. 10.96) with EPR on at 3.
OSCAR reports her AHI over the last year as ranging from a high of 0.51 to a low of 0.00, averaging 0.32.
We thought that meant things were good. Are we missing something?
All of the above we will be discussing with the doctor in our upcoming appointment, but with an AHI that low is there something we are not seeing that we should ask about?

[Crimson Nape]

Hi jschmoyer! -

Post a screenshot of one of the Daily screens will allow us to form a better opinion. Please use the F12key, so it will provide the image we need. A 2-minute zoomed image of the flow rate would be helpful as well.

Also, since this another member's thread, I am splitting your post into its own thread. I will be naming it, jschmoyer - Therapy Thread. I will be sending a confirmation PM, describing this action, to you as well.

- Red

[Gideon]

The numbers look good but there are other factors.
BiPAP typically with a higher pressure differential (4 vs 3 with EPR) is more comfortable.  
Believe it or not most medical personnel don't recognize that EPR is basically a limited BiPAP only recognizing it as a comfort feature (that can therefore be ignored).

Your charts will tell us if there is something else going on.

[jschmoyer]

Are theses OK ?
She takes a prescribed diuretic twice a day, which causes her to get up during the night for relief.
And then sometimes since she is up anyway, she tends to "chores" before going back to bed.
Her yearly average is 7:15 hours per night.
We just switched from EPR 1 to EPR 3 and she prefers this, but it hasn't been long enough for her to really settle into it.

           

[jschmoyer]

*BUMP*

[Crimson Nape]

Your flow limits are driving the pressure so high.   Since you are at the maximum EPR that this machine can provide, and the flow limit is going to drive the AS10 to its maximum set pressure, I would reduce the maximum to 10 cm.  Actually, the flow limit is going to negate the use of a variable pressure range and may necessitate going to a fixed pressure.

[jschmoyer]

Thank You.
Should we reduce the maximum pressure all at once or in steps to allow her to adjust to it?

[Crimson Nape]

I would drop it all at once. It is far easier to experience a lower pressure than an increased one.

[jschmoyer]

Thank You