Maybe need a pressure increase?

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Ruinednose
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Re: Maybe need a pressure increase?

Post by Ruinednose » Fri Jan 05, 2018 9:11 pm

TedVPAP wrote:
Ruinednose wrote:Also having an issue... I cannot change the max epap... Just the max iPap. See picture below

https://imgur.com/a/lnIAz

Whatever I do, these are the only options I have
Please look at the three links below; they explain what information is necessary and how to display it.
The important info is event flags, flow rate, and pressure.
Also keep in mind that the machine flags breathing disturbances. It doesn't know if you are truly asleep which is the only time that OSA is relevant. Breathing irregularities are more likely to occur when you are awake or near sleeping which can be mistakenly flagged. Therefore only the data when you are confident that you are asleep should be used to assess your OSA treatment.

Thank you for helping but those links don't show how to get all the adjustments available to change, all I can change is max IPAP and min EPAP

I cannot change max EPAP or min IPAP

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Ruinednose
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Re: Maybe need a pressure increase?

Post by Ruinednose » Fri Jan 05, 2018 9:13 pm

Okie bipap wrote:Raising your minimum EPAP will raise your minimum IPAP. Minimum IPAP is your minimum EPAP plus your pressure support. Maximum EPAP is your maximum IPAP minus your pressure support.

Thank you so much, so I raised Min EPAP from 6 to 7. (max epap is not available for change)

I raised MAX IPAP to 20. (but cannot change the min IPAP)

Am I ok? PS is 5

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Pugsy
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Re: Maybe need a pressure increase?

Post by Pugsy » Fri Jan 05, 2018 9:23 pm

Ruinednose wrote: Thank you so much, so I raised Min EPAP from 6 to 7. (max epap is not available for change)

I raised MAX IPAP to 20. (but cannot change the min IPAP)

Am I ok? PS is 5
Yes. You are fine.

Max EPAP isn't available as a setting choice on your machine. It's inferred by the other settings like EPAP plus PS.
Looks like you have the PR S1 model 750. I used to have one of those and I have a 760 now so I am familiar with the machine.
You may need even more EPAP minimum but lets see what happens if the machine can simply move as needed.

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Ruinednose
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Re: Maybe need a pressure increase?

Post by Ruinednose » Fri Jan 05, 2018 9:39 pm

Pugsy wrote:
Ruinednose wrote: Thank you so much, so I raised Min EPAP from 6 to 7. (max epap is not available for change)

I raised MAX IPAP to 20. (but cannot change the min IPAP)

Am I ok? PS is 5
Yes. You are fine.

Max EPAP isn't available as a setting choice on your machine. It's inferred by the other settings like EPAP plus PS.
Looks like you have the PR S1 model 750. I used to have one of those and I have a 760 now so I am familiar with the machine.
You may need even more EPAP minimum but lets see what happens if the machine can simply move as needed.
Thank you all, I really appreciate it, I will post pictures of the sleepy head tomorrow,

Pugsy did you look at my new pictures of sleepy head a few days back with lower AHI? What do you think?

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TedVPAP
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Re: Maybe need a pressure increase?

Post by TedVPAP » Fri Jan 05, 2018 9:47 pm

Ruinednose wrote:
TedVPAP wrote:
Ruinednose wrote:Also having an issue... I cannot change the max epap... Just the max iPap. See picture below

https://imgur.com/a/lnIAz

Whatever I do, these are the only options I have
Please look at the three links below; they explain what information is necessary and how to display it.
The important info is event flags, flow rate, and pressure.
Also keep in mind that the machine flags breathing disturbances. It doesn't know if you are truly asleep which is the only time that OSA is relevant. Breathing irregularities are more likely to occur when you are awake or near sleeping which can be mistakenly flagged. Therefore only the data when you are confident that you are asleep should be used to assess your OSA treatment.

Thank you for helping but those links don't show how to get all the adjustments available to change, all I can change is max IPAP and min EPAP

I cannot change max EPAP or min IPAP
Agree - I was not trying to help you control your machine. You also need to learn as to what data to post.

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Pugsy
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Re: Maybe need a pressure increase?

Post by Pugsy » Fri Jan 05, 2018 10:04 pm

I don't know what to make of those CAs at this point.
We can't fix centrals with your machine anyway...so what we do is fix what can be fixed with a little more pressure and then worry about what is left that can't be fixed.

It's really odd to have one ugly cluster of CAs like that one night and nothing on another night.
We can't help but wonder "what changed??".

You can't fix centrals with more pressure with your machine.
What we can do is fix the obstructive stuff and cross our fingers that the centrals are related to post arousal stuff caused by the obstructive stuff not being adequately prevented.
Those OAs, hyponeas, Flow limitations and snores....that's all obstructive stuff and while it isn't horribly horrible it points to sub optimal OSA therapy...the idea being to do some fine tuning and see what happens with the obstructive stuff cleaned up and then address the CAs if they remain.

It's all I know to do. At this point we don't know if the centrals/CAs are real or not for one thing and even if they are we can't fix them with your machine anyway.
So we aren't ignoring the centrals but instead putting them on the back burner for now and fix what we can maybe fix with a little more pressure and then see if the centrals still want to pop up once the other stuff is better cleaned up.

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Ruinednose
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Re: Maybe need a pressure increase?

Post by Ruinednose » Fri Jan 05, 2018 10:17 pm

Pugsy wrote:I don't know what to make of those CAs at this point.
We can't fix centrals with your machine anyway...so what we do is fix what can be fixed with a little more pressure and then worry about what is left that can't be fixed.

It's really odd to have one ugly cluster of CAs like that one night and nothing on another night.
We can't help but wonder "what changed??".

You can't fix centrals with more pressure with your machine.
What we can do is fix the obstructive stuff and cross our fingers that the centrals are related to post arousal stuff caused by the obstructive stuff not being adequately prevented.
Those OAs, hyponeas, Flow limitations and snores....that's all obstructive stuff and while it isn't horribly horrible it points to sub optimal OSA therapy...the idea being to do some fine tuning and see what happens with the obstructive stuff cleaned up and then address the CAs if they remain.

It's all I know to do. At this point we don't know if the centrals/CAs are real or not for one thing and even if they are we can't fix them with your machine anyway.
So we aren't ignoring the centrals but instead putting them on the back burner for now and fix what we can maybe fix with a little more pressure and then see if the centrals still want to pop up once the other stuff is better cleaned up.


I really really appreciate all this help

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Pugsy
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Re: Maybe need a pressure increase?

Post by Pugsy » Fri Jan 05, 2018 10:20 pm

Another note.
I don't see that your centrals are pressure related...or at least there are no obvious signs of it.
If the tiny 1 cm pressure increase on EPAP seems to create more centrals then we regroup but I really don't see it at this point.

What I would like to change though...after some thought and looking at the central cluster is that PS of 5.
Lets reduce it to 3.

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TedVPAP
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Re: Maybe need a pressure increase?

Post by TedVPAP » Fri Jan 05, 2018 10:48 pm

OSA is still the dominate problem. Raise all pressures by 2cm-H2O. Once you get into the right area, then we can fine tune.

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Use data to optimize your xPAP treatment:
how to see your data https://sleep.tnet.com/resources/sleepyhead
how to present your data https://sleep.tnet.com/resources/sleepyhead/shorganize
how to post your data https://sleep.tnet.com/reference/tips/imgur

Ruinednose
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Re: Maybe need a pressure increase?

Post by Ruinednose » Fri Jan 05, 2018 11:08 pm

Pugsy wrote:Another note.
I don't see that your centrals are pressure related...or at least there are no obvious signs of it.
If the tiny 1 cm pressure increase on EPAP seems to create more centrals then we regroup but I really don't see it at this point.

What I would like to change though...after some thought and looking at the central cluster is that PS of 5.
Lets reduce it to 3.
OK great, what is the PS anyway guys? I never was aware of this PS thing

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Ruinednose
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Re: Maybe need a pressure increase?

Post by Ruinednose » Fri Jan 05, 2018 11:09 pm

TedVPAP wrote:OSA is still the dominate problem. Raise all pressures by 2cm-H2O. Once you get into the right area, then we can fine tune.
Thank. You so so so much

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Pugsy
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Re: Maybe need a pressure increase?

Post by Pugsy » Fri Jan 05, 2018 11:13 pm

PS is Pressure support or the difference between inhale (IPAP) and exhale (EPAP).
Your machine has a hidden default that you can't see to a minimum PS of 2 (you can't change it) so what you are setting is really the max PS on a model 750 machine. The 760 model actually allows 2 separate settings for PS ...a minimum and maximum but your machine has the one setting because the 2 cm minimum is a hidden default.

Usually PS is a comfort feature but it can be used for other reasons. Too much PS can cause centrals in some people and sometimes any PS can cause centrals in a rare few people...I don't think that is happening in your situation but wanted to limit PS just in case.

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TedVPAP
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Re: Maybe need a pressure increase?

Post by TedVPAP » Fri Jan 05, 2018 11:45 pm

Ruinednose wrote:
TedVPAP wrote:OSA is still the dominate problem. Raise all pressures by 2cm-H2O. Once you get into the right area, then we can fine tune.
Thank. You so so so much
Hum, I don't know how to interpret your response; bad typing, sarcasm, ... Not sure what you are saying.
I am blunt so I will reiterate; more pressure will help you. So my answer to the question you posted as the Subject of your thread is Yes.

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Additional Comments: AutoPAP 16-20, Ultimate Chin Strap http://sleepapneasolutionsinc.com/
Use data to optimize your xPAP treatment:
how to see your data https://sleep.tnet.com/resources/sleepyhead
how to present your data https://sleep.tnet.com/resources/sleepyhead/shorganize
how to post your data https://sleep.tnet.com/reference/tips/imgur

Ruinednose
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Location: Oklahoma

Re: Maybe need a pressure increase?

Post by Ruinednose » Sat Jan 06, 2018 9:20 am

Pugsy wrote:PS is Pressure support or the difference between inhale (IPAP) and exhale (EPAP).
Your machine has a hidden default that you can't see to a minimum PS of 2 (you can't change it) so what you are setting is really the max PS on a model 750 machine. The 760 model actually allows 2 separate settings for PS ...a minimum and maximum but your machine has the one setting because the 2 cm minimum is a hidden default.

Usually PS is a comfort feature but it can be used for other reasons. Too much PS can cause centrals in some people and sometimes any PS can cause centrals in a rare few people...I don't think that is happening in your situation but wanted to limit PS just in case.

I don't know how to multi quote to select all replying and helping to this thread.

I increased min EPAP from 6 to 7.
I increases max IPAP from 12 to 13.5 (just to start out, willing to increase more if you suggest)

Here are pictures from sleepy head, I circled with red some info, it seems the machine still said max 12 iPap, yet in another entry on the left side of said 13.5

https://imgur.com/a/uefr4


I feel like I got so, so sleep, with a few less early morning arousal

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Okie bipap
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Re: Maybe need a pressure increase?

Post by Okie bipap » Sat Jan 06, 2018 9:33 am

Perhaps the early morning cluster of CAs was SWJ. When my wife or I have this show up in the early morning, it usually happens when we are drifting in and out of sleep.

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