• In S mode, CAs are prevalent even at low PS if trigger is kept at medium e.g. IPAP=12,EPAP=8 gives around 5 CA/hr.
  

• I've tried tongue retainers and, like MADs and iNAP, I can't tolerate them.
  
• I'm not sure what to make of the CO2 comment. My experience keeps pointing to symptoms of hyperventilation/overbreathing i.e. hypocapnia. I did some research into Buteyko breathing and it asserts that most us, especially with anxiety (which I definitely have), are actually overbeathing and the resulting hypocapnia causes a number of serious health consequences, namely; a reduced ability for oxygen to unbind from haemoglobin and become available to cells (the Bohr effect), vasoconstriction of arteries and capillaries (especially to the brain), bronchoconstriction and nervous system overactivity (low CO2 raises pH causing hypocalcemia). You can read more about it here: https://www.normalbreathing.com/co2/
  I have been using a Frolov device (hypoxia and hypercapnia training) for the past few days and I feel much better after each session i.e. calmer, more energy, breathing is more slow and even, so this suggests to me that my body is lacking in CO2. Unfortunately it hasn't improved my sleep as advertised (yet).
  

• I suppose there might be microscopic levels of mould or other irritants in my room. Without buying an air purifier, is there any way to know? If there were irritants in the air though, surely I should have experienced nasal congestion during the day by now, or found relief when using a nasal steroid before bed, no?
  
• In S mode I do use EasyBreathe. Having it disabled feels like an airbag is going off in my face. I have heard that maxing out the rise time can reduce CO2 washout, so perhaps I could try that in the future.
  
• Yes, there is an iVAPS mode on my device, though I haven't tried it yet. The settings available are: Target Pt Rate, Target Va, EPAP, minPS, maxPS, Ti Max, Ti Min, Trigger and Cycle.
  

(04-28-2024, 07:48 AM)Humancyclone7 Wrote: To answer SingleH:

• In S mode, CAs are prevalent even at low PS if trigger is kept at medium e.g. IPAP=12,EPAP=8 gives around 5 CA/hr. Perhaps try the middle ground setting of high, you may find a compromise between Medium and Very High.
  

• I've tried tongue retainers and, like MADs and iNAP, I can't tolerate them. OK
  
• I'm not sure what to make of the CO2 comment. My experience keeps pointing to symptoms of hyperventilation/overbreathing i.e. hypocapnia. I did some research into Buteyko breathing and it asserts that most us, especially with anxiety (which I definitely have), are actually overbeathing and the resulting hypocapnia causes a number of serious health consequences, namely; a reduced ability for oxygen to unbind from haemoglobin and become available to cells (the Bohr effect), vasoconstriction of arteries and capillaries (especially to the brain), bronchoconstriction and nervous system overactivity (low CO2 raises pH causing hypocalcemia). You can read more about it here: https://www.normalbreathing.com/co2/
  I have been using a Frolov device (hypoxia and hypercapnia training) for the past few days and I feel much better after each session i.e. calmer, more energy, breathing is more slow and even, so this suggests to me that my body is lacking in CO2. Unfortunately it hasn't improved my sleep as advertised (yet). I myself am still on the learning curve with all this, so I'm afraid I cant give you much in the way of guidance on this.
  

• I suppose there might be microscopic levels of mould or other irritants in my room. Without buying an air purifier, is there any way to know? If there were irritants in the air though, surely I should have experienced nasal congestion during the day by now, or found relief when using a nasal steroid before bed, no? I probably made more of an issue out of this than it needs to be, the key point was to ensure that you have a relatively clean, dust free environment with air being delivered to the room either via the window as oppose to ventilating the room, then sealing it as if its a small room, your CO2 will just increase drastically from evening to morning.
  
• In S mode I do use EasyBreathe. Having it disabled feels like an airbag is going off in my face. I have heard that maxing out the rise time can reduce CO2 washout, so perhaps I could try that in the future. Adjust the Rise time, by increasing the the rise time, you will avoid the airbag effect and as you say potentially affect CO2 washout.
  
• Yes, there is an iVAPS mode on my device, though I haven't tried it yet. The settings available are: Target Pt Rate, Target Va, EPAP, minPS, maxPS, Ti Max, Ti Min, Trigger and Cycle. I dont know if you are familiar but iVAPS focuses on volume rather than pressure, so it tries to ensure you get the same volume with each breath and therefore adjusts its behaviour for each breath to deliver a "target" volume. Its used for a more complex cases typically people with restrictive lung conditions like COPD and Scoliosis. However there is nothing to stop you testing it out. One of the features I like is the auto adjusting PS which can expand and contract accordingly on each breath as opposed to the fixed PS range on Vauto mode. You have the US firmware version by your description as you dont have the minEPAP,max EPAP option.
  Do you have a "learn targets" option, its quite complicated figuring out the target Pt and Va, so there is an automatic mode where the machine estimates what you need and then does that part for you. Whether this mode is suitable for you is another thing, but as it sounds like you are suffering you may want to give it a try and see. There are some posts on this forum with more information on setting this up.

I noticed your Timin is set to 0.70, is there any reason for this, do you have any restrictive disorder in relation to your breathing?

Do you use any supplements or anything else to improve your sleep. I find Camomile tea reliably increases my deep sleep figures according to my smartwatch and I certainly feel a lot more rested on the nights I drink it beforehand.

(04-28-2024, 09:25 AM)Humancyclone7 Wrote: One theory I have, over than leaks, is overventilation. As outlined in the previous post, I think hypocapnia has the potential to cause arousals/put the body into a state of stress and we can certainly expect hypocapnia at high PS. What I'm concerned about is that things like backup rate and trigger sensitivity do nothing to address this, and only address the lack of respiratory drive hypocapnia causes — by forcing a breathe it aborts a CA event, but it does not address the lack of CO2, in fact, I would imagine that backup rate/trigger actually exacerbate the problem by forcing you to overbreathe.

SingleH, you mentioned that I could treat my TECSA by slowly increasing PS in 0.2 increments until I could tolerate PS=9.5 i.e. waiting until my chemoreceptors adapt to the low CO2 levels. For the same reason as above, wouldn't this also be unhealthy? My respiratory drive may have adapted to the low CO2 levels, but my body would still be in a state of hypocapnia, won't it? And by making my breathing more sensitive to CO2, won't it mess with my daytime breathing i.e. encourage me to hyperventilate?

It seems to me that the treatment for TESCA should focus on retaining CO2/lowering washout e.g. EERS, rather than trying to adapt to unnaturally low CO2 levels.