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+--- Thread: EPAP (expel pressure) help! (/Thread-EPAP-expel-pressure-help)
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RE: EPAP (expel pressure) help! - berkberk - 01-03-2020
Sleeprider - Was starting to get that impression, not just from this board, but from a few I've researched. No better sounding board than groups of many actual users who can give honest reviews that hold up to facts/graphs.
Tried to do a 2ish min segment of what seemed the most glaring to me of event and how the did (or did not) handle it. Basically what I'm seeing is I had and event that lasted 1ish min, and the system didn't respond until 2-3 min later when I wasn't having issues? I very well may be missing something as it's the 1st time looking at these graphs. Added all of them in case that helps.
Again, Thank You!
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RE: EPAP (expel pressure) help! - Sleeprider - 01-04-2020
The detail of that event suggests a brief OA that starts with a breath-hold (inspiration with no exhale) and seems to end with 3 breaths that look like a change of position IMO. A longer apnea with 4 pressure pulses ends with a small exhale and recovery breathing, slowing to normal. I don't see anything especially remarkable in this sequence and your OAI is low. A closer look shows a consistently low expiratory flow rate that starts fast but coasts into the next inspiration. This would be consistent with COPD, and the exhales at the end of the chart that bookend the VS2 are particularly long.
Looking at events like this can be useful, but so can looking at what happens to the respiratory flow when pressure changes. Just for yourself, take a look at how your respiration responds to higher and lower EPAP and see if you can draw any useful conclusions about the range of pressure that works without causing extended expiration time.
RE: EPAP (expel pressure) help! - berkberk - 01-16-2020
Thank you everyone (especially Matt00926 and SleepRider)
I've changed to the ResMed AirCurve 10 vauto (bipap). Already it's a bit easier to sleep, but I've been woken a few times by the need to exhale. Discussed with Pulmonologist PA having a LOW intake setting, and a high CYCLE setting and she agreed. Told my DME that was the settings we agreed would help, she set me up and off I went. BUT, I still felt it was too fast to switch over to INHALE and triggered a little longer (but better than the DreamStation) on inhale if I did that funky swallow small intake.
Talked to DME on the phone today, and she was never able to tell me if I had Hi or Low settings for Intake/Cycle, but kept saying I was the lowest of respiratory time at a 1... whatever that means. Now remember I'm still under the "Insurance is evaluating me not sure if the machine is mine now until I can meet their requirements".
Soooooo, finally went rouge tonight and entered the clinician settings... Intake/Cycle were both at Medium, despite telling her Pulmonologist said to set at Very Low and Very High... so I changed them Intake to Low and Cycle to High. Ti Min was 0.3 and Ti Max was 2.0 - so I changed my Ti Min to 0.1 incase I do that little inhale thingy, it can stop after 0.1s instead of 0.3s (think I'm interpreting that right?)
Started to email her tonight, but figured me being able to sleep all night with it (longest so far is 4.75hrs) and better compliance would be a easier to "ask for forgiveness", lol. Seriously though... I repeated the Low intake and High exhale/cycle to her at least 5 times while she was setting it up and she never did it, so really, I was just following doctor's orders ;-)
Thanks again for all the help here... I'll let you guys know how it goes in a few days.
RE: EPAP (expel pressure) help! - SarcasticDave94 - 01-16-2020
Going rogue is forgivable if you show them why. Hope you'll get favorable results.
RE: EPAP (expel pressure) help! - trish6hundred - 01-18-2020
Hi berkberk,
WELCOME! to the forum.!
It's good to hear that you were able to change machines.
Good luck with getting your settings dialed in and also, good luck with CPAP therapy..
RE: EPAP (expel pressure) help! - Sleeprider - 01-18-2020
You are on the better machine with more reliable data. For example, your flow rate is now sampled at 25 Hz rather than only 5 Hz. This could give us a completely different picture of your therapy. When you get a chance, let's get back to looking at some charts with the new machine, and I'll feel more comfortable suggesting settings based on results rather than guessing.