+- Apnea Board Forum - CPAP | Sleep Apnea (https://www.apneaboard.com/forums)
+-- Forum: Public Area (https://www.apneaboard.com/forums/Forum-Public-Area)
+--- Forum: Main Apnea Board Forum (https://www.apneaboard.com/forums/Forum-Main-Apnea-Board-Forum)
+--- Thread: Think I'm getting a handle on this. Or am I? (/Thread-Think-I-m-getting-a-handle-on-this-Or-am-I)
Think I'm getting a handle on this. Or am I? - spudhorse - 11-28-2023
I switched to a nasal pillow mask (ResMed P10) from a nasal mask (ResMed N20). I have some facial hair and why I ever wound up with the N20 I don't know. Once I realized that mouth leakage was actually the larger problem, I started experimenting with a soft cervical collar.
In this chart from last night, somewhere, I think, about 6:00 I took off the cervical collar because I woke up but I couldn't get back to sleep. I thought it made for an interesting chart.
Any additional insights?
Thanks,
Mark
RE: Think I'm getting a handle on this. Or am I? - gainerfull - 11-28-2023
What's your back up rate set to? How'd you end up at 18/14?
RE: Think I'm getting a handle on this. Or am I? - spudhorse - 11-28-2023
I have no idea about the backup rate. I haven't poked into the clinical menu but now's as good a time as any. The pressure was sleep lab recommendation and the PA I visited said "looked good." Of course, I think he was hoping to leave early that day.
RE: Think I'm getting a handle on this. Or am I? - spudhorse - 11-28-2023
Is that Resp. Rate? In which instance, it's 14. Mode is ST if that matters.
RE: Think I'm getting a handle on this. Or am I? - PeaceLoveAndPizza - 11-28-2023
According to the clinical manual for the ST (is there a difference between the ST and ST-A?) the backup rate is on the clinical setup screen below IPAP and EPAP. It should be listed as iBR (Intelligent Backup Rate on/off) and Backup rate expressed as cmH2O. Below that there are a number of important parameters e.g. resp rate, backup rate, etc.
I am still learning about ST and ASV devices, so I will quote SleepRider describing how the ASV works with backup rate:
Backup rate
The AirCurve 10 ASV device uses breath phase mapping to provide a timed backup rate that is
synchronized with the patient’s own breathing. When the patient deviates from the ventilatory
target, the ASV device aims to stabilize the patient by adjusting Pressure Support. If necessary, it
will adjust the timed backup rate from one that matches the patient’s own recent rate towards the
built-in default 15 BPM backup rate.
RE: Think I'm getting a handle on this. Or am I? - spudhorse - 11-28-2023
IPAP 18.0
EPAP 14.0
Resp. Rate 14.0
Ti Max 2.0s
Ti Min 0.5s
Rise Time 200ms
Trigger Med
Cycle Med
Mask Nasal
Ramp Time 30 minutes
No IBR
RE: Think I'm getting a handle on this. Or am I? - PeaceLoveAndPizza - 11-28-2023
Mea Maxima Culpa. Apparently the ST does not support backup rates. That requires an ST-A. Thanks to Crimson Nape for pointing that out.
https://www.apneaboard.com/forums/Thread-URGENT-CALL-FROM-DME-RE-RESMED-ST-vs-RESMED-ST-A
RE: Think I'm getting a handle on this. Or am I? - SarcasticDave94 - 11-28-2023
FWIW within ResMed, ST (Spontaneous - Timed) is the stupid version of a ventilator mode. ST-A is smarter one, included is iVAPS (ResMed's take on AVAPS), which is not on the ST.
RE: Think I'm getting a handle on this. Or am I? - spudhorse - 11-28-2023
Well there you. We both learned something.
Back to my original question. Anything else we can infer from the OSCAR data at this point or how I'm going about things?
RE: Think I'm getting a handle on this. Or am I? - PeaceLoveAndPizza - 11-28-2023
I can’t comment on the settings due to lack of familiarity on the machine, but the one thing that stands out to me is the way things went off the trolley when you took off the cervical collar. It looked like a good night until about 07:15 when the hypopnoea’s and leaks show up with regularity.
Plenty of comfortable collars to choose from out there ranging from soft to very firm, and various lengths and heights. It takes a bit of time to adjust once you have found one that works for you.