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+--- Thread: Problems with first hour (/Thread-Problems-with-first-hour)
RE: Problems with first hour - RLSdss - 02-12-2018
You are right I missed that. I'm going to change settings tonight and see what happens.
RE: Problems with first hour - RLSdss - 02-13-2018
Last night I used settings of 22,12,9,10,2 Auto , Flex 2 and Ramp at 7 for 10min. I had a comfortable night and won't need to use ramp in future. When I got up to go to the bathroom (BPH, Flomax helps but does not cure) my epap was always 9 and ipap was always 11. AHI was OK but hypoxia is still too high and my Ox report shows 5 minutes of sub 88% O2 sat. Most events occur after I go back to sleep? The flow chart shows a flattening of the rise in pressure so I think I need to change settings some? The detail chart seems to indicate max pressure is ok? What do you guys think?
RE: Problems with first hour - Sleeprider - 02-13-2018
(02-13-2018, 09:59 AM)RLSdss Wrote: Last night I used settings of 22,12,9,10,2 Auto , Flex 2 and Ramp at 7 for 10min. I had a comfortable night and won't need to use ramp in future. When I got up to go to the bathroom (BPH, Flomax helps but does not cure) my epap was always 9 and ipap was always 11. AHI was OK but hypoxia is still too high and my Ox report shows 5 minutes of sub 88% O2 sat. Most events occur after I go back to sleep? The flow chart shows a flattening of the rise in pressure so I think I need to change settings some? The detail chart seems to indicate max pressure is ok? What do you guys think?
When referring to settings it would be much clearer to say EPAP 9-12, PS 2-10 and Pmax 22.
I think you need to consider PS 2-12 and Pmax 23.
RE: Problems with first hour - RLSdss - 02-13-2018
OK that makes sense, Thanks.
RE: Problems with first hour - RLSdss - 02-13-2018
Wouldn't a Pmax of 24 be better?
RE: Problems with first hour - Sleeprider - 02-13-2018
I'm all for going as high as you're willing. There was a time a while back you were very resistant to higher pressures. Having enough room for the pressure support to do its work will make a positive difference.
RE: Problems with first hour - RLSdss - 02-13-2018
You are right about that. I think it may have been the combination of settings that blew my mask off. Last night I had no trouble at all. Unless I'm mistaken an apap max of 12 and ps max of 12 doesn't make sense if you max out at 23. Thanks again.
RE: Problems with first hour - ajack - 02-13-2018
I'm also for opening up your max epap and max PS. By all means raise them in steps if that's what you need to do. Other than min epap, I would work up to the titrated prescription or default settings on a philips, till otherwise indicated.
The default advised max settings, are the max available on the machine. This gives the machine room to move.
The philips works on recent peak flow and uses that for it's program. It's different to resmed, that uses recent minute vent.
I also think, you may need to raise your min epap as you go along, to clear the OA and H.
http://incenter.medical.philips.com/doclib/enc/9792335/BiPAPAutoSVAdvanced_Protocol.pdf%3ffunc%3ddoc.Fetch%26nodeid%3d9792335
![[Image: Qfuj0iz.jpg]](http://i.imgur.com/Qfuj0iz.jpg)
*If multiple obstructive events are observed at the beginning of the
study use a higher EPAPmin
Note:
• Establish initial settings as indicated or as ordered by physician
• Initial BiPAP autoSV Advanced settings may be adjusted to patient condition
or severity
• Bi-Flex may be adjusted to patient comfort
• If numerous hypopneas are noted, maintain PS > 4 cm H2O
RE: Problems with first hour - RLSdss - 02-13-2018
That's more or less what I did to get the results shown in the Detail Chart. What would you change on the settings shown that gave me this result?
RE: Problems with first hour - RLSdss - 02-16-2018
New settings yealding good results. I'm sleeping well and feeling good. But my ASV recorded HI has no relationship to my actual O2 Sat. Wed. night HI was 6.4 Basil O2 sat was 95.3, Thur. night Hi was 1.7 and my Basil O2 sat was a little less then Wed. at 94.9. You would think more hypopnia would yeald lower O2 sat. Anyway your suggestions (Sleeprider) have helped a lot. I don't think I need to juggle my settings anymore unless something changes radically. Tomorrow I'm going to Utah for a few days and will be at and altitude of 5000 feet or better which should be interesting. Thanks again.