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what is this in expiratory cycle? - Printable Version

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what is this in expiratory cycle? - koy23 - 12-24-2022

I can not understand what this means? is that expiratory flow limit?
my settings are
p30i
vauto
EPAP: 7.8
P.S: 1.4
IPAP: 10
Trigger : high
Cycle: very High
Ti max: 3s
Timin: 0.6s

happy holidays!


RE: what is this in expiratory cycle? - Sleeprider - 12-25-2022

Your very high cycle setting is probably creating instability by dropping from IPAP to EPAP prematurely. I can only guess why you are seeing this, but your settings are not very logical, and this seems to have appeared coincident with that change.


RE: what is this in expiratory cycle? - koy23 - 12-25-2022

I thik I was writing in a previous post the cycle/trigger variants I tried, well if i change cycle to high instead of very high or medium, i get a sudden inhale spasm on sleep-onset, i do feel the premature drop but that is the only way i do not get the sudden inhale spasm when I'm falling asleep, i think i do have a neurological problem for my autonomous nervous system 

what would be a logical settings from your point of view seeing the screenshots?


RE: what is this in expiratory cycle? - Sleeprider - 12-25-2022

You have many threads where you discuss various aspects of your therapy. That is the reason we like members to keep things like this together. My comment is that this phenomenon has not been characteristic of your therapy. What changed?


RE: what is this in expiratory cycle? - koy23 - 12-25-2022

Sorry about that feel free to combine the posts.
The answer to your question is I changed mask to nasal pillow and I could tolerate little higher pressure than before and have not seen these flow limitations in expiration before


RE: what is this in expiratory cycle? - pholynyk - 12-25-2022

Is it possible that you could use the next larger size pillows? It occurs to me that if the cones of the pillows inside or just outside you nose are a little small they could be interfering with the outflow...

Just a thought; I'm not sure how you could check unless you had a fit pack to select from.


RE: what is this in expiratory cycle? - koy23 - 12-26-2022

I reviewed my whole past year in which i was using Smode with IPAP/EPAP 11.6 to 12 with F30 FFM, i could notice that pressure increase was not still effective, leaks were the biggest problems where events were more obvious.

I kept reading the forum about PS vs EPAP Bilevel threads, so I decided to restart from fresh using the P30i pillow mask, As you can see from screenshots I started EPAP 6, PS 3 and left IPAP open to 14.

As you can see 95% epap was at 7 and PS 3. but I'm not sure how to deal with these expiratory flow limitations. As I mentioned in previous threads, i have a nervous spasms from the machine so trigger needs to be high and Cycle very high other wise i get a sudden inhale while falling asleep. You can see these sudden inhales through the flow graph they happen with EVERY combination every pressure, why do I need the machine? bc If I do not , i'll wake up as soon as i'm falling asleep, so with all the trials and meds i'm taking, it seems that those sudden inhales don't wake me up when it is just one breath.

Should i continue like that for few more days? should i update EPAP to the 95% (7) or try increasing PS 0.5 to 3.5 ?

note: I can't tolerate epap higher than 8 as i would get the chipmunks cheeks, due to surgeries and tongue partially cut and displaced there is no trainings i can do to keep my tongue at the roof of mouth, the only way to increase EPAP > 8 is to use FFM which i have not been lucky with leaks ( tried many FFM masks, padacheeck, etc) I also tape my mouth as my jaw drops automatically when i'm asleep.

Hope you can have better insight to give me some guidance of this restart.


RE: what is this in expiratory cycle? - koy23 - 01-05-2023

still trying, can anyone tell me what can be done with this airflow leading to arousal? should i increase epap and reduce airflow?